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Nutritional risk, frailty and functional status in elderly heart failure patients
Get PDFAims: Heart failure (HF) in elderly patients is frequently associated with frailty, malnutrition and reduced functional status. This study assessed the associations between nutritional risk, functional capacity, frailty and length of hospital stay (LOHS) in elderly patients hospitalized with HF. Methods and results: A cross‐sectional study of 200 patients aged 60–91 years (mean age 72.3 ± 6.6; 70.5% male) hospitalized for HF. Nutritional status was assessed using the Mini Nutritional Assessment (MNA), functional capacity with Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) scales, and frailty using Fried's criteria. BMI, central obesity, comorbidities and LOHS were also recorded. Frailty was present in 65% of participants; 36.5% were malnourished or at nutritional risk. Well‐nourished patients had significantly higher IADL scores (P = 0.002). Mean LOHS was longer in frail compared with pre‐frail patients (6.18 ± 2.37 vs. 5.41 ± 1.60 days; P = 0.016). In multivariable logistic regression, frailty independently predicted increased LOHS (OR = 4.063, 95% CI: 1.36–12.1; P = 0.012). BMI, central obesity and comorbidity burden were not associated with functional status or LOHS. Conclusions: Frailty was independently associated with increased LOHS in elderly HF patients. Poor nutritional status was significantly linked to reduced instrumental functional capacity. Routine frailty and nutritional screening may help identify patients who could benefit from early interventions aimed at improving functional outcomes and reducing hospitalization time
Catalytic Biomass Gasification for Syngas Production: Recent Progress in Tar Reduction and Future Perspectives
Get PDFBiomass gasification is an effective process for converting organic wastes into syngas. Syngas is a biofuel that possesses several potential applications in the energy sector. However, the major bottleneck for the commercialization of this technology is tar production in biomass gasification, which affects gasifier performance and syngas yield/quality. Tar can be destructed by adopting in situ or ex situ modes of utilizing catalysts in biomass gasification. The added advantage of tar reduction is enhanced syngas energy content. Despite their advantages, catalysts face challenges such as high costs, declining performance over time, and difficulties in regeneration and recycling. Deactivation can also occur due to poisoning, fouling, and carbon buildup. While some natural materials have been tested as alternative materials, the financial sustainability and affordability of catalysts remain crucial for large-scale syngas production. This paper offers an overview of tar reduction strategies and the role of various catalysts in the gasification process and future perspectives on catalyst development for biomass gasification
Affective symptoms, cognitive function and self-care behaviours in adults with heart failure according to ejection fraction phenotype
No full textAims: The aim of this study was to compare affective symptoms, cognitive dysfunction, and self-care behaviours among different heart failure (HF) phenotypes and to explore their interrelationships, particularly examining how cognitive and affective factors influence self-care practices. Methods and results: This cross-sectional study involved 250 older adults hospitalized for acute decompensated HF, categorized into three groups based on left ventricular ejection fraction (EF): HF with reduced EF (HFrEF), mildly reduced EF (HFmrEF), and preserved EF (HFpEF). Affective symptoms were assessed using the Hospital Anxiety and Depression Scale and Patient Health Questionnaire-9 (PHQ-9), while cognitive function was evaluated with the Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE). Self-care behaviours were measured using the European Heart Failure Self-Care Behavior Scale. Among participants, 42% had HFrEF, 18.4% had HFmrEF, and 39.6% had HFpEF. Cognitive dysfunction was more pronounced in HFpEF patients (MMSE median = 28.0, IQR = 26.0–29.0) compared with those with HFrEF (median = 28.0, IQR = 27.0–29.0) or HFmrEF (median = 29.0, IQR = 27.3–29.0, P = 0.008). Higher MMSE scores were significantly associated with better self-care behaviours in HFpEF patients (Spearman’s r = −0.299, P = 0.003) but not in the other groups. Significant differences were found in specific self-care behaviours, including contacting healthcare providers and adherence to a low-sodium diet. Conclusion: Although variations in cognitive function and self-care behaviors were observed across HF phenotypes, these differences were not statistically significant after adjusting for demographic and clinical factors. Tailored interventions should be based on a comprehensive assessment of cognitive and emotional health, rather than HF phenotype alone
Composite Motion Control of Cable-Driven Continuum Robots: An Auxiliary-System Based Compensation Method
No full textHigh-performance motion control of cable-driven continuum robots is challenging due to the inherent model uncertainties, actuator saturation, and measurement delays. Inthis article,we utilize the idea of auxiliary systemto reveal the dynamics of the model uncertainties, actuator saturation, andmeasurement delays, and design a composite motion control strategy to compensate themsimultaneously. First, a time-delay auxiliary system is designed using Pade approximation technique to approximate the saturated time delay, thereby transforming the saturated continuum robot system with time delay into one without time delay. A disturbance auxiliary system and a saturated auxiliary system are also designed to estimate model uncertainties and address actuator saturation, respectively. Second, based on the designed auxiliary systems, a feedback controller is proposed to compensate the model uncertainties, actuator saturation, and measurement delays. The stability of the closed loop system under the proposed control scheme is analyzed as well. Finally, the effectiveness of the proposed control scheme is verified by comparative simulations and experiments
An Analytical Framework for the Selective Extraction and Determination of Nine Multiclass Endocrine-Disrupting Chemicals from Haircare Products
Get PDFHumans are exposed to pollutants daily through various routes, including skin contact. A key concern is the presence of endocrine-disrupting chemicals, which means they can mimic, block or interfere with the body’s natural hormones, in many everyday items, among which are personal care products. We set up a chromatographic method to simultaneously assess the occurrence of nine endocrine disruptors and to verify the compliance with mandatory regulations concerning the potential fraudulent additions of preservatives. A total of twenty-six haircare products were collected and analyzed. The limits of detection ranged from 0.052 μg mL−1 to 1.744 μg mL−1, while the limits of quantification ranged from 0.175 μg mL−1 to 5.815 μg mL−1, respectively. Analyte recovery was between 66% and 87%, demonstrating the accuracy of the method in these target formulations. Even if the recovered quantity of parabens did not exceed the legal limits, the analysis detected bis(2-ethylhexyl) phthalate (DEHP) in 2 real samples and dibutyl phthalate (DBP) in all 26 samples, with concentrations ranging from 151.01 μg/100 g to 1042.58 μg/100 g. Although the European Union regulates the quantity of potentially harmful compounds in consumer goods, repeated use of certain products, such as haircare formulations, could result in chronic exposure to several endocrine disruptors
Clustering-Based Resource Management for Consumer Cost Optimization in IoT Edge Computing Environments
Get PDFEdge computing emerges as a pivotal model in the era of next-generation consumer electronics and the emerging challenges of multimodal data-driven decision-making. Specifically, edge computing offers an open computing architecture for the vast and diverse consumer multimodal data generated by mobile computing and Internet of Things (IoT) technologies. While edge computing is instrumental in optimizing latency and bandwidth control in processing consumer multimodal data, the viability of employing edge resources is complicated by high service costs and the complexities of managing multimodal data diversity. This study introduces an innovative optimization method for distributing multimodal data on edge storage, considering both the I/O (input/output) speed and the overall distribution cost. The core part of our approach is the deployment of intelligent algorithms that ensure equitable data distribution across storage servers, thus eliminating unused space and reducing extra costs. Given the complexity of this NP-hard (non-deterministic polynomial-time) challenge, our study reveals a unique model incorporating an edge-broker component in combination with novel algorithms. The proposed algorithms aim to harmonize data distribution and reduce resource allocation expenses in a multimodal edge environment. Our proposed approach achieves excellent results, highlighting the efficacy of the proposed algorithms in several parameters such as makespan, cost, multimodal data security, and total processing time. Empirical tests reveal that the BCA (Best Clustering Algorithm) performs best, achieving a minimum load balancing rate of 92.2%, an average variance of 0.04, and an average run time of 0.56 seconds
Love and Midwifery
No full textThis unique book argues that love underpins safe, effective, high quality, midwifery care, and enables readers to explore sustainable and compassionate ways to engage with their profession.At a time when midwives are struggling to stay connected with the passion that brought them into the profession, and fear, distress and trauma are prevalent within maternity care for both staff and those receiving care, this book maps a new way forward. It encourages reflection and discussion about how love impacts midwives’ experience of their practice and improves the quality of care they are able to provide for women, and their families. It develops a theoretical basis for understanding why love is relevant to midwifery, how midwives think of love, and the ways that it is communicated in practice. It offers practical ways in which love can be appropriately nurtured and applied in contemporary maternity settings, whilst upholding the professional standards required of all maternity care providers. Many chapters include the authentic words of midwives reflecting on the role of love in their own practice experiences.Love and Midwifery is a valuable contribution to the literature around compassion, kindness, resilience, moral distress and trauma in maternity care, helping midwives to realise and feel proud of the love in their work. It is an essential read for all midwives from student to experienced practitioner, as well as the wider maternity care workforce
Fine-scale residency and temperature-driven habitat selection in a migratory shark species
Get PDFMany marine species exhibit complex and diverse movements that vary across spatial and temporal scales. These movements must be accounted for when designing effective management and conservation efforts. While environmental cues such as temperature and salinity have been shown to influence the movements of mobile species, it is increasingly documented that social factors can also influence space use and population behaviour. Understanding how various factors influence movement enhances our ability to predict the space use of highly dynamic ocean species. Spurdog (Squalus acanthias), known for their tendency to aggregate and use of both coastal and oceanic environments, are an ideal model species for studying drivers of movement. To investigate movement and habitat selection in spurdog, we conducted an acoustic telemetry study from June 2016 to July 2017, tagging 51 spurdog in a partially enclosed fjordic sea loch on the west coast of Scotland. The thermal profile of Loch Etive was recorded to complement the movement data. Our study revealed temperature as a pivotal driver of movement and habitat selection in spurdog, with the unique thermal environment of the fjord enabling year-round residency at a previously undocumented spatial scale, suggesting that such habitats may be especially important for mobile marine species. This study demonstrates the importance of understanding environmental influences on space use and movement to develop effective, climate-resilient management strategies for spurdog and other mobile marine species
Stroke recovery—what are people talking about on Twitter? A content analysis
Get PDFPurposePrioritisation exercises seek out what matters to key stakeholders to inform the planning of research. Social media platforms are potentially useful data sources. The aim was to examine the content of tweets, short messages containing text and pictures, to ascertain the priorities of Twitter users regarding stroke recovery.Materials and methodsContent analysis of Twitter was conducted. An electronic search used the identifiers: #strokesurvivor and #strokerecovery. Tweets spanning four weeks from January 2021 were analysed.ResultsThere were 1361 tweets extracted and 486 analysed following exclusion of duplicates and unrelated material. Six themes were uncovered (n = number of tweets): maintaining motivation and positivity (153); sharing of resources (146); raising awareness of stroke (74); symptomatic aspects of recovery (39); experience of rehabilitation (63); and concerns about Covid-19 (17).ConclusionsDespite the brevity of tweets, a rich picture arose. A key limitation was lack of biographical data about Twitter users. Recommendations about topics requiring attention from stroke researchers, clinicians and policy makers are: management of psychological problems; public perception of stroke; rehabilitation considerations including treatment burden, person-centred care and equality of care; symptom management including fatigue and aphasia. Findings can be used to supplement and validate other priority-setting exercises
Vortex generators in heat sinks: Design, optimisation, applications and future trends
Get PDFVortex generators (VGs) have been identified as an exceedingly effective method in augmenting heat transfer in minichannels, a significant feature of cutting-edge heat sinks, heat exchangers and electronics cooling tools. This paper aims to discuss the various types of vortex generators, specifically delta winglet, rectangular winglet, trapezoidal and perforated, as well as their impact on improving convective heat transfer. This study focuses on the configurations that define geometric parameters, including the angle of attack, height and spacing in relation to the improvement in thermal or hydraulic performance. Strategies such as nanofluids, dimples, Response Surface Methodology analysis and Artificial Neural Networks are crucial to improve VG designs to maximise thermal efficiency and minimise pressure loss. Additionally, the paper considers potential trends, such as the further miniaturisation of the VGs in terms of micro-level utilisation, more intricate VG shapes, together with the development of smart VGs that can alter their configuration depending on the current thermal conditions. To conclude, this review will provide beneficial information pertaining to current VG technology, the application of VG in high-performance cooling systems, and also identify areas for future research concerning VG technology
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