Impact of malnutrition on 12-month mortality following acute hip fracture

Background Studies investigating the relationship between malnutrition and post-discharge mortality following acute hip fracture yield conflicting results. This study aimed to determine whether malnutrition independently predicted 12-month post-fracture mortality after adjusting for clinically relevant covariates. Methods An ethics approved, prospective, consecutive audit was undertaken for all surgically treated hip fracture inpatients admitted to a dedicated orthogeriatric unit (November 2010–October 2011). The 12-month mortality data were obtained by a dual search of the mortality registry and Queensland Health database. Malnutrition was evaluated using the Subjective Global Assessment. Demographic (age, gender, admission residence) and clinical covariates included fracture type, time to surgery, anaesthesia type, type of surgery, post-surgery time to mobilize and post-operative complications (delirium, pulmonary and deep vein thrombosis, cardiac complications, infections). The Charlson Comorbidity Index was retrospectively applied. All diagnoses were confirmed by the treating orthogeriatrician. Results A total of 322 of 346 patients were available for audit. Increased age (P = 0.004), admission from residential care (P < 0.001), Charlson Comorbidity Index (P = 0.007), malnutrition (P < 0.001), time to mobilize >48 h (P < 0.001), delirium (P = 0.003), pulmonary embolism (P = 0.029) and cardiovascular complication (P = 0.04) were associated with 12-month mortality. Logistic regression analysis demonstrated that malnutrition (odds ratio (OR) 2.4 (95% confidence interval (CI) 1.3–4.7, P = 0.007)), in addition to admission from residential care (OR 2.6 (95% CI 1.3–5.3, P = 0.005)) and pulmonary embolism (OR 11.0 (95% CI 1.5–78.7, P = 0.017)), independently predicted 12-month mortality. Conclusions Findings substantiate malnutrition as an independent predictor of 12-month mortality in a representative sample of hip fracture inpatients. Effective strategies to identify and treat malnutrition in hip fracture should be prioritized.

Studies of phosphazenes. 12. Reactions of N4P4Cl8 with dibenzylamine- isolation of an unusual "bicyclic" phosphazene, N4P4[N(CH2Ph)2]6(NCH2Ph)

Octachlorocyclotetraphosphazene, N4P4CIa, reacts with dibenzylamine to give the chloro(dibenzy1amino) derivatives, N4P,C18,[N(CH2Ph)2],,, n = 1, 2 (two isomers), and 4 (three isomers). Nongeminal structures have been assigned to these compounds on the basis of ‘H and jlP NMR spectra. The presence of at least two tris(dibenzylamin0) derivatives in some reaction mixtures is also inferred from NMR spectra. Steric effects become important at the tetrakis stage of chlorine replacement, and further substitution by dibenzylamine to give monocyclic tetrameric derivatives does not occur. A “bicyclic” phosphazene, N4P4[N(CH2Ph)2]6(NCHzPh)is, obtained from the reaction of N4P4Claw ith an excess of dibenzylamine in boiling methyl cyanide. The formation of this derivative and its spectroscopic data are discussed.

Plan zemelʻnogo uchastka poselka N 12

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Plan zemelʻnogo uchastka poselka N 12 Leninskogo fonda

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Autuus on katsojan silmässä : lukijakeskeinen tutkimus autuaaksijulistuksista Matt. 5 : 1-12

Autuus on katsojan silmässä: lukijakeskeinen tutkimus autuaaksijulistuksista Matt. 5 : 1-12 on reseptioanalyyttisellä metodilla tehty tutkimus siitä, miten akateeminen tutkimuskirjallisuus ja kymmenen valikoitua Jeesus-elokuvaa ovat ymmärtäneet autuaaksijulistusten merkityksen. Kartoitettuaan autuaaksijulistusten tulkintahistoriaa ja Jeesus-elokuvien kulttuurihistoriaa tutkielma kääntyy reseptiohistorialliseksi analyysiksi. Akateemisen tutkimuskirjallisuuden ja Jeesus-elokuvien esittämät tulkinnat Matteuksen evankeliumin autuaaksijulistuksista rinnas-tetaan suhteessa autuaaksijulistusten tyyliin, sisältöön, rakenteeseen ja merkitykseen. Autuaaksijulistusten tyylin tulkinnan analysointi tapahtuu vertailemalla millainen narratiivinen sijainti autuaaksijulistuksille on tarinassa annettu, millaiseksi elokuvat ja tutkimuskirjallisuus tulkitsevat julistusten esitykselliset puitteet sekä mitä näkemyksiä niillä on julistusten kohdeyleisöstä ja Jeesuksen esiintymistavasta. Autuaaksijulistusten sisällön analysointi tarkoittaa yksittäisten autuaaksijulistusten merkityksen selvittelyä. Tämä tapahtuu edelleen Jeesus-elokuvien ja tutkimuskirjallisuuden tekemiä tulkintoja vertailemalla. Näiden lisäksi tekijä esittää oman käännöksensä autuaaksijulistuksista eksegeettisen analyysin keinoin. Käännöksen tavoitteena ei kuitenkaan ole sanatarkkuus, vaan dynaamisuus lukijan tulkinnan säilyttämiseksi. Autuaaksijulistusten rakenteen analysointi esittelee muutamia erilaisia malleja, joiden mukaan tutkimuskirjallisuudessa Matteuksen evankeliumin autuaaksijulistuksia on ryhmitelty. Tässä alaluvussa elokuva-aineiston ja tutkimuskirjallisuuden erot ovat selkeimmin näkyvillä, sillä elokuvat pyrkivät ryhmittelyn sijasta luomaan autuaaksijulistuksille kokonaan uuden rakenteen, joka sopii elokuvakerrontaan julistuslistaa paremmin. Autuaaksijulistusten merkitystä analysoitaessa tutkielmassa asetetaan rinnan kolme Jeesus-elokuvaa, jotka edustavat tulkintahistoriasta tuttuja tulkinnallisia pääsuuntia: autuaaksijulistukset tulkitaan joko eettisiksi kehotuksiksi tai lupauksiksi armosta. Kolmas Jeesus-elokuva edustaa kontroversiaalista näkemystä, joka kiistää molemmat edellä mainitut tulkintatavat. Johtopäätöksissä osoitetaan reseptiohistorialliseen analyysiin viitaten, että tulkintojen muotoutuminen ei ole yksinkertaista. Tulkintaan vaikuttavat paitsi tulkitsijan ennakkokäsitykset, myös tulkittava teksti ja tulkintatilanne. Johtopäätöksissä puolustetaan myös populaarikulttuurin teologisten elementtien tutkimusta osana eksegetiikkaa.

Dynamic viscosity of ternary mixtures of dichlorodifluoromethane (R-12), chlorodifluoromethane (R-22), and dichlorotetrafluoroethane (R-114) vapors

The viscosities of ternary mixtures of R-12, R-22, and R-114 vapors were determined at ambient temperature and pressure within +-1% by using an oscillating disk viscometer. The empirical viscosity obtained by Wllke's equation compares very well with the experimental results obtained with this vlscometer. In the case of this ternary vapor mixture, as long as the molar fraction ratio of R-12 to R-114 Is maintained at approximately 2"' (=Inverse ratio of thelr molecular weights) the viscosity of the ternary mixture at ambient temperature and pressure remalns constant irrespective of the percentage of R-22 present in the mixture.

STEM education K-12: perspectives on integration

This commentary was stimulated by Yeping Li's first editorial (2014) citing one of the journal's goals as adding multidisciplinary perspectives to current studies of single disciplines comprising the focus of other journals. In this commentary I argue for a greater focus on STEM integration, with a more equitable representation of the four disciplines in studies purporting to advance STEM learning. The STEM acronym is often used in reference to just one of the disciplines, commonly science. Although the integration of STEM disciplines is increasingly advocated in the literature, studies that address multiple disciplines appear scant with mixed findings and inadequate directions for STEM advancement. Perspectives on how discipline integration can be achieved are varied, with reference to multidisciplinary, interdisciplinary, and transdisciplinary approaches adding to the debates. Such approaches include core concepts and skills being taught separately in each discipline but housed within a common theme; the introduction of closely linked concepts and skills from two or more disciplines with the aim of deepening understanding and skills; and the adoption of a transdisciplinary approach, where knowledge and skills from two or more disciplines are applied to real-world problems and projects with the aim of shaping the total learning experience. Research that targets STEM integration is an embryonic field with respect to advancing curriculum development and various student outcomes. For example, we still need more studies on how student learning outcomes arise not only from different forms of STEM integration but also from the particular disciplines that are being integrated. As noted in this commentary, it seems that mathematics learning benefits less than the other disciplines in programs claiming to focus on STEM integration. Factors contributing to this finding warrant more scrutiny. Likewise, learning outcomes for engineering within K-12 integrated STEM programs appear under-researched. This commentary advocates a greater focus on these two disciplines within integrated STEM education research. Drawing on recommendations from the literature, suggestions are offered for addressing the challenges of integrating multiple disciplines faced by the STEM community.

Expanding the Peptide beta-Turn in alpha gamma Hybrid Sequences: 12 Atom Hydrogen Bonded Helical and Hairpin Turns

Hybrid peptide segments containing contiguous alpha and gamma amino acid residues can form C-12 hydrogen bonded turns which may be considered as backbone expanded analogues of C-10 beta-turns) found in alpha alpha segments. Exploration of the regular hydrogen bonded conformations accessible for hybrid alpha gamma sequences is facilitated by the use of a stereochemically constrained gamma amino acid residue gabapentin (1-aminomethylcyclohexaneacetic acid, Gpn), in which the two torsion angles about C-gamma-C-beta (theta(1)) and C-beta-C-alpha (theta(2)) are predominantly restricted to gauche conformations. The crystal structures of the octapeptides Boc-Gpn-Aib-Gpn-Aib-Gpn-Aib-Gpn-Aib-OMe (1) and Boc-Leu-Phe-Val-Aib-Gpn-Leu-Phe-Val-OMe (2) reveal two distinct conformations for the Aib-Gpn segment. Peptide 1 forms a continuous helix over the Aib(2)-Aib(6) segment, while the peptide 2 forms beta-hairpin structure stabilized by four cross-strand hydrogen bonds with the Aib-Gpn segment forming a nonhelical C-12 turn. The robustness of the helix in peptide 1 in solution is demonstrated by NMR methods. Peptide 2 is conformationally fragile in solution with evidence of beta-hairpin conformations being obtained in methanol. Theoretical calculations permit delineation of the various C-12 hydrogen bonded structures which are energetically feasible in alpha gamma and gamma alpha sequences.

From the {Cu(μ2-S)N}4 butterfly architecture to the {Cu(μ3-S)N}12 double wheel

Copper(I) complexes with {Cu(μ2-S)N}4 and {Cu(μ3-S)N}12 core portions of butterfly-shaped or double wheel architectures have been isolated in the reaction of Cu(I) with the Schiff base ligand C6H4(CHNC6H4S)2, aiso-abtâ, under different conditions. View the MathML source containing the tetranuclear electroneutral complex View the MathML source is formed by the reaction of CuI in acetonitrilic solution and recrystallization from DMF, whereas View the MathML source containing dodecanuclear View the MathML source wheels is accessible starting from CuBF4. Complexes 2 and 4 represent the first examples of cyclic complexes with the same overall stoichiometry but different ring sizes. The ligand induces two different coordination environments around copper(I) by switching between μ2- and μ3-sulfur bridging modes.

Melting of an Anchored Bilayer: Molecular Dynamics Simulations of the Structural Transition in (CnH2n+1NH3)(2)PbI4 (n=12, 14, 16, 18)

The thermally driven Structural phase transition in the organic-inorganic hybrid perovskite (CnH2n+1NH3)(2)PbI4 has been investigated using molecular dynamics (MD) simulations. This system consists of positively charged alkyl-amine chains anchored to a rigid negatively charged PbI4 sheet with the chains organized as bilayers with a herringbone arrangement. Atomistic simulations were performed using ail isothermal-isobaric ensemble over a wide temperature range from 65 to 665 K for different alkyl chain lengths, n = 12, 14, 16, and 18. The simulations are able to reproduce the essential Features of the experimental observations of this system, including the existence of a transition, the linear variation of the transition temperature with alkyl chain length, and the expansion of the bilayer thickness at the transition. By use of the distance fluctuation Criteria, it is Shown that the transition is associated With a Melting of the alkyl chains of the anchored bilayer. Ail analysis of the conformation of the alkyl chains shows increased disorder in the form of gauche defects above due melting transition. Simulations also show that the melting transition is characterized by the complete disappearance of all-trans alkyl chains in the anchored bilayer, in agreement with experimental observations. A conformationally disordered chain has a larger effective cross-sectional area, and above due transition a uniformly tilted arrangement of the anchored chains call no longer be Sustained. At the melt the angular distribution of the orientation of the chains are 110 longer uniform; the chains are splayed allowing for increased space for individual chains of the anchored bilayer. This is reflected in a sharp rise in the ratio of the mean head-to-head to tail-to-tail distance of the chains of the bilayer at the transition resulting in in expansion of the bilayer thickness. The present MD simulations provide a simple explanation as to how changes in conformation of individual alkyl-chains gives rise to the observed increase in the interlayer lattice spacing of (CnH2n+1NH3)(2)PbI4 at the melting transition.

12-weeks supervised exercise training is a feasible and efficacious treatment for reducing depression in youth with major depressive disorder

Introduction: Major Depressive Disorder (MDD) has high prevalence among adolescents and young adults. Evidence of any effective treatments is limited. Exercise as an effective treatment for adults has some support but studies in younger populations are lacking. Therefore the aim of this study was to investigate the feasibility and preliminary efficacy of brief motivational interviewing (MI) plus 12-weeks exercise training as a treatment for MDD in youth...

Metabolomic and proteomic analysis of breast cancer patient samples suggests that glutamate and 12-HETE in combination with CA15-3 may be useful biomarkers reflecting tumour burden

Evaluation of protein and metabolite expression patterns in blood using mass spectrometry and high-throughput antibody-based screening platforms has potential for the discovery of new biomarkers for managing breast cancer patient treatment. Previously identified blood-based breast cancer biomarkers, including cancer antigen 15.3 (CA15-3) are useful in combination with imaging (computed tomography scans, magnetic resonance imaging, X-rays) and physical examination for monitoring tumour burden in advanced breast cancer patients. However, these biomarkers suffer from insufficient levels of accuracy and with new therapies available for the treatment of breast cancer, there is an urgent need for reliable, non-invasive biomarkers that measure tumour burden with high sensitivity and specificity so as to provide early warning of the need to switch to an alternative treatment. The aim of this study was to identify a biomarker signature of tumour burden using cancer and non-cancer (healthy controls/non-malignant breast disease) patient samples. Results demonstrate that combinations of three candidate biomarkers from Glutamate, 12-Hydroxyeicosatetraenoic acid, Beta-hydroxybutyrate, Factor V and Matrix metalloproteinase-1 with CA15-3, an established biomarker for breast cancer, were found to mirror tumour burden, with AUC values ranging from 0.71 to 0.98 when comparing non-malignant breast disease to the different stages of breast cancer. Further validation of these biomarker panels could potentially facilitate the management of breast cancer patients, especially to assess changes in tumour burden in combination with imaging and physical examination.

Is it the economy, stupid? The role of social versus economic factors in people’s support for hosting the Olympic Games: Evidence from 12 democratic countries

Public referenda have gained momentum as a democratic tool to legitimize public mega projects such as hosting the Olympic Games. Interest groups in favour of hosting the Olympics therefore try to influence voters through public campaigns that primarily focus on economic benefits. However, recent studies find no or hardly any economic impact of hosting the Olympics, instead providing evidence for a positive social impact. This raises the question whether citizens consider economic or social factors when deciding on hosting the Olympics. Based on representative survey data from 12 countries, our results suggest that economic factors can influence voting behaviour, although the influence of social factors is stronger.

Growing Up Vietnamese in Finland - Looking Back 12 Years Later : The Well-Being and Sociocultural Adaptation of Vietnamese as Children or Adolescents and as Young Adults

Varttuminen vietnamilaisena Suomessa: 12 vuoden seurantajakso – Vietnamilaisten hyvinvointi ja sosiokulttuurinen sopeutuminen lapsena/nuorena sekä nuorena aikuisena Tämä tutkimus oli määrällinen pitkittäistutkimus lapsena tai nuorena vuosina 1979-1991 Suomeen saapuneiden vietnamilaisten akkulturaatiosta (kulttuurin muutoksista), psyykkisestä hyvinvoinnista ja sosiokulttuurisesta sopeutumisesta. Tutkimukseen osallistui ensimmäisessä vaiheessa (vuonna 1992) 97 satunnaisesti valittua vietnamilaista peruskoululaista ympäri maata, joita verrattin suomalaisiin luokkatovereihin. Seurantavaiheeseen (vuonna 2004) osallistui 59 ensimmäisessä vaiheessa mukana ollutta vietnamilaista, nyt iältään 20 – 31 -vuotiaita. Tutkimuksen tavoitteena oli selvittää mitkä tekijät ennustivat akkulturaation lopputuloksia, samalla huomioiden iän ja ympäristön (kontekstin) vaikutukset psyykkiseen hyvinvointiin ja sosiokulttuuriseen sopeutumiseen. Yksittäiset akkulturaatiodimensiot (kieli, arvot ja identiteetti) osoittautuivat tärkeämmiksi psyykkiselle hyvinvoinnille ja sosiokulttuuriselle sopeutumiselle kuin etniset, kansalliset tai kaksikulttuuriset profiilit, joissa yhdistyivät ao. kieli, arvot ja identiteetti. Identiteettimuutosta tapahtui (etniseen) vietnamilaiseen suuntaan ajan kuluessa, kun taas arvomuutosta tapahtui (kansalliseen) suomalaiseen suuntaan. Sekä suomen että vietnamin kielen taito lisääntyivät ajan myötä, millä oli myönteisiä vaikutuksia sekä psyykkiseen hyvinvointiin että sosiokulttuuriseen sopeutumiseen. Lähtötilanteen psyykkinen hyvinvointi ennusti hyvinvointia (masennuksen puutetta ja itsetuntoa) aikuisena, mutta sosiokulttuurinen sopeutuminen (koulumenestys) lapsena tai nuorena ei ennustanut kouluttautumista aikuisena. Parempi suomen kielen taito ja vähemmän identifioitumista suomalaiseksi aikuisena sekä masentuneisuuden puute ja vähemmän koettua syrjintää lapsena tai nuorena erottelivat psyykkisesti paremmin voivat aikuiset (ei-masentuneet) heistä, jotka olivat masentuneita. Parempaa kouluttautumista aikuisena ennustivat toisaalta vähemmän koettua syrjintää lapsena tai nuorena ja toisaalta aikuisena parempi suomen kielen taito, suurempi kansallisten (suomalaisten) itsenäisyysarvojen kannattaminen, mutta kuitenkin vähemmän identifioitumista suomalaisiin. Koetun syrjinnän merkitys psyykkiselle hyvinvoinnille, erityisesti lapsena tai nuorena, sekä sen pitkäaikaisvaikutukset psyykkiselle hyvinvoinnille ja sosiokulttuuriselle sopeutumiselle aikuisena osoittavat tarpeen puuttua varhain psyykkisiin ongelmiin sekä parantaa etnisten ryhmien välisiä suhteita. Avainsanat: akkulturaatio, psyykkinen hyvinvointi, sosiokultuurinen sopeutuminen, kieli, arvot, identiteetti, vietnamilainen, Suomi, lapset, nuoret, nuoret aikuiset