Introduction: With increasing proportion of the elderly in the world, detecting and preventing frailty assumes importance to improve the quality of life and health. The study aimed to estimate the ...prevalence of frailty, disability and its determinants and their relation with mortality among community dwelling elderly cohort. Materials and Methods: The study was conducted in a cohort in rural Haryana, India, and was followed till October 2018. Frailty was assessed using the Edmonton Frailty Scale and disability was assessed using the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) scale by trained physicians. Results: The prevalence of frailty was found to be 47.3% (95% confidence interval CI: 44.0-50.8). The median WHODAS-2 score was found to be 10.4 (2.1-29.2). Those who were older (odds ratio OR - 2.5; 95% CI: 1.8-3.4), women (OR - 3.3; 95% CI: 2.2-4.9) and those with chronic disease (OR 2.3; 95% CI: 1.7-3.1) had higher rates of frailty. The adjusted hazard ratio of death among frail people was 4.7 (2.3-9.7). Conclusion: In this study we found the frailty is associated with the mortality among community dwelling elderly. Thus early identification of the frailty and its determinants may help us to reduce the mortality related to this.
Accurate estimation of dementia prevalence is essential for making effective public and social care policy to support individuals and families suffering from the disease. The purpose of this paper is ...to estimate the prevalence of dementia in India using a semi-supervised machine learning approach based on a large nationally representative sample.
The sample of this study is adults 60 years or older in the wave 1 (2017-2019) of the Longitudinal Aging Study in India (LASI). A subsample in LASI received extensive cognitive assessment and clinical consensus ratings and therefore has diagnoses of dementia. A semi-supervised machine learning model was developed to predict the status of dementia for LASI participants without diagnoses. After obtaining the predictions, sampling weights and age standardization to the World Health Organization (WHO) standard population were applied to generate the estimate for prevalence of dementia in India.
The prevalence of dementia for those aged 60 years and older in India was 8.44% (95% CI: 7.89%-9.01%). The age-standardized prevalence was estimated to be 8.94% (95% CI: 8.36%-9.55%). The prevalence of dementia was greater for those who were older, were females, received no education, and lived in rural areas.
The prevalence of dementia in India may be higher than prior estimates derived from local studies. These prevalence estimates provide the information necessary for making long-term planning of public and social care policy. The semi-supervised machine learning approach adopted in this paper may also be useful for other large population aging studies that have a similar data structure.
We investigate the interactions between a cantilevered flexible beam and cross-flow of a viscoelastic fluid. Unlike Newtonian fluids, viscoelastic fluids exhibit elastic flow instabilities even in ...the absence of inertia. These elastic flow instabilities drive the oscillations of flexible structures placed in their flow path. In this work, the fluid–structure interactions between the flow of viscoelastic wormlike micelle solution and a flexible cantilevered beam is studied as a function of the Weissenberg number and the beam’s tip angle. At low Weissenberg numbers, the flow remained stable and the beam deflected in the direction of flow. As the Weissenberg number was increased, a separated vortex appeared upstream of the cantilever near its tip. At a critical Weissenberg number of Wi=11, the flow became unstable. For beams with small tip angles of 0° and 25°, no oscillations were observed. However, for beams with larger tip angles of 45° and 65°, oscillatory motions coupled to the flow instability were observed, where the amplitude of the beam oscillations increased with increasing tip angle. Particle image velocimetry measurements showed that the elastic flow instability was characterized by the periodic formation of strong fluid jet that originated upstream of the beam in a region of strong extensional flow where it likely resulted from the local breakdown of the wormlike micelle solution. This jet was accompanied by a pair of counter-rotating vortices on its sides as it entrained fluid around the tip of the beam. The frequency of oscillations of the beams with large tip angles increased monotonically with Weissenberg number, while their amplitudes of oscillations initially increased with Weissenberg number before decaying to zero for Wi>20, despite the fact that the flow remained unstable. Our results showed that oscillations were only possible when the tip of the cantilevered beam made a positive angle with respect to the primary incoming flow direction.
•Viscoelastic flow instabilities can lead to flow-induced oscillations of solid structures.•Cantilevered beams placed in wormlike micelle solutions can oscillate due to the formation of vortices around their tips.•The tip geometry determines whether the beam oscillates or not.
Due to the complex, elaborate and expensive estimation of bearing capacity (
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) of geogrid-reinforced sand bed resting over a group of vertically encased stone columns floating in soft clay, it ...is required to develop a precise empirical model, which is supposed to be nonlinear. To date, there is no established bearing capacity equation available on this topic. The aim of this work is to develop a precise
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prediction model using support vector regression (SVR) technique. A total of 245 experimental datasets were collected and used to train and test the SVM models estimating the
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. Three SVR models were developed based on three different kernel functions, namely exponential radial basis kernel function (ERBF), radial basis kernel function (RBF) and polynomial kernel function (POLY), and their performances were examined. Out of the three SVR models, one with ERBF was found to be the best one, having the lowest statistical error and maximum generalization ability of the training and testing data. The performance of SVR-ERBF model was compared with adaptive neuro-fuzzy inference system (ANFIS) model, and it was observed that SVR-ERBF model outperforms ANFIS model to predict
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. A sensitivity analysis was also conducted to identify the relative importance and contribution of each input variable on output (
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) prediction. Finally, using the SVR-ERBF model, an empirical equation is proposed to predict
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for practical application purposes. Obtained results approve that the SVR-ERBF model can be used as a powerful and reliable alternative to solve highly nonlinear problems such as indirect estimation of
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Most people are convinced that their body parts are in fact their own, but in some clinical conditions, this sense of ownership can be lost 1. Perceptual illusions, most famously the rubber hand ...illusion (RHI) 2, demonstrate that a sense of ownership over a body part (or an entire body 3) that is not in fact ours can be easily induced in healthy volunteers. But does illusory ownership over an artificial body part have consequences for the real body part, the one that has been ‘replaced'? Recent data show the RHI induces a small but robust drop in skin temperature of the real hand. That is, blood flow to the ‘disowned’ hand seems to be selectively reduced 1. Such a finding is particularly relevant to the immune system because a primary role of the immune system is to ‘discriminate self from non-self’4. We predicted that the innate immune system may be upregulated in a manner consistent with rejection of the replaced hand. Consistent with this prediction, we report here that the RHI increases histamine reactivity, which is a key final pathway of the innate immune response and has been implicated in autoimmune disorders, including multiple sclerosis 5. Our finding has direct implications for autoimmune disorders and a range of neurological and psychiatric conditions characterised by a disrupted sense of ownership over one's body (see 1 for a list of conditions), and has broader implications that extend well beyond previous assertions about the mind-body link.
Low and middle-income countries like India anticipate rapid population aging and increases in dementia burden. In India, dementia screening scales originally developed in other contexts need to be ...assessed for feasibility and validity, given the number of different languages and varying levels of literacy and education.
Using data from the Longitudinal Aging Study in India-Diagnostic Assessment of Dementia (N = 4,028), we characterize the performance of the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE). We described patterns and correlates of missingness, evaluated the psychometric properties of the scale, and assessed criterion validity against the Hindi Mental State Examination (HMSE) using linear regression.
Several IQCODE items had high levels of missingness, which was associated with urbanicity, respondent's gender, and informant's generation (same vs. younger generation). Full IQCODE scores showed strong criterion validity against the HMSE; each 1-point increase in IQCODE score was associated with a 3.03-point lower score on the HMSE, controlling for age, gender, and urbanicity. The statistically significant association between IQCODE and HMSE was stronger in urban than rural settings (p-value for interaction = 0.04). Associations between IQCODE and HMSE remained unchanged after removing the three items with the highest levels of differential missingness (remembering addresses and telephone numbers, ability to work with familiar machines, ability to learn to use new gadget or machine).
Findings raise questions about the value of including items with high proportions of missingness, which may signal cultural irrelevance, while removing them did not affect criterion validity.
Graphene oxide (GO) nanosheets dispersed a supramolecular hydrogel network (GOSHGel) has been achieved. The microstructures of GO dispersed hydrogels are investigated. Our previously reported a ...benign supramolecular hydrogel (SHGel) was used and mixed with exfoliated monolayers of GO to offer GOSHGel through several interplaying non-covalent type supramolecular interactions. The GOSHGel was employed as the stabilizing agent for the direct sun-ray mediated photo-chemically synthesized ‘Green’ silver nanoparticles (Ag-NPs). In vitro and in vivo toxicity assessments approve the bio-relevant nature of the GOSHGel capped Ag-NPs. The Ag-NPs were potentially antimicrobial against bacteria, including gram −ve bacterium (Escherichia coli) and gram +ve bacterium (Bacillus subtilis), and fungal pathogen, Pichia guilliermondii. Remarkably, these GOSHGel capped Ag-NPs also showed tremendous anticancer activity tested against human breast cancer cell. Both, GOSHGel and Ag-NPs embedded GOSHGel, were useful as the cell supportive scaffolds. This cell attachment was selective for non-malignant cell i.e. macrophages. Confocal microscopic study revealed the luminescent nature of GOSHGel capped Ag-NPs.
The graphene oxide nanosheets dispersed supramolecular hydrogel that acts as the stabilizing scaffold for the synthesis of bioactive ‘Green’ silver nanoparticles under direct exposure of Sun-light. The GO nanosheets dispersed supramolecular hydrogel capped silver nanoparticles are extremely effective for inducing lethality in pathogenic bacteria and fungus. Display omitted
•Graphene Oxide nanosheets dispersed supramolecular hydrogels are synthesized.•Microstructural and rheological patterns of different hydrogels are characterized.•The sun-ray mediated hydrogel capped ‘Green’ silver nanoparticles are synthesized.•Bio-activities of Ag-NPs against bacteria, fungus and cancer cell are investigated.•Cell attachment and intracellular imaging by hydrogel and Ag-NPs are explored.
Germline BAP1 mutations predispose to several cancers, in particular malignant mesothelioma. Mesothelioma is an aggressive malignancy generally associated with professional exposure to asbestos. ...However, to date, we found that none of the mesothelioma patients carrying germline BAP1 mutations were professionally exposed to asbestos. We hypothesized that germline BAP1 mutations might influence the asbestos-induced inflammatory response that is linked to asbestos carcinogenesis, thereby increasing the risk of developing mesothelioma after minimal exposure. Using a BAP1(+/-) mouse model, we found that, compared with their wild-type littermates, BAP1(+/-) mice exposed to low-dose asbestos fibers showed significant alterations of the peritoneal inflammatory response, including significantly higher levels of pro-tumorigenic alternatively polarized M2 macrophages, and lower levels of several chemokines and cytokines. Consistent with these data, BAP1(+/-) mice had a significantly higher incidence of mesothelioma after exposure to very low doses of asbestos, doses that rarely induced mesothelioma in wild-type mice. Our findings suggest that minimal exposure to carcinogenic fibers may significantly increase the risk of malignant mesothelioma in genetically predisposed individuals carrying germline BAP1 mutations, possibly via alterations of the inflammatory response.
Safety and efficacy data on pegylated asparaginase (PEG-ASP) in adult acute lymphoblastic leukaemia (ALL) induction regimens are limited. The UK National Cancer Research Institute UKALL14 trial ...NCT01085617 prospectively evaluated the tolerability of 1000 IU/m
PEG-ASP administered on days 4 and 18 as part of a five-drug induction regimen in adults aged 25-65 years with de novo ALL. Median age was 46.5 years. Sixteen of the 90 patients (median age 56 years) suffered treatment-related mortality during initial induction therapy. Eight of the 16 died of sepsis in combination with hepatotoxicity. Age and Philadelphia (Ph) status were independent variables predicting induction death >40 versus ⩽40 years, odds ratio (OR) 18.5 (2.02-169.0), P=0.01; Ph- versus Ph+ disease, OR 13.60 (3.52-52.36), P<0.001. Of the 74 patients who did not die, 37 (50.0%) experienced at least one grade 3/4 PEG-ASP-related adverse event, most commonly hepatotoxicity (36.5%, n=27). A single dose of PEG-ASP achieved trough therapeutic enzyme levels in 42/49 (86%) of the patients tested. Although PEG-ASP delivered prolonged asparaginase activity in adults, it was difficult to administer safely as part of the UKALL14 intensive multiagent regimen to those aged >40 years. It proved extremely toxic in patients with Ph+ ALL, possibly owing to interaction with imatinib.
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