The objectives of this study were to determine: 1) the prevalence of frailty using Fried's phenotype method and the Short Performance Physical Battery (SPPB), 2) agreement between frailty assessment ...methods, 3) the feasibility of assessing frailty using Fried's phenotype method and the SPPB.
This cross-sectional study was conducted at a geriatric out-patient clinic in Hamilton, Canada. A research assistant conducted all frailty assessments. Patients were classified as non-frail, pre-frail or frail according to Fried's phenotype method and the SPPB. Agreement among methods is reported using the Cohen kappa statistic (standard error). Feasibility data included the percent of eligible participants agreeing to attempt the frailty assessments (criterion for feasibility: ≥90% of patients agreeing to the frailty assessment), equipment required, and safety considerations. A p-value of <0.05 is considered significant.
A total of 110 participants (92%) and 109 participants (91%) agreed to attempt Fried's phenotype method and SPPB, respectively. No adverse events occurred during any assessments. According to Fried's phenotype method, the prevalence of frailty and pre-frailty was 35% and 56%, respectively, and according to the SPPB, the prevalence of frailty and pre-frailty was 50% and 35%, respectively. There was fair to moderate agreement between methods for determining which participants were frail (0.488 0.082, p < 0.001) and pre-frail (0.272 0.084, p = 0.002).
Frailty and pre-frailty are common in this geriatric outpatient population, and there is fair to moderate agreement between Fried's phenotype method and the SPPB. Over 90% of the patients who were eligible for the study agreed to attempt the frailty assessments, demonstrating that according to our feasibility criteria, frailty can be assessed in this patient population. Assessing frailty may help clinicians identify high-risk patients and tailor interventions based on baseline frailty characteristics.
ABSTRACT We investigate the solar phenomena associated with the origin of the solar energetic particle (SEP) event observed on 2014 February 25 by a number of spacecraft distributed in the inner ...heliosphere over a broad range of heliolongitudes. These include spacecraft located near Earth; the twin Solar TErrestrial RElations Observatory spacecraft, STEREO-A and STEREO-B, located at ∼1 au from the Sun 153° west and 160° east of Earth, respectively; the MErcury Surface Space ENvironment GEochemistry and Ranging mission (at 0.40 au and 31° west of Earth); and the Juno spacecraft (at 2.11 au and 48° east of Earth). Although the footpoints of the field lines nominally connecting the Sun with STEREO-A, STEREO-B and near-Earth spacecraft were quite distant from each other, an intense high-energy SEP event with Fe-rich prompt components was observed at these three locations. The extent of the extreme-ultraviolet wave associated with the solar eruption generating the SEP event was very limited in longitude. However, the white-light shock accompanying the associated coronal mass ejection extended over a broad range of longitudes. As the shock propagated into interplanetary space it extended over at least ∼190° in longitude. The release of the SEPs observed at different longitudes occurred when the portion of the shock magnetically connected to each spacecraft was already at relatively high altitudes ( 2 R above the solar surface). The expansion of the shock in the extended corona, as opposite to near the solar surface, determined the SEP injection and SEP intensity-time profiles at different longitudes.
The global survey method (GSM) technique unites simultaneous ground-level observations of cosmic rays in different locations and allows us to obtain the main characteristics of cosmic-ray variations ...outside of the atmosphere and magnetosphere of Earth. This technique has been developed and applied in numerous studies over many years by the Institute of Terrestrial Magnetism, Ionosphere and Radiowave Propagation (IZMIRAN). We here describe the IZMIRAN version of the GSM in detail. With this technique, the hourly data of the world-wide neutron-monitor network from July 1957 until December 2016 were processed, and further processing is enabled upon the receipt of new data. The result is a database of homogeneous and continuous hourly characteristics of the density variations (an isotropic part of the intensity) and the 3D vector of the cosmic-ray anisotropy. It includes all of the effects that could be identified in galactic cosmic-ray variations that were caused by large-scale disturbances of the interplanetary medium in more than 50 years. These results in turn became the basis for a database on Forbush effects and interplanetary disturbances. This database allows correlating various space-environment parameters (the characteristics of the Sun, the solar wind,
et cetera
) with cosmic-ray parameters and studying their interrelations. We also present features of the coupling coefficients for different neutron monitors that enable us to make a connection from ground-level measurements to primary cosmic-ray variations outside the atmosphere and the magnetosphere. We discuss the strengths and weaknesses of the current version of the GSM as well as further possible developments and improvements. The method developed allows us to minimize the problems of the neutron-monitor network, which are typical for experimental physics, and to considerably enhance its advantages.
Summary
A large Canadian cohort was studied over 10 years to see if proton pump inhibitor (PPI) use increased the risk of sustaining a fragility fracture. We found an increased risk of fracture in ...individuals who used PPIs. The risk remained after controlling for other known fracture risk factors.
Introduction
Multiple retrospective studies have linked proton pump inhibitor use with increased risk of fragility fracture. We prospectively studied the association between PPI use and fracture in a large cohort over a 10-year period while controlling for known fracture risk factors.
Methods
We studied 9,423 participants in the Canadian Multicenter Osteoporosis Study. The cohort was formed in 1995–1997 and followed for 10 years with monitoring for incident nontraumatic fracture and PPI use. Cox regression analyses were used to assess the association between PPI use and incident fracture risk.
Results
PPI use, coded as a time-dependent variable, was associated with a shorter time to first nontraumatic fracture, hazard ratio (HR) = 1.75 (95 % confidence interval (CI) 1.41–2.17,
p
< 0.001). After controlling for multiple risk factors, including femoral neck bone density, the association remained significant, HR = 1.40 (95 % CI 1.11–1.77,
p
= 0.004). Similar results were obtained after controlling for bisphosphonate use, using PPI “ever” use, or when the outcome was restricted to hip fracture.
Conclusions
In this large prospective population-based cohort study, we found an association between PPI use and increased risk of fragility fracture. Although the increased risk found was modest, this finding is important, given the high prevalence of PPI use and the excess morbidity and mortality associated with osteoporosis-related fractures.
Organic farming has been proposed as an alternative agricultural system to help solve environmental problems, like the sustainable management of soil micronutrients, without inputs of chemical ...fertilizers. The purposes of this study were: i) to assess Fe, Mn, Zn and Cu bioavailability through the determination of sequentially extracted chemical forms (fractions) and their correlation with foliar micronutrient concentrations in mature organic olive (cv. ‘Chondrolia Chalkidikis’) groves; ii) to determine the soil depth and the available forms (fractions) by which the 4 metals are taken up by olive trees. DTPA extractable (from the soil layers 0–20, 20–40 and 40–60 cm) and foliar micronutrient concentrations were determined in two organic olive groves. Using the Tessier fractionation, five fractions, for all the metals, were found: exchangeable, bound to carbonates (acid–soluble), bound to Fe-Mn oxides (reducible), organic (oxidizable), as well as residual form. Our results indicated that Fe was taken up by the olive trees as organic complex, mainly from the soil layer 40–60 cm. Manganese was taken up from the exchangeable fraction (0–20 cm); Zinc was taken up as organic complex from the layers 0–20 and 40–60 cm, as well as in the exchangeable form from the upper 20 cm. Copper was taken up from the soil layers 0–20 and 40–60 cm as soluble organic complex, and as exchangeable ion from the upper 20 cm. Our data reveal the crucial role of organic matter to sustain metal (Fe, Zn and Cu) uptake -as soluble complexes-by olive trees, in mature organic groves grown on calcareous soils; it is also expected that these data will constitute a thorough insight and useful tool towards a successful nutrient and organic C management for organic olive groves, since no serious nutritional deficiencies were found.
Principal component analysis of soil metal fractions in different depths suggested covariations with soil properties in organic olive groves. This graph demonstrates that the accumulation of organic matter in surface soils (0–20 cm) controls the bioavailability of Fe, Mn, Zn and Cu whether estimated on the basis of a single extraction (DTPA) or based on the labile fractions of a sequential extraction scheme. Display omitted
•Soil metal fractions were studied in two organic olive groves.•Fe, Mn, Zn and Cu were taken up by trees as exchangeable ions and organic complexes.•Most foliar nutrient concentrations were within the optimum range of sufficiency.•Maintenance of soil organic matter is crucial to sustain metal uptake.
Aims.
The first relativistic solar proton event of solar cycle 25 was detected on 28 October 2021 by neutron monitors (NMs) on the ground and particle detectors on board spacecraft in near-Earth ...space. This is the first ground-level enhancement (GLE) of the current cycle. A detailed reconstruction of the NM response together with the identification of the solar eruption that generated these particles is investigated based on in situ and remote-sensing measurements.
Methods.
In situ proton observations from a few MeV to ∼500 MeV were combined with the detection of a solar flare in soft X-rays, a coronal mass ejection, radio bursts, and extreme ultraviolet (EUV) observations to identify the solar origin of the GLE. Timing analysis was performed, and a relation to the solar sources was outlined.
Results.
GLE73 reached a maximum particle rigidity of ∼2.4 GV and is associated with type III, type II, and type IV radio bursts and an EUV wave. A diversity of time profiles recorded by NMs was observed. This points to the event having an anisotropic nature. The peak flux at
E
> 10 MeV was only ∼30 pfu and remained at this level for several days. The release time of ≥1 GV particles was found to be ∼15:40 UT. GLE73 had a moderately hard rigidity spectrum at very high energies (
γ
∼ 5.5). Comparison of GLE73 to previous GLEs with similar solar drivers is performed.
Summary
This systematic review summarizes the effect of combined exercise and nutrition intervention on muscle mass and muscle function. A total of 37 RCTs were identified. Results indicate that ...physical exercise has a positive impact on muscle mass and muscle function in subjects aged 65 years and older. However, any interactive effect of dietary supplementation appears to be limited.
Introduction
In 2013, Denison et al. conducted a systematic review including 17 randomized controlled trials (RCTs) to explore the effect of combined exercise and nutrition intervention to improve muscle mass, muscle strength, or physical performance in older people. They concluded that further studies were needed to provide evidence upon which public health and clinical recommendations could be based. The purpose of the present work was to update the prior systematic review and include studies published up to October 2015.
Methods
Using the electronic databases MEDLINE and EMBASE, we identified RCTs which assessed the combined effect of exercise training and nutritional supplementation on muscle strength, muscle mass, or physical performance in subjects aged 60 years and over. Study selection and data extraction were performed by two independent reviewers.
Results
The search strategy identified 21 additional RCTs giving a total of 37 RCTs. Studies were heterogeneous in terms of protocols for physical exercise and dietary supplementation (proteins, essential amino acids, creatine, β-hydroxy-β-methylbuthyrate, vitamin D, multi-nutrients, or other). In 79% of the studies (27/34 RCTs), muscle mass increased with exercise but an additional effect of nutrition was only found in 8 RCTs (23.5%). Muscle strength increased in 82.8% of the studies (29/35 RCTs) following exercise intervention, and dietary supplementation showed additional benefits in only a small number of studies (8/35 RCTS, 22.8%). Finally, the majority of studies showed an increase of physical performance following exercise intervention (26/28 RCTs, 92.8%) but interaction with nutrition supplementation was only found in 14.3% of these studies (4/28 RCTs).
Conclusion
Physical exercise has a positive impact on muscle mass and muscle function in healthy subjects aged 60 years and older. The biggest effect of exercise intervention, of any type, has been seen on physical performance (gait speed, chair rising test, balance, SPPB test, etc.). We observed huge variations in regard to the dietary supplementation protocols. Based on the included studies, mainly performed on well-nourished subjects, the interactive effect of dietary supplementation on muscle function appears limited.
The enzymatic arsenal of several soil microorganisms renders them particularly suitable for the degradation of lignocellulose, a process of distinct ecological significance with promising ...biotechnological implications. In this study, we investigated the spatiotemporal diversity and distribution of bacteria and fungi with 16S and Internally Trascribed Spacer (ITS) ribosomal RNA next-generation-sequencing (NGS), focusing on forest mainland
and insular
habitats of Greece. We analyzed samples during winter and summer periods, from different soil depths, and we applied optimized and combined targeted meta-omics approaches aiming at the peroxidase-catalase family enzymes to gain insights into the lignocellulose degradation process at the soil microbial community level. The microbial communities recorded showed distinct patterns of response to season, soil depth and vegetation type. Overall, in both forests
,
,
were the most abundant bacteria phyla, while the other phyla and the super-kingdom of
were detected in very low numbers. Members of the orders
,
,
,
,
,
,
, and
(
), and
,
,
,
,
, and
(
) were the most abundant for
. By using optimized "universal" PCR primers that targeted the peroxidase-catalase enzyme family, we identified several known and novel sequences from various
, even from taxa appearing at low abundance. The majority of the sequences recovered were manganese peroxidases from several genera of
,
,
,
,
,
, and
, while lignin -and versatile-peroxidases were limited to two to eight species, respectively. Comparisons of the obtained sequences with publicly available data allowed a detailed structural analysis of polymorphisms and functionally relevant amino-acid residues at phylogenetic level. The targeted metagenomics applied here revealed an important role in lignocellulose degradation of hitherto understudied orders of
, such as the
and
, while it also suggested the auxiliary activity of particular members of
,
,
, and
. The application of NGS-based metagenomics approaches allows a better understanding of the complex process of lignocellulolysis at the microbial community level as well as the identification of candidate taxa and genes for targeted functional investigations and genetic modifications.
A consistent approach for the inherently imbalanced problem of solar energetic particle (SEP) events binary prediction is being presented. This is based on solar flare and coronal mass ejection (CME) ...data and combinations of both thereof. We exploit several machine learning (ML) and conventional statistics techniques to predict SEPs. The methods used are logistic regression (LR), support vector machines (SVM), neural networks (NN) in the fully connected multi-layer perceptron (MLP) implementation, random forests (RF), decision trees (DTs), extremely randomized trees (XT) and extreme gradient boosting (XGB). We provide an assessment of the methods employed and conclude that RF could be the prediction technique of choice for an optimal sample comprised by both flares and CMEs. The best-performing method gives a Probability of Detection (POD) of 0.76(±0.06), False Alarm Rate (FAR) of 0.34(±0.10), true skill statistic (TSS) 0.75(±0.05), and Heidke skill score (HSS) 0.69(±0.04). We further show that the most important features for the identification of SEPs, in our sample, are the CME speed, width and flare soft X-ray (SXR) fluence.
Summary
We estimate the current burden of illness of osteoporosis in Canada is double ($4.6 billion) our previous estimates ($2.3 billion) due to improved data capture of the multiple encounters and ...services that accompany a fracture: emergency room, admissions to acute and step-down non-acute institutions, rehabilitation, home-assisted or long-term residency support.
Introduction
We previously estimated the economic burden of illness of osteoporosis-attributable fractures in Canada for the year 2008 to be $2.3 billion in the base case and as much as $3.9 billion. The aim of this study is to update the estimate of the economic burden of illness for osteoporosis-attributable fractures for Canada based on newly available home care and long-term care (LTC) data.
Methods
Multiple national databases were used for the fiscal-year ending March 31, 2011 (FY 2010/2011) for acute institutional care, emergency visits, day surgery, secondary admissions for rehabilitation, and complex continuing care, as well as national dispensing data for osteoporosis medications. Gaps in national data were supplemented by provincial and community survey data. Osteoporosis-attributable fractures for Canadians age 50+ were identified by ICD-10-CA codes. Costs were expressed in 2014 dollars.
Results
In FY 2010/2011, the number of osteoporosis-attributable fractures was 131,443 resulting in 64,884 acute care admissions and 983,074 acute hospital days. Acute care costs were $1.5 billion, an 18 % increase since 2008. The cost of LTC was 33.4 times the previous estimate ($31 million versus $1.03 billion) because of improved data capture. The cost for rehabilitation and secondary admissions increased 3.4 fold, while drug costs decreased 19 %. The overall cost of osteoporosis was over $4.6 billion, an increase of 83 % from the 2008 estimate.
Conclusion
Since the 2008 estimate, new Canadian data on home care and LTC are available which provided a better estimate of the burden of osteoporosis in Canada. This suggests that our previous estimates were seriously underestimated.
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