Association of Nutritional, Functional Status and Lifestyle Habits with Bone Health Status Amongst the Institutionalized Elderly

The rising incidence of osteoporosis is well established especially among institutionalized residents. The aim of the study was to determine the association of nutritional status, functional status and lifestyle habits with bone health status among institutionalized elderly. Bone health status was assessed using Quantitative Ultrasound Sonometry (QUS-2), which measures Broadband Ultrasound Attenuation (BUA, dB/MHz) at the calcaneus. Body weight, height and body fat were assessed using SECA 767 and body fat analyzer (HBF-302 Omron). Sociodemographic background, reproductive history, history of bone fracture, lifestyle habits, dietary intake and functional status (Elderly Mobility Scale-EMS and Instrumental Activity Daily Living- IADL) of the subjects were assessed using appropriate instruments. Data were analyzed using SPSS software version 13.0 and Malaysian food composition database A total of 363 subjects comprising of 158 males (43.5%) and 205 females (56.5%) were recruited from 33 old folk’s homes and nursing homes in the Klang Valley. The subjects comprised of 79.3% Chinese, 11.6% Indians, 5.5% Malays and other races (3.6%). The mean age of the subjects was 75.8 ± 9.1 years old. The mean weight, height and body fat mass for male and female were 56.7 ± 11.9 and 50.6 ± 13.8, 161.9 ± 7.7 and 149.5 ± 11.7, 15.6 ± 7.0 and 16.7 ± 11.8, respectively. Mean Body Mass Index (BMI) for male and female were 21.6 ± 4.3kg/m 2 and 22.4 ± 5.6 kg/m 2 . Based on BMI classification, 23.3% of the subjects were underweight, 52.9% with normal weight and 23.8% were overweight and obese. The mean BUA was 61.4 ± 19.8 dB/MHz. Majority of the subjects had second tertile of BUA and there was only 10.0% of subject with third tertile of BUA. The mean energy intake was 1311 ± 312 Kcal. The mean calcium intake was low, with 428 ± 277 mg in males and 454 ± 281 mg in females. More than 50% of the subjects had daily calcium intake less than RNI for Malaysian. Approximately half of the subjects achieved 75 th percentile for EMS. However, score for IADL was low, with a mean of 8.6 ± 4.6. There were 61.7% of subjects who exercised currently with a majority of them practicing brisk walking. The results revealed significant correlation between BUA and weight (r=0.390, p<0.01), fat mass (r=0.156, p<0.01), phosphorus intake (r=-0.148, p<0.05), protein intake (r=-0.121, p<0.05), vitamin C (0.120, p<0.05), EMS (r=0.241, p<0.01) and IADL (r=0.250, p<0.01), duration exercise per session (r=0.138, p<0.05). Body weight, IADL score, and vitamin C intake were the main contributors for bone health status among the subjects, which explain 21.5% of the variation in the BUA significantly (p<0.001). As a conclusion, institutionalized elderly should be given better care or intervention in achieving optimal body weight and dietary intakes through providence of better nutrition and rehabilitation efforts to improve functional status

Magnetoresistive biosensors with on-chip pulsed excitation and magnetic correlated double sampling.

Giant magnetoresistive (GMR) sensors have been shown to be among the most sensitive biosensors reported. While high-density and scalable sensor arrays are desirable for achieving multiplex detection, scalability remains challenging because of long data acquisition time using conventional readout methods. In this paper, we present a scalable magnetoresistive biosensor array with an on-chip magnetic field generator and a high-speed data acquisition method. The on-chip field generators enable magnetic correlated double sampling (MCDS) and global chopper stabilization to suppress 1/f noise and offset. A measurement with the proposed system takes only 20 ms, approximately 50× faster than conventional frequency domain analysis. A corresponding time domain temperature correction technique is also presented and shown to be able to remove temperature dependence from the measured signal without extra measurements or reference sensors. Measurements demonstrate detection of magnetic nanoparticles (MNPs) at a signal level as low as 6.92 ppm. The small form factor enables the proposed platform to be portable as well as having high sensitivity and rapid readout, desirable features for next generation diagnostic systems, especially in point-of-care (POC) settings

The customer choice model of commercial retailers based on MarKov analysis

The PREDICTS project—Projecting Responses of Ecological Diversity In Changing Terrestrial Systems (www.predicts.org.uk)—has collated from published studies a large, reasonably representative database of comparable samples of biodiversity from multiple sites that differ in the nature or intensity of human impacts relating to land use. We have used this evidence base to develop global and regional statistical models of how local biodiversity responds to these measures. We describe and make freely available this 2016 release of the database, containing more than 3.2 million records sampled at over 26,000 locations and representing over 47,000 species. We outline how the database can help in answering a range of questions in ecology and conservation biology. To our knowledge, this is the largest and most geographically and taxonomically representative database of spatial comparisons of biodiversity that has been collated to date; it will be useful to researchers and international efforts wishing to model and understand the global status of biodiversity

The two electron molecular bond revisited: from Bohr orbits to two-center orbitals

In this review we first discuss extension of Bohr's 1913 molecular model and show that it corresponds to the large-D limit of a dimensional scaling (D-scaling) analysis, as developed by Herschbach and coworkers. In a separate but synergetic approach to the two-electron problem, we summarize recent advances in constructing analytical models for describing the two-electron bond. The emphasis here is not maximally attainable numerical accuracy, but beyond textbook accuracy as informed by physical insights. We demonstrate how the interplay of the cusp condition, the asymptotic condition, the electron-correlation, configuration interaction, and the exact one electron two-center orbitals, can produce energy results approaching chemical accuracy. Reviews of more traditional calculational approaches, such as Hartree-Fock, are also given. The inclusion of electron correlation via Hylleraas type functions is well known to be important, but difficult to implement for more than two electrons. The use of the D-scaled Bohr model offers the tantalizing possibility of obtaining electron correlation energy in a non-traditional way.Comment: 99 pages, 29 figures, review article, to appear in Advances in Atomic, Molecular and Optical Physic

Topical clobetasol for the treatment of toxic epidermal necrolysis: study protocol for a randomized controlled trial.

BackgroundToxic epidermal necrolysis (TEN) is a rare systemic allergic drug eruption with high patient mortality. Currently, no established treatments have been shown to be effective for TEN beyond supportive care. Prior studies of systemic corticosteroids have yielded conflicting data, with some showing a possible benefit and others reporting in increased mortality. However, topical steroids have shown promise for treatment of ocular sequelae of TEN, such as scarring and vision loss. We have designed a randomized controlled trial to evaluate topical clobetasol for treatment of the epidermal manifestations of TEN. In addition, we propose genetic studies to characterize the TEN transcriptome and alterations in cutaneous gene expression that might occur following topical steroid treatment.Methods/designThis split-body randomized, double-blind, placebo-controlled Phase IIa proof-of-concept trial will evaluate the safety and efficacy of once-daily topical clobetasol applied to the skin of patients with TEN. This multicenter trial will recruit a total of 15 patients between the ages of 12 and 85 from the University of California Davis Medical Center and Shriners Hospital for Children inpatient burn units. Designated treatment areas on opposite sides of the body will be treated with blinded clobetasol 0.05% ointment or control petrolatum ointment daily for 14 days. On day 3 of therapy, a biopsy will be taken from the treated area for genetic studies. The primary study aims will be to establish the safety of topical clobetasol treatment and determine the time to cessation of skin detachment for the control and clobetasol-treated areas. Secondary endpoints will evaluate efficacy using parameters such as time to 90% re-epithelialization and percentage of affected skin at 0, 3, 6, 9, 12 and 15 days. Genomic DNA and RNA will be obtained from biopsy samples, to characterize the TEN transcriptome and identify changes in gene expression after topical steroid treatment.DiscussionTopical steroids have shown promise for treating ocular complications of TEN, but to date have not been evaluated for cutaneous manifestations of the disease. This trial will investigate clinical and molecular outcomes of topical clobetasol application and hopefully provide insight into the disease pathophysiology.Trial registrationClinicalTrials.gov NCT02319616. https://clinicaltrials.gov/ct2/show/NCT02351037

An Interprofessional Curriculum on Antimicrobial Stewardship Improves Knowledge and Attitudes Toward Appropriate Antimicrobial Use and Collaboration.

BackgroundInappropriate antimicrobial use can threaten patient safety and is the focus of collaborative physician and pharmacist antimicrobial stewardship teams. However, antimicrobial stewardship is not comprehensively taught in medical or pharmacy school curricula. Addressing this deficiency can teach an important concept as well as model interprofessional healthcare.MethodsWe created an antimicrobial stewardship curriculum consisting of an online learning module and workshop session that combined medical and pharmacy students, with faculty from both professions. Learners worked through interactive, branched-logic clinical cases relating to appropriate antimicrobial use. We surveyed participants before and after the curriculum using validated questions to assess knowledge and attitudes regarding antimicrobial stewardship and interprofessional collaboration. Results were analyzed using paired χ2 and t tests and mixed-effects logistic regression.ResultsAnalysis was performed with the 745 students (425 medical students, 320 pharmacy students) who completed both pre- and postcurriculum surveys over 3 years. After completing the curriculum, significantly more students perceived that they were able to describe the role of each profession in appropriate antimicrobial use (34% vs 82%, P &lt; .001), communicate in a manner that engaged the interprofessional team (75% vs 94%, P &lt; .001), and describe collaborative approaches to appropriate antimicrobial use (49% vs 92%, P &lt; .001). Student favorability ratings were high for the online learning module (85%) and small group workshop (93%).ConclusionsA curriculum on antimicrobial stewardship consisting of independent learning and an interprofessional workshop significantly increased knowledge and attitudes towards collaborative antimicrobial stewardship among preclinical medical and pharmacy students

Forty-Four Pass Fibre Optic Loop for Improving the Sensitivity of Surface Plasmon Resonance Sensors

A forty-four pass fibre optic surface plasmon resonance sensor that enhances detection sensitivity according to the number of passes is demonstrated for the first time. The technique employs a fibre optic recirculation loop that passes the detection spot forty- four times, thus enhancing sensitivity by a factor of forty-four. Presently, the total number of passes is limited by the onset of lasing action of the recirculation loop. This technique offers a significant sensitivity improvement for various types of plasmon resonance sensors that may be used in chemical and biomolecule detections.Comment: Submitted for publication; patent disclosure submitte

Cardiac-directed expression of a catalytically inactive adenylyl cyclase 6 protects the heart from sustained β-adrenergic stimulation.

ObjectivesIncreased expression of adenylyl cyclase type 6 (AC6) has beneficial effects on the heart through cyclic adenosine monophosphate (cAMP)-dependent and cAMP-independent pathways. We previously generated a catalytically inactive mutant of AC6 (AC6mut) that has an attenuated response to β-adrenergic receptor stimulation, and, consequently, exhibits reduced myocardial cAMP generation. In the current study we test the hypothesis that cardiac-directed expression of AC6mut would protect the heart from sustained β-adrenergic receptor stimulation, a condition frequently encountered in patients with heart failure.Methods and resultsAC6mut mice and transgene negative siblings received osmotic mini-pumps to provide continuous isoproterenol infusion for seven days. Isoproterenol infusion caused deleterious effects that were attenuated by cardiac-directed AC6mut expression. Both groups showed reduced left ventricular (LV) ejection fraction, but the reduction was less in AC6mut mice (p = 0.047). In addition, AC6mut mice showed superior left ventricular function, manifested by higher values for LV peak +dP/dt (p = 0.03), LV peak -dP/dt (p = 0.008), end-systolic pressure-volume relationship (p = 0.003) and cardiac output (p&lt;0.03). LV samples of AC6mut mice had more sarco/endoplasmic reticulum Ca2+-ATPase (SERCA2a) protein (p&lt;0.01), which likely contributed to better LV function. AC6mut mice had lower rates of cardiac myocyte apoptosis (p = 0.016), reduced caspase 3/7 activity (p = 0.012) and increased B-cell lymphoma 2 (Bcl2) expression (p = 0.0001).ConclusionMice with cardiac-directed AC6mut expression weathered the deleterious effects of continuous isoproterenol infusion better than control mice, indicating cardiac protection

Evolution of RF-signal cognition for wheeled mobile robots using pareto multi-objective optimization

This article describes a simulation model in which a multi-objective approach is utilized for evolving an artificial neural networks (ANNs) controller for an autonomous mobile robot. A mobile robot is simulated in a 3D, physics-based environment for the RF-localization behavior. The elitist Pareto-frontier Differential Evolution (PDE) algorithm is used to generate the Pareto optimal set of ANNs that could optimize two objectives in a single run; (1) maximize the mobile robot homing behavior whilst (2) minimize the hidden neurons involved in the feed-forward ANN. The generated controllers are evaluated on its performances based on Pareto analysis. Furthermore, the generated controllers are tested with four different environments particularly for robustness assessment. The testing environments are different from the environment in which evolution was conducted. Interestingly however, the testing results showed some of the mobile robots are still robust to the testing environments. The controllers allowed the robots to home in towards the signal source with different movements’ behaviors. This study has thus revealed that the PDE-EMO algorithm can be practically used to automatically generate robust controllers for RFlocalization behavior in autonomous mobile robots