Pretreatment malnutrition and quality of life - association with prolonged length of hospital stay among patients with gynecological cancer: A cohort study

Background Length of hospital stay (LOS) is a surrogate marker for patients' well-being during hospital treatment and is associated with health care costs. Identifying pretreatment factors associated with LOS in surgical patients may enable early intervention in order to reduce postoperative LOS. Methods This cohort study enrolled 157 patients with suspected or proven gynecological cancer at a tertiary cancer centre (2004-2006). Before commencing treatment, the scored Patient Generated - Subjective Global Assessment (PG-SGA) measuring nutritional status and the Functional Assessment of Cancer Therapy-General (FACT-G) scale measuring quality of life (QOL) were completed. Clinical and demographic patient characteristics were prospectively obtained. Patients were grouped into those with prolonged LOS if their hospital stay was greater than the median LOS and those with average or below average LOS. Results Patients' mean age was 58 years (SD 14 years). Preoperatively, 81 (52%) patients presented with suspected benign disease/pelvic mass, 23 (15%) with suspected advanced ovarian cancer, 36 (23%) patients with suspected endometrial and 17 (11%) with cervical cancer, respectively. In univariate models prolonged LOS was associated with low serum albumin or hemoglobin, malnutrition (PG-SGA score and PG-SGA group B or C), low pretreatment FACT-G score, and suspected diagnosis of cancer. In multivariable models, PG-SGA group B or C, FACT-G score and suspected diagnosis of advanced ovarian cancer independently predicted LOS. Conclusions Malnutrition, low quality of life scores and being diagnosed with advanced ovarian cancer are the major determinants of prolonged LOS amongst gynecological cancer patients. Interventions addressing malnutrition and poor QOL may decrease LOS in gynecological cancer patients.

Active power flow control in a distribution system using discontinuous voltage controller

stract This paper proposes a hybrid discontinuous control methodology for a voltage source converter (VSC), which is used in an uninterrupted power supply (UPS) application. The UPS controls the voltage at the point of common coupling (PCC). An LC filter is connected at the output of the VSC to bypass switching harmonics. With the help of both filter inductor current and filter capacitor voltage control, the voltage across the filter capacitor is controlled. Based on the voltage error, the control is switched between current and voltage control modes. In this scheme, an extra diode state is used that makes the VSC output current discontinuous. This diode state reduces the switching losses. The UPS controls the active power it supplies to a three-phase, four-wire distribution system. This gives a full flexibility to the grid to buy power from the UPS system depending on its cost and load requirement at any given time. The scheme is validated through simulation using PSCAD.

Voltage unbalance reduction in low voltage distribution networks with rooftop PVs

Voltage Unbalance (VU) is a power quality issue arising within the low voltage residential distribution networks due to the random location and rating of single-phase rooftop photovoltaic cells (PVs). In this paper, an analysis has been carried out to investigate how PV installations, their random location and power generation capacity can cause an increase in VU. Several efficient practical methods are discussed for VU reduction. Based on this analysis, it has been shown that the installation of a DSTATCOM can reduce VU. In this paper, the best possible location for DSTATCOM and its efficient control method to reduce VU will be presented. The results are verified through PSCAD/EMTDC and Monte Carlo simulations.

Improving detection probabilities for pests in stored grains

BACKGROUND: The presence of insects in stored grains is a significant problem for grain farmers, bulk grain handlers and distributors worldwide. Inspections of bulk grain commodities is essential to detect pests and therefore to reduce the risk of their presence in exported goods. It has been well documented that insect pests cluster in response to factors such as microclimatic conditions within bulk grain. Statistical sampling methodologies for grains, however, have typically considered pests and pathogens to be homogeneously distributed throughout grain commodities. In this paper we demonstrate a sampling methodology that accounts for the heterogeneous distribution of insects in bulk grains. RESULTS: We show that failure to account for the heterogeneous distribution of pests may lead to overestimates of the capacity for a sampling program to detect insects in bulk grains. Our results indicate the importance of the proportion of grain that is infested in addition to the density of pests within the infested grain. We also demonstrate that the probability of detecting pests in bulk grains increases as the number of sub-samples increases, even when the total volume or mass of grain sampled remains constant. CONCLUSION: This study demonstrates the importance of considering an appropriate biological model when developing sampling methodologies for insect pests. Accounting for a heterogeneous distribution of pests leads to a considerable improvement in the detection of pests over traditional sampling models.

Impact of soil texture on the distribution of soil organic matter in physical and chemical fractions

Previous research on the protection of soil organic C from decomposition suggests that soil texture affects soil C stocks. However, different pools of soil organic matter (SOM) might be differently related to soil texture. Our objective was to examine how soil texture differentially alters the distribution of organic C within physically and chemically defined pools of unprotected and protected SOM. We collected samples from two soil texture gradients where other variables influencing soil organic C content were held constant. One texture gradient (16-60% clay) was located near Stewart Valley, Saskatchewan, Canada and the other (25-50% clay) near Cygnet, OH. Soils were physically fractionated into coarse- and fine-particulate organic matter (POM), silt- and clay-sized particles within microaggregates, and easily dispersed silt-and clay-sized particles outside of microaggregates. Whole-soil organic C concentration was positively related to silt plus clay content at both sites. We found no relationship between soil texture and unprotected C (coarse- and fine-POM C). Biochemically protected C (nonhydrolyzable C) increased with increasing clay content in whole-soil samples, but the proportion of nonhydrolyzable C within silt- and clay-sized fractions was unchanged. As the amount of silt or clay increased, the amount of C stabilized within easily dispersed and microaggregate-associated silt or clay fractions decreased. Our results suggest that for a given level of C inputs, the relationship between mineral surface area and soil organic matter varies with soil texture for physically and biochemically protected C fractions. Because soil texture acts directly and indirectly on various protection mechanisms, it may not be a universal predictor of whole-soil C content.