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1.
Fam Syst Health ; 2024 Mar 07.
Artículo en Inglés | MEDLINE | ID: mdl-38451708

RESUMEN

INTRODUCTION: Studies in the United States have shown associations between family/shared meal frequency and child health and well-being. Less is known about family/shared meal characteristics (e.g., frequency, meal type, meal activities) in adults and international samples and whether there are protective associations between family/shared meal frequency and emotional well-being. Also unknown, is whether family meals provide protective associations for other family members in the household. METHOD: In a 2022 cross-sectional study, an online survey was administered in the United States, Italy, and Germany. One adult respondent (49.5% female; Mage = 45.6) from each household (n = 1,983) reported on family/shared meals and well-being. A second family member (e.g., partner, child) responded in a subset of households (n = 1,915). Descriptive statistics by country, Spearman correlations between meal frequency and well-being, and Kruskal-Wallis comparisons of mood indicators across countries were run. RESULTS: The majority of adults across countries engaged in six or more family/shared meals per week, with more meals on weekends. Breakfast, lunch, and dinner family/shared meals were more common on weekends, and European countries reported engaging in a higher prevalence of all meal types. Higher frequency of family/shared meals was significantly correlated with fewer depressive symptoms, more connectedness, and higher levels of happiness in adults across countries and in a second household member. DISCUSSION: Family/shared meals were beneficial across an international sample and may provide protective spillover effects for multiple household members. Clinicians and researchers who work with families may want to consider assessing for and intervening on family meal frequency. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

2.
ACS Biomater Sci Eng ; 10(3): 1880-1891, 2024 Mar 11.
Artículo en Inglés | MEDLINE | ID: mdl-38374716

RESUMEN

Giant plasma membrane vesicles (GPMVs) have been utilized as a model to study phase separation in the plasma membrane. Additionally, GPMVs have been employed as vehicle for delivering molecular cargo, including small molecule drugs and nanoparticles. Nearly all examples of GPMV production use a defined salt buffer that is a stark contrast to typical cell culture medium. In this study, we demonstrate that the addition of formaldehyde and dithiothreitol to a standard culture medium was capable of generating GPMVs at a concentration equal to or higher than the traditional production buffer. These methods were evaluated for two human cell lines: kidney endothelial and Schwann cells (SCs). Morphological properties of the resultant GPMVs exhibited no significant differences between the two formulations. Factors such as pH and seeding density significantly influenced the production of GPMVs in both mediums. The cell type and seeding density was shown to influence the number of GPMVs to the greatest extent. SCs yield more GPMVs at higher seeding densities compared to endothelial cells. Stability of the membrane of the GPMVs produced in both mediums was evaluated by monitoring passive diffusion of two fluorescently tagged dextrans (3 and 10 kDa). Regardless of the production formulation or cell type, approximately 85% GPMVs are impermeable to either dextran. Cold storage for on-demand use and shipping are essential for broader use of GPMVs. Toward this aim, we have evaluated the GMPV number and morphologies following storage at -80 °C and in liquid nitrogen. A significant loss of the GPMV number, ∼30%, was observed following storage across production formulations as well as cell types. Our results indicate that smaller GMPVs, <5 µm are more stable for preservation. In conclusion, GPMVs can be produced in a broad range of formulations, exhibit a high degree of stability, and can undergo cold storage for further adoption.


Asunto(s)
Células Endoteliales , Humanos , Línea Celular , Membrana Celular/química , Membrana Celular/metabolismo
3.
ACS Omega ; 8(43): 40442-40455, 2023 Oct 31.
Artículo en Inglés | MEDLINE | ID: mdl-37929081

RESUMEN

To reduce the production cost of chemicals from renewable resources, the feedstock loading must be high and the catalyst must be of low cost and efficient. In this study, at a very short reaction time of 10 min at 125 °C, concentrated sugar solutions (20 wt %, 101 wt % on solvent) were converted to 5-hydroxymethylfurfural (HMF) over a cotton gin trash (CGT)-derived sulfonated carbon catalyst in a 1-butyl-3-methyl-imidazolium chloride ([BMIM]Cl) and 2-methyltetrahydrofuran (MeTHF) biphasic system. We report, for the first time, that the presence of glucose either as a covalently bonded monomer in sucrose or in a mixture with fructose achieved yields of HMF up to 62 mol % compared to a value of only 39 mol % obtained with fructose on its own. In the concentrated reaction medium, glucose, fructose, and sucrose molecules produce difructose anhydrides, dimers/reversion products, and sucrose isomers. The glucose-fructose dimers formed in sucrose and glucose/fructose reaction systems play a critical role in the transformation of the sugars to a higher-than-expected HMF yield. Thus, a strategy of using cellulosic glucose, where it is partially converted to fructose content and the high sugar concentration sugar mixture is then converted to HMF, should be exploited for future biorefineries.

5.
Waste Manag ; 172: 11-24, 2023 Dec 01.
Artículo en Inglés | MEDLINE | ID: mdl-37708808

RESUMEN

Sustainable implementation of thermochemical conversion of biomass to targeted products is dependent on innovations in catalyst design and tuning of structure-property relationships. This study details the use of potassium feldspar (K-feldspar) as a support doped with different iron (Fe) concentrations via wet impregnation (WI) method for hydrothermal liquefaction (HTL) of sugarcane bagasse anaerobic digestate. The Fe/K-feldspar supported catalysts were synthesized and characterized using X-ray diffraction, Inductively Coupled Plasma Optical Emission spectroscopy, Brunauer-Emmet-Teller and Scanning Electron Microscopy analytical methods. Amongst all the catalysts, K-feldspar dopped with 10 wt% Fe (WI-10) was more effective, producing 51.2 wt% bio-crude. The catalyst's activity has been related to the balanced proportion of the microcline: sanidine: haematite (2.8:3.3:1) phases of Fe present on the catalyst, the surface area (porosity), and the surface functionality, thus conferring desirable activity properties. In addition, the WI-10 catalyst had a better selectivity towards substituted phenols that can potentially be used for higher-value applications such as the production of Nylons 6 and 66, and bioplastics. The bio-oil produced with WI-10 has also been demonstrated to be highly stable. The catalyst was reusable up to four times maintaining moderate catalytic performance, and a simple regeneration protocol was shown to restore the activity of the catalyst. The resulting solid residue also exhibited promise as a viable material for use in electrodes for Lithium-ion batteries (LiB). Therefore, this research has demonstrated a promising and sustainable resource recovery strategy for valorising wet biomass wastes into streams of useful products for valuable chemical production and energy application.


Asunto(s)
Fenoles , Saccharum , Celulosa , Hierro , Temperatura , Anaerobiosis , Biomasa , Biocombustibles
6.
Eur Geriatr Med ; 14(2): 285-293, 2023 04.
Artículo en Inglés | MEDLINE | ID: mdl-37002428

RESUMEN

PURPOSE: Pre-operative scores based on patient characteristics are commonly used to predict hip fracture outcomes. Mobility, an indicator of pre-operative function, has been neglected as a potential predictor. We assessed the ability of pre-fracture mobility to predict post-operative outcomes following hip fracture. METHODS: We analysed prospectively collected data from hip fracture surgery patients at a large-volume trauma unit. Mobility was classified into four groups. Post-operative outcomes studied were mortality and residence at 30 days, medical complications within 30- or 60-days post-operatively, and prolonged length of stay (LOS, ≥ 28 days). We performed multivariate regression analyses adjusting for age and sex to assess the discriminative ability of the Nottingham Hip Fracture Score (NHFS), with and without mobility, for predicting outcomes using the area under the receiver operating characteristic curve (AUROC). RESULTS: 1919 patients were included, mean age 82.6 (SD 8.2); 1357 (70.7%) were women. Multivariate analysis demonstrated patients with worse mobility had a 1.7-5.5-fold higher 30-day mortality (p ≤ 0.001), and 1.9-3.2-fold higher likelihood of prolonged LOS (p ≤ 0.001). Worse mobility was associated with a 2.3-3.8-fold higher likelihood of living in a care home at 30-days post-operatively (p < 0.001) and a 1.3-2.0-fold higher likelihood of complications within 30 days (p ≤ 0.001). Addition of mobility improved NHFS discrimination for discharge location, AUROC NHFS 0.755 [0.733-0.777] to NHFS + mobility 0.808 [0.789-0.828], and LOS, AUROC NHFS 0.584 [0.557-0.611] to NHFS + mobility 0.616 [0.590-0.643]. CONCLUSION: Incorporating mobility assessment into risk scores may improve casemix adjustment, prognostication following hip fracture, and identify high-risk patient groups requiring enhanced post-operative care at admission.


Asunto(s)
Fracturas de Cadera , Humanos , Femenino , Anciano de 80 o más Años , Masculino , Medición de Riesgo , Fracturas de Cadera/cirugía , Factores de Riesgo , Curva ROC , Hospitalización
7.
Sci Rep ; 12(1): 19416, 2022 11 12.
Artículo en Inglés | MEDLINE | ID: mdl-36371566

RESUMEN

The current COVID-19 pandemic outbreak poses a serious threat to public health, demonstrating the critical need for the development of effective and reproducible detection tests. Since the RT-qPCR primers are highly specific and can only be designed based on the known sequence, mutation sensitivity is its limitation. Moreover, the mutations in the severe acute respiratory syndrome ß-coronavirus (SARS-CoV-2) genome led to new highly transmissible variants such as Delta and Omicron variants. In the case of mutation, RT-qPCR primers cannot recognize and attach to the target sequence. This research presents an accurate dual-platform DNA biosensor based on the colorimetric assay of gold nanoparticles and the surface-enhanced Raman scattering (SERS) technique. It simultaneously targets four different regions of the viral genome for detection of SARS-CoV-2 and its new variants prior to any sequencing. Hence, in the case of mutation in one of the target sequences, the other three probes could detect the SARS-CoV-2 genome. The method is based on visible biosensor color shift and a locally enhanced electromagnetic field and significantly amplified SERS signal due to the proximity of Sulfo-Cyanine 3 (Cy3) and AuNPs intensity peak at 1468 cm-1. The dual-platform DNA/GO/AuNP biosensor exhibits high sensitivity toward the viral genome with a LOD of 0.16 ng/µL. This is a safe point-of-care, naked-eye, equipment-free, and rapid (10 min) detection biosensor for diagnosing COVID-19 cases at home using a nasopharyngeal sample.


Asunto(s)
Técnicas Biosensibles , COVID-19 , Nanopartículas del Metal , Humanos , SARS-CoV-2/genética , Oro , Pandemias , COVID-19/diagnóstico , Técnicas Biosensibles/métodos , Genoma Viral/genética , ADN , ARN Viral/genética
8.
Foods ; 11(14)2022 Jul 21.
Artículo en Inglés | MEDLINE | ID: mdl-35885414

RESUMEN

The clarification of sugarcane juice is a crucial stage in the sugar manufacturing process, as it affects evaporator performance, sugar quality and yield. The emergence of environmentally friendly and efficient adsorption technology has resulted in widespread interest in carbon-based materials. However, their low adsorption capacity and reusability make them unsuitable for processing sugarcane juice. Here, we provide a cost-effective and sustainable method to dope hydroxyapatite (HAP) nanoparticles on porous carbon (BBC) derived from sugarcane bagasse (BBC-HAP). The composite shows excellent adsorption capacity for color extract from sugarcane juice of 313.33 mg/g, far more effective than the commercially available carbon-based adsorbents. Isotherm studies show that the adsorption of BBC-HAP composite to the colorants is a monolayer process. The pseudo-first-order (PFO) and pseudo-second-order (PSO) kinetic models demonstrate that the adsorption process is dominated by chemisorption and supplemented by physical adsorption.

9.
Fam Process ; 61(3): 1195-1207, 2022 09.
Artículo en Inglés | MEDLINE | ID: mdl-35388908

RESUMEN

This study examined the prevalence of relationship undermining statements by psychotherapists as reported by clients in individual therapy who presented with relationship problems, and whether these statements were associated with worse outcomes for client relationships. Participants (n = 101) reported on recollections of whether their therapist had suggested that their partner would never change, had a diagnosable personality/mental health disorder, had negative motives, that the relationship was doomed from the start or beyond repair now, or that divorce/breakup was their best option. Findings showed high prevalence of these undermining statements and associations with poorer relationship outcomes and shorter duration of therapy. We discuss potential explanations for this phenomenon and offer implications for the training of therapists who treat individual clients with relationship problems.


Asunto(s)
Trastornos Mentales , Psicoterapeutas , Humanos , Trastornos Mentales/terapia , Motivación , Relaciones Profesional-Paciente , Psicoterapia
10.
Bioresour Technol ; 352: 127112, 2022 May.
Artículo en Inglés | MEDLINE | ID: mdl-35381335

RESUMEN

Solid state anaerobic digestion (SS-AD) of lignocellulose is effective in improving biomethane productivity but is limited by low biomass digestibility and lack of substrate-specific working microorganisms. In this study, the effects of different pretreatment methods on biomethane production by SS-AD of sugarcane trash were studied. The biomethane production, fitted to a modified Gompertz's model, predicted a maximum methane yield of 214.2 L/kg volatile solids (VS) and productivity of 6.9 L/kg VS/day from KOH-pretreated trash, respectively. Microbial community analysis showed that bacterial community was significantly associated with volatile acids and pretreatment types while archaeal community was significantly associated with methane yield. Microbial community dynamics was revealed in SS-AD. Main genera related to pretreatment method were identified and discussed. This study generated important information on SS-AD of lignocellulosic biomass pretreated by different methods, which is useful for developing bioaugmentation strategies to improve biomethane production by SS-AD.


Asunto(s)
Microbiota , Saccharum , Anaerobiosis , Biocombustibles , Reactores Biológicos , Grano Comestible , Cinética , Metano
11.
Waste Manag ; 140: 110-120, 2022 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-35078075

RESUMEN

This study aims to identify suitable processing conditions for converting pyrolytic solid residue from off-the-road tyres (OTR) to improve carbon materials properties that can be used in multiple applications and the recovery of minerals from OTR. Pyrolysis of OTR at 800 °C and a heating rate 2 °C.min-1 gave a carbon material with the highest surface area, most defective carbon structures, and the highest micro-porosity. This operating condition was used to compare the conventional three-step carbonization approach, which involves a demineralization stage that produces high volumes of toxic wastewater, with a two-step approach that bypasses this stage. Analysis of the carbon structures showed that the quality of the carbon material from the two-step approach is similar to the three-step approach. This two-step approach resulted in a solid and a liquid phase, in which âˆ¼ 93.4% of Zn was selectively fractionated to the liquid phase. The wastewater from the acid wash of the carbonized OTR was neutralized to recover the SiO2, of which 55.5% was reactive SiO2. The SiO2 was found to have an exceptionally high cross-linking ratio of 5.94, achievable only when SiO2 is reacted with silane groups. The study demonstrated that the engineered carbon material from OTR has a H2 uptake of 1.03 wt% at 77 K and 1.2 bar, and the sulfonated counterpart was an effective catalyst (64% conversion) for the Aldol condensation of levunilic acid to two dimer products [tetrahydro-2- methyl-5,γ-dioxo-2-furanpentanoic acid (TMDFA) and 3-(2-methyl-5-oxo- tetrahydrofuran-2-yl)-4-oxopentanoic acid (MOTOA)] that are precursors for fuels and chemicals.


Asunto(s)
Carbono , Silanos , Dióxido de Silicio , Zinc
12.
J Marital Fam Ther ; 48(2): 411-426, 2022 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33864390

RESUMEN

We present two related studies on confiding about relationships among African Americans. Study one examined how African Americans serve as confidants in their social networks for people having couple relationship concerns. Using a national survey of African American adults, this study documented the prevalence of confiding relationships, the kinds of problems brought to confidants, and which confidant behaviors are seen as helpful and not helpful. Study two was a randomized controlled trial of Marital First Responders-AA, a culturally adapted version of the Marital First Responders program. Results showed improved skills among African Americans participants who were already natural confidants, as well greater frequency of confiding interactions in their social networks. Enhancing the abilities of natural confidants may be particularly important in the African American community because of stresses on couple relationships and the relatively lower use of therapy services.


Asunto(s)
Negro o Afroamericano , Matrimonio , Adulto , Humanos , Red Social
13.
Bioorg Med Chem ; 46: 116369, 2021 09 15.
Artículo en Inglés | MEDLINE | ID: mdl-34482229

RESUMEN

SNM1A is a zinc-dependent nuclease involved in the removal of interstrand crosslink lesions from DNA. Inhibition of interstrand crosslink repair enzymes such as SNM1A is a promising strategy for improving the efficacy of crosslinking chemotherapy drugs. Initial studies have demonstrated the feasibility of developing SNM1A inhibitors, but the full potential of this enzyme as a drug target has yet to be explored. Herein, the synthesis of a family of squaramide- and thiosquaramide-bearing nucleoside derivatives and their evaluation as SNM1A inhibitors is reported. A gel electrophoresis assay was used to identify nucleoside derivatives bearing an N-hydroxysquaramide or squaric acid moiety at the 3'-position, and a thymidine derivative bearing a 5'-thiosquaramide, as candidate SNM1A inhibitors. Quantitative IC50 determination showed that a thymidine derivative bearing a 5'-thiosquaramide was the most potent inhibitor, followed by a thymidine derivative bearing a 3'-squaric acid. UV-Vis titrations were carried out to evaluate the binding of the (thio)squaramides to zinc ions, allowing the order of inhibitory potency to be rationalised. The membrane permeability of the active inhibitors was investigated, with several compounds showing promise for future in vivo applications.


Asunto(s)
Enzimas Reparadoras del ADN/antagonistas & inhibidores , Inhibidores Enzimáticos/farmacología , Quinina/análogos & derivados , Enzimas Reparadoras del ADN/metabolismo , Relación Dosis-Respuesta a Droga , Inhibidores Enzimáticos/síntesis química , Inhibidores Enzimáticos/química , Humanos , Estructura Molecular , Quinina/síntesis química , Quinina/química , Quinina/farmacología , Relación Estructura-Actividad
14.
Foods ; 10(7)2021 Jul 05.
Artículo en Inglés | MEDLINE | ID: mdl-34359431

RESUMEN

The development of volatile compounds and their precursors during the dehydration process of membrane-clarified sugarcane juice to non-centrifugal sugar (NCS) was investigated. Head-space solid phase microextraction/gas chromatography-mass spectrometry (HS-SPME/GC-MS) coupled with chemometrics was employed to assess the differences at the various stages of the dehydration process. A total of 111 volatile compounds were identified, among which 57 were endogenous compounds from sugarcane juice and displayed an attenuated abundance in the first 30 min. Typical oxygen and nitrogen heterocyclic compounds, including furans and pyrazines, and aldehydes derived were found to be the main volatiles contributing to the formation of NCS characteristic aroma, with phenols, alcohols, esters, acids, and sulfur compounds as supplementary odor. Free amino acids and reducing sugars were identified as important precursors for the aroma development process. The low temperature (90-108 °C) and micro vacuum condition (-0.03 MPa) approach used in this study could be an alternative option for the manufacture of NCS.

15.
Micromachines (Basel) ; 12(6)2021 Jun 19.
Artículo en Inglés | MEDLINE | ID: mdl-34205255

RESUMEN

The environmental crisis, due to the rapid growth of the world population and globalisation, is a serious concern of this century. Nanoscience and nanotechnology play an important role in addressing a wide range of environmental issues with innovative and successful solutions. Identification and control of emerging chemical contaminants have received substantial interest in recent years. As a result, there is a need for reliable and rapid analytical tools capable of performing sample analysis with high sensitivity, broad selectivity, desired stability, and minimal sample handling for the detection, degradation, and removal of hazardous contaminants. In this review, various gold-carbon nanocomposites-based sensors/biosensors that have been developed thus far are explored. The electrochemical platforms, synthesis, diverse applications, and effective monitoring of environmental pollutants are investigated comparatively.

16.
J Frailty Sarcopenia Falls ; 6(2): 66-78, 2021 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-34131603

RESUMEN

OBJECTIVES: Risk stratification scores are used in hip fracture surgery, but none incorporate objective tests for low muscle strength. Grip strength testing is simple and cheap but not routinely assessed for patients with hip fracture. This project aimed to assess the feasibility of implementing grip strength testing into admission assessment of patients with hip fracture. METHODS: A scalable protocol and a corresponding training programme of instructional presentations and practical assessments were designed and delivered by and for physiotherapy staff. Grip strength values were collected pre-surgery on patients with hip fracture at a single centre whilst supine in bed. Implementation of the process was evaluated using narrative, quantitative and cost measures. RESULTS: 53 hip fracture patients with a mean age 80.6 (SD 10.4), of which 36 (67.9%) were female, were included. Testing was offered to 42/52 (81%) patients. Cognitive impairment prevented 14/42 (33%) of patients from completing testing; one patient declined testing. Of the 27 patients who completed testing, 14/27 (52%) had low grip strength as defined by EWGSOP2 criteria. The projected cost of testing for one year was £2.68-£2.82 per patient. Fidelity to the protocol was high using multiple criteria. CONCLUSIONS: Grip strength assessment is acceptable to physiotherapy staff and can be rapidly and cost-effectively implemented into hip fracture admission assessment.

17.
Environ Sci Pollut Res Int ; 28(28): 37867-37881, 2021 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-33723770

RESUMEN

It is well established that pretreatment of lignocellulosic biomass is required to achieve an effective enzymatic saccharification process. At the present time, most of the touted pre-treatment technologies would cause environmental pollution and unsustainable water use for the pretreated material prior to enzymatic saccharification. To address these shortcomings, the pretreatment technology which combines the supercritical CO2, SC-CO2 (a green solvent), acetic acid, and steam explosion was used to assess the pretreatment of wheat straw for enzymatic saccharification. The effects of solvent concentration, impregnation temperature and time, pre-treatment time, and temperature, as well as SC-CO2 pressure, contact time, and temperature, were evaluated. The results identified that at the optimum SC-CO2 pressure of 18 MPa, the highest amount of reducing sugars (RS) was produced from the cellulosic pulp using Acetic acid/Steam/SC-CO2 at 200 °C for 30 min, a value 20% more than the pulp produced with the Water/Steam/SC-CO2. The effectiveness of the pretreatment process was attributed not only to delignification and defibrillation but also to the exposure of the cellulose structure evidenced from the proportion of the ß-glycosidic linkages as shown by FTIR. Passing SC-CO2 after the pretreatment reduces the amounts of fermentation inhibitors and eliminates the use of wash water.


Asunto(s)
Vapor , Triticum , Ácido Acético , Dióxido de Carbono , Hidrólisis , Lignina
18.
J Marital Fam Ther ; 47(4): 882-890, 2021 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-33411353

RESUMEN

A widely cited but poorly supported idea in the couples therapy field is that the average couple waits six years before starting therapy for serious relationship problems. This figure is often accompanied by the notion that many couples come "too late" and have poor prospects for recovery. This is the first large-sample study on the delay between the onset of serious marital problems and entry into couples therapy (N = 270) and individual therapy (N = 101) for relationship problems. We found an average interval of 2.68 years from onset of problems and entering couples therapy, with the great majority of couples entering therapy within two years. Findings were similar for seeking individual therapy for relationship problems. The main clinical implication is that therapists have little reason to be pessimistic about the majority of couples waiting so long before starting therapy that their problems are not resolvable.


Asunto(s)
Terapia de Parejas , Conflicto Familiar , Humanos
19.
Bioresour Technol ; 319: 124137, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-32971334

RESUMEN

Biomethane production was systematically evaluated with sugarcane trash pretreated by liquid hot water (LHW), dilute acid (DA) and KOH solutions. Multiple linear regression analysis identified glucan in pretreated solid residue as well as C5 sugars and acetic acid in pretreatment hydrolysate as the key parameters affecting biomethane potentials. Moreover, biomethane production was best simulated using Chen & Hashimoto model with a predicted highest methane yield of 187 mL/g initial total solids (TS) based on LHW (130 °C for 15 min) and KOH (10% on trash, 150 °C for 60 min) pretreatments. KOH pretreatment led to a biomethane yield of 167 mL/g initial TS at day 25, 82%, 34% and 33% higher than those achieved with untreated and pretreated trash samples with optimal LHW and DA conditions, respectively. This study led to the identification of best kinetic model and pretreatment condition for biomethane production from sugarcane trash through a systematic evaluation.


Asunto(s)
Saccharum , Glucanos , Cinética , Metano , Agua
20.
J Am Med Dir Assoc ; 22(3): 663-669.e2, 2021 03.
Artículo en Inglés | MEDLINE | ID: mdl-32893139

RESUMEN

OBJECTIVES: Independent validation of risk scores after hip fracture is uncommon, particularly for evaluation of outcomes other than death. We aimed to assess the Nottingham Hip Fracture Score (NHFS) for prediction of mortality, physical function, length of stay, and postoperative complications. DESIGN: Analysis of routinely collected prospective data partly collected by follow-up interviews. SETTING AND PARTICIPANTS: Consecutive hip fracture patients were identified from the Northumbria hip fracture database between 2014 and 2018. Patients were excluded if they were not surgically managed or if scores for predictive variables were missing. METHODS: C statistics were calculated to test the discriminant ability of the NHFS, Abbreviated Mental Test Score (AMTS), and American Society of Anesthesiologists (ASA) grade for in-hospital, 30-day, and 120-day mortality; functional independence at discharge, 30 days, and 120 days; length of stay; and postoperative complications. RESULTS: We analyzed data from 3208 individuals, mean age 82.6 (standard deviation 8.6). 2192 (70.9%) were female. 194 (6.3%) died during the first 30 days, 1686 (54.5%) were discharged to their own home, 211 (6.8%) had no mobility at 120 days, 141 (4.6%) experienced a postoperative complication. The median length of stay was 18 days (interquartile range 8-28). For mortality, C statistics for the NHFS ranged from 0.68 to 0.69, similar to ASA and AMTS. For postoperative mobility, the C statistics for the NHFS ranged from 0.74 to 0.83, similar to AMTS (0.61-0.82) and better than the ASA grade (0.68-0.71). Length of stay was significantly correlated with each score (P < .001 by Jonckheere-Terpstra test); NHFS and AMTS showed inverted U-shaped relationships with length of stay. For postoperative complications, C statistics for NHFS (0.54-0.59) were similar to ASA grade (0.53-0.61) and AMTS (0.50-0.58). CONCLUSIONS AND IMPLICATIONS: The NHFS performed consistently well in predicting functional outcomes, moderately in predicting mortality, but less well in predicting length of stay and complications. There remains room for improvement by adding further predictors such as measures of physical performance in future analyses.


Asunto(s)
Fracturas de Cadera , Anciano de 80 o más Años , Femenino , Fracturas de Cadera/cirugía , Humanos , Tiempo de Internación , Alta del Paciente , Complicaciones Posoperatorias/epidemiología , Estudios Prospectivos , Estudios Retrospectivos , Factores de Riesgo
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