Home-dwelling older adults' experiences of living with both frailty and multimorbidity: A meta-ethnography.

OBJECTIVES: To systematically review qualitative studies about home-dwelling older adults' experiences of living with both frailty and multimorbidity. METHODS: This study adopted a meta-ethnography; the databases included PubMed, Embase, CINAHL, Web of Science, PsycINFO, SCOPUS, and Google Scholar. Qualitative peer-reviewed articles in English were searched up to December 31, 2021. Themes and concepts were extracted through constant comparison across the included studies by three reviewers. RESULTS: Of the 147 articles screened, nine qualitative articles, encompassing a total sample of 173 participants, were included. The four final synthesised themes were 'Being isolated in a closed life,' 'Being dependent on help from others,' 'Rebuilding to maximise quality of life,' and 'Struggling to live a meaningful life.' CONCLUSION: Home-dwelling older adults with both frailty and multimorbidity are more likely to be socially isolated due to their physical limitations and lack of integration between hospital-based care and community healthcare services.

The Association of Index-to-Ring Finger Ratio With Trapeziometacarpal Joint Osteoarthritis in an Elderly Korean Population.

OBJECTIVE: Index-to-ring finger ratio (IRFR) has been reported to be associated with joint osteoarthritis (OA). We aimed to evaluate the association between IRFR and trapeziometacarpal joint (TMCJ) OA in an elderly Korean population. METHODS: A population-based sample included 604 participants with a mean age of 74.8 years. IRFR was radiographically measured by the ratio of the length of the right second to fourth phalangeal bones ("phalangeal IRFR") and metacarpal bones ("metacarpal IRFR"), and was visually classified as either type 1 (index finger longer than or equal to ring finger) or type 2 (index finger shorter than ring finger). Odds ratios (ORs) for the presence of OA (Kellgren-Lawrence [KL] grade > 1) and for severe OA (KL grade > 2) were analyzed using logistic regression. RESULTS: The phalangeal IRFR averaged 91.3%, the metacarpal IRFR 116.7%, and 304 out of 604 participants (50.3%) had type 2 IRFR. We found TMCJ OA in 112 participants (18.5%), and severe TMCJ OA in 33 participants (5.5%). Presence of TMCJ OA was significantly associated with age (OR 1.04; 95% CI 1.01-1.06) and metacarpal IRFR (OR 0.94; 95% CI 0.88-0.99), and severe TMCJ OA with age (OR 1.08; 95% CI 1.03-1.12) and type 2 IRFR (OR 3.07; 95% CI 1.13-8.33). CONCLUSION: Radiographic IRFR, specifically metacarpal IRFR, was associated with the presence of TMCJ OA, and visual IRFR with severe TMCJ OA in both elderly Korean men and women. The results of this study suggest that IRFR might serve as an easily measurable biomarker to identify patients vulnerable to TMCJ OA.

Study on dependence of dose enhancement on cluster morphology of gold nanoparticles in radiation therapy using a body-centred cubic model.

Gold nanoparticles (GNPs) injected in a body for dose enhancement in radiation therapy are known to form clusters. We investigated the dependence of dose enhancement on the GNP morphology using Monte-Carlo simulations and compared the model predictions with experimental data. The cluster morphology was approximated as a body-centred cubic (BCC) structure by placing GNPs at the 8 corners and the centre of a cube with an edge length of 0.22-1.03 µm in a 4 × 4 × 4 µm3 water-filled phantom. We computed the dose enhancement ratio (DER) for 50 and 260 kVp photons as a function of the distance from the cube centre for 12 different cube sizes. A 10 nm-wide concentric shell shaped detector was placed up to 100 nm away from a GNP at the cube centre. For model validation, simulations based on BCC and nanoparticle random distribution (NRD) models were performed using parameters that corresponded to the experimental conditions, which measured increases in the relative biological effect due to GNPs. We employed the linear quadratic model to compute cell surviving fraction (SF) and sensitizer enhancement ratio (SER). The DER is inversely proportional to the distance to the GNPs. The largest DERs were 1.97 and 1.80 for 50 kVp and 260 kVp photons, respectively. The SF predicted by the BCC model agreed with the experimental value within 10%, up to a 5 Gy dose, while the NRD model showed a deviation larger than 10%. The SERs were 1.21 ± 0.13, 1.16 ± 0.11, and 1.08 ± 0.11 according to the experiment, BCC, and NRD models, respectively. We most accurately predicted the GNP radiosensitization effect using the BCC approximation and suggest that the BCC model is effective for use in nanoparticle dosimetry.

Novel method of producing nanoparticles for gadolinium-scintillator-based digital radiography.

Radiation image sensor properties affect the dose of radiation that patients are exposed to in a clinical setting. Numerous radiation imaging systems use scintillators as materials that absorb radiation. Rare-earth scintillators produced from elements such as gadolinium, yttrium, lutetium, and lanthanum have been investigated to improve the properties of radiation imaging systems. Although such rare-earth scintillators are manufactured with a bulk structure, they exhibit low resolution and low efficiency when they are used as conversion devices. Nanoscintillators have been proposed and researched as a possible solution to these problems. According to the research, the optical properties and size of fine scintillators are affected by the sintering temperature used to produce nanoscintillators instead of the existing bulk-structured scintillators. Therefore, the main purpose of this research is to develop radiation-imaging sensors based on nanoscintillators in order to evaluate the quantitative properties of various scintillators produced under various conditions such as sintering temperature. This is accomplished by measuring acquired phantom images, and modulation transfer functions (MTFs) for complementary-symmetry metal-oxide-semiconductor (CMOS) image sensors under the same X-ray conditions. Low-temperature solution combustion was used to produce fine scintillators consisting of 5 wt% of europium as an activator dopant in a Gd2O3 scintillator host. Variations in the characteristics of the fine scintillators were investigated. The characteristics of fine scintillators produced at various sintering temperatures (i.e., 600, 800, or 1000 degrees C) and with a europium concentration of 0.5 wt% were also analyzed to determine the optimal conditions for synthesizing the fine scintillators.

Optimization of nano-phosphor synthesis by including sensitizer doping for medical X-ray imaging.

Medical radiation imaging systems employ phosphors such as CaWO4 as X-ray receptor materials. Unfortunately, the conversion efficiencies of these materials are rather low (approx. 5%). Alternatives that comprise a bulk structure have been fabricated from rare earth metals, but they are not efficient enough to produce high quality images. Nano-phosphors do not suffer from the limitations inherent to the bulk structures of conventional phosphors. We examined the effects of sensitizer doping conditions on the optical characteristics and morphology of the rare earth phosphor Gd2O3:Eu to fabricate a novel type of nano-phosphor. We optimized a temperature solution-combustion procedure for producing phosphors doped with 5 wt% Eu. Scanning electron microscopy images showed that the phosphors were 20-30 nm in diameter and X-ray diffraction analysis revealed that they underwent polycrystalline growth upon the addition of a sensitizer, similar to the polycrystalline growth of bulk phosphors. In addition, the phosphors exhibited a strong peak at 613 nm and luminescence similar to conventional phosphors. Phosphors that were produced using citric acid as a sensitizer showed more than double the level of luminescence and could be used to produce higher quality images compared to non-sensitized phosphors. The phosphors also exhibited a high degree of luminescence stability.

Hierarchically mesoporous-macroporous bioactive glasses scaffolds for bone tissue regeneration.

Hierarchically 2D/3D mesoporous-macroporous bioactive glasses (MMBG) with good molding capabilities and compressive modulus were synthesized by sol-gel method and evaporation-induced self-assembly process in the presence of both nonionic triblock copolymers, EO(70)PO(20)EO(70) (P123) or EO(100)PO(65)EO(100) (F127), templates and methyl cellulose template. P123 or F127 acts as both a template, inducing the formation of mesopore, and an effective dispersant of MC, which produces macropores. In vitro bioactivity studies were carried out in simulated body fluid and showed superior bone-forming bioactivities of hierarchical MMBG. Human osteoblastlike cells, MG63, were seeded on MMBG and were determined using MTT [3-(4,5-dimethylthiazol-2-yl)-2,5,-diphenyl-tetrazolium bromide] assay to confirm biocompatibilities of MMBG.

Atopy and house dust mite sensitization as risk factors for asthma in children.

Asthma is commonly described as an atopic disease in childhood, but some cases of this disorder do not fit this description. The aim of this study was to evaluate the frequency of atopy, asthma, and sensitization to house dust mites in children with allergic symptoms. This study was performed at the Severance Hospital of Yonsei University with patients who visited the allergy clinic for evaluation of nonspecific upper respiratory symptoms, typical symptoms of asthma, or a general health workup. The patients were divided into three age groups: 0-3 years (group 1), 4-7 years (group 2), and 8-12 years (group 3). Of the 1,244 children examined, 844 (67.8%) were atopic and 400 (32.2%) were non-atopic. The frequency of atopy and asthma increased with age. Asthma was diagnosed in the same proportion (64%) of atopic and non-atopic children. As risk factors for asthma symptoms, the positive values of house dust mite (HDM) sensitivity were significantly increased in groups 1, 2, and 3 to 53.5%, 68.9%, and 80.2%, respectively. A significant difference between the percentage of asthmatics sensitized to HDM and that of asthmatics not sensitized to HDM was found only in group 3. In conclusion, asthma is related to atopy with increasing age, and house dust mite sensitization seems to be an important determinant of asthma in older children in Korea.

Chemical, structural properties, and osteoconductive effectiveness of bone block derived from porcine cancellous bone.

The purpose of this study is to determine the efficacy of bioactive calcium phosphate obtained from porcine cancellous bone for the treatment of bone defects and nonunion. Porcine cancellous bone blocks were heat treated at 1300 degrees C for 2 h. The chemical composition, calcium-to-phosphate ratio, and microstructure of the porcine bone blocks were examined. For in vivo implantation, bone defects were created on the anteromedial aspect of the proximal tibia in seven beagle dogs and the xenograft bone blocks were placed into these defects. Plain radiographs were taken at 2-week intervals for roentgenographic evaluation. At 12 weeks, the specimens were stained with hematoxylin and eosin (H&E). The composition and morphology of heat-treated porcine cancellous bone were found to be similar to heat-treated human cancellous bone. Radiographs showed union between the host bone/bone-block interfaces. At 12 weeks, uniform and substantial new bone formation was observed. It is concluded that heat-treated porcine cancellous bone demonstrated effective osteoconductivity. This high-temperature heat-treatment technique has several advantages, including decreased risk of disease transmission and immunoreactivity, while also offering excellent biocompatibility.