Comorbidity among inpatients with dementia: a preliminary cross-sectional study in West China.

OBJECTIVE: To investigate comorbidities among hospitalized patients with dementia. METHOD: Data were extracted from the discharge records in our hospital. Comorbidities based on ICD-10 were selected from the Charlson Comorbidity Index (CCI) and Elixhauser Comorbidity Index (ECI). The distributions of these comorbidities were described in dementia inpatients and age- and sex-matched nondementia controls, as well as in inpatients with Alzheimer's disease and vascular dementia. A logistic regression model was applied to identify dementia-specific morbid conditions. RESULTS: A total of 3355 patients with dementia were included, with a majority of 1503 (44.8%) having Alzheimer's disease, 395 (11.8%) with vascular dementia, and 441 (13.1%) with mixed dementia. The mean number of comorbidities was 3.8 in dementia patients (vs. 2.9 in controls). The most prevalent comorbidities in inpatients with dementia compared with those without dementia were cerebral vascular disease (73.0% vs. 35.9%), hypertension (62.8% vs. 56.2%), and peripheral vascular disease (53.7% vs. 31.2%). Comorbidities associated with dementia included epilepsy (OR 4.8, 95% CI 3.5-6.8), cerebral vascular disease (OR 4.1, 95% CI 3.7-4.5), depression (OR 4.0, 95% CI 3.2-5.0), uncomplicated diabetes (OR 1.5, 95% CI 1.4-1.7), peripheral vascular disease (OR 1.8, 95% CI 1.6-2.0), rheumatoid arthritis collagen vascular disease (OR 1.7, 95% CI 1.3-2.3), and anemia (OR 1.2, 95% CI 1.04-1.3). Some comorbidities suggested a protective effect against dementia. They were hypertension (OR 0.8, 95% CI 0.7-0.9), COPD (OR 0.6, 95% CI 0.5-0.6), and solid tumor without metastasis (OR 0.4, 95% CI 0.3-0.4). Vascular dementia has more cardiovascular and cerebrovascular comorbidities than Alzheimer's disease. CONCLUSION: Patients with dementia coexisted with more comorbidities than those without dementia. Comorbidities (esp. cardio-cerebral vascular risks) in patients with vascular dementia were more than those in patients with AD. Specifically, vascular and circulatory diseases, epilepsy, diabetes and depression increased the risk of dementia.

Characterization and nutritional value of hydrothermal liquid products from distillers grains.

Hydrothermal liquid products (HLPs) produced by hydrothermal treatment (HTT) contain a large amount of nitrogen, phosphorus and other substances, while the environmental problems caused by arbitrary discharge. This work explored the effects of temperature, reaction time and solid-liquid ratio on the chemistry of HLPs of two different distillers grains, with a focus on nutrient composition. Increased HTT temperature was related to increased HLPs pH, dissolved organic carbon content, and aromaticity, and decreased electrical conductivity. Maximum nutrient extraction efficiencies observed for NH4+-N, NO3--N and PO43- were 92.0, 89.9, and 94.3%, respectively. Response surface methodology showed that the release of nutrient extraction efficiency was the greatest at the hydrothermal treatment of 200 °C for 1 h, and using a solid/liquid ratio of 10%. Comparative studies, the nutritional value of HLPs are appropriate for use as an agricultural fertilizer, and its use as a substitute for synthetic fertilizers could increase the sustainability and profitability of farming.

Effective Sb(V) removal from aqueous solution using phosphogypsum-modified biochar.

Antimonate is the dominant form of antimony (Sb) in Sb mine water. The treatment of high-Sb mine water essentially reduces the discharge of antimonate oxyanions ([Sb(OH)6]-) in it. Biochar obtained from phosphogypsum-modified anaerobic digested distillers' grain (PADC) can effectively adsorb antimonate from water. In this work, using batch adsorption experiments, mathematical models, and characterization methods, the mechanism of Sb(V) adsorption by PADC was studied. Compared with pristine biochar, PADC biochar showed abundant lamellar and vesicular structures with significant calcium ion loading on the surface. The kinetics data of the adsorption of Sb(V) on the PADC biochar followed the Elovich equation (R2 = 0.992), indicating that heterogeneous adsorption had occurred. The results also showed that intraparticle diffusion played an important role in controlling Sb(V) adsorption by PADC biochar. The Redlich-Peterson model best fit the Sb(V) adsorption isotherm (R2 = 0.997), indicating that the adsorption was a combination of the Langmuir and Freundlich models. The maximum adsorption capacity of PADC biochar for Sb(V) is 8123 mg/kg, which is more than twice that of the pristine biochar (3487 mg/kg) and is sufficient for Sb(V) treatment in most mine water. Fourier transform infrared (FTIR) spectra, X-ray photoelectron spectroscopy (XPS), X-ray diffractometry (XRD), and Transmission electron microscopy with energy dispersive X-ray spectroscopy (TEM-EDS) analyses revealed that the dominant mechanism of Sb(V) removal by PADC biochar was the formation of Ca-O-Sb complexes or amorphous surface precipitation as well as electrostatic adsorption. This work demonstrated the potential of PADC biochar in the treatment of Sb-contaminated mine water.

Hydrothermal carbonization of distillers grains with clay minerals for enhanced adsorption of phosphate and methylene blue.

A novel one-pot synthesis method was developed to prepare modified hydrochar by co-hydrothermal carbonization of waste distillers grains using low-cost clay minerals (attapulgite or vermiculite). The loading of the clay minerals onto hydrochar surfaces altered the structure and surface composition of the hydrochar such that the clay-modified hydrochars showed better ability to adsorb methylene blue and phosphate in aqueous solution than the pristine hydrochar. The maximum methylene blue and phosphate adsorption capacities of the modified hydrochar reached 340.3 and 96.9 mg g-1, respectively, comparable or higher than that of many commercial sorbents. Multiple mechanisms, including electrostatic attraction, ion exchange, complexation, and physical adsorption, controlled the adsorption process. These results highlight excellent potential for distillers grains-derived hydrochar-clay composites as an environmental sorbent, capable of removing a variety of contaminants from aqueous solutions.

Ratio of Optic Nerve Sheath Diameter to Eyeball Transverse Diameter by Ultrasound Can Predict Intracranial Hypertension in Traumatic Brain Injury Patients: A Prospective Study.

BACKGROUND: Measuring optic nerve sheath diameter (ONSD), an indicator to predict intracranial hypertension, is noninvasive and convenient, but the reliability of ONSD needs to be improved. Instead of using ONSD alone, this study aimed to evaluate the reliability of the ratio of ONSD to eyeball transverse diameter (ONSD/ETD) in predicting intracranial hypertension in traumatic brain injury (TBI) patients. METHODS: We performed a prospective study on patients admitted to the Surgery Intensive Care Unit. The included 52 adults underwent craniotomy for TBI between March 2017 and September 2018. The ONSD and ETD of each eyeball were measured by ultrasound and computed tomography (CT) scan within 24 h after a fiber optic probe was placed into lateral ventricle. Intracranial pressure (ICP) > 20 mmHg was regarded as intracranial hypertension. The correlations between invasive ICP and ultrasound-ONSD/ETD ratio, ultrasound-ONSD, CT-ONSD/ETD ratio, and CT-ONSD were each analyzed separately. RESULTS: Ultrasound measurement was successfully performed in 94% (n = 49) of cases, and ultrasound and CT measurement were performed in 48% (n = 25) of cases. The correlation efficiencies between ultrasound-ONSD/ETD ratio, ultrasound-ONSD, CT-ONSD/ETD ratio, and ICP were 0.613, 0.498, and 0.688, respectively (P < 0.05). The area under the curve (AUC) values of the receiver operating characteristic (ROC) curve for the ultrasound-ONSD/ETD ratio and CT-ONSD/ETD ratio were 0.920 (95% CI 0.877-0.964) and 0.896 (95% CI 0.856-0.931), respectively. The corresponding threshold values were 0.25 (sensitivity of 90%, specificity of 82.3%) and 0.25 (sensitivity of 85.7%, specificity of 83.3%), respectively. CONCLUSION: The ratio of ONSD to ETD tested by ultrasound may be a reliable indicator for predicting intracranial hypertension in TBI patients.