Fracture Index Research Articles

Frailty transition and burden on mortality risk in middle-aged and older population: a prospective cohort study

The effect of frailty transition and burden on the risk of all-cause mortality in South Korea remains unclear. This study aimed to investigate the risk of all-cause mortality using the most recent frailty index (FI), changes in FI, and frailty burden. We analyzed data from the Korean Genome and Epidemiology Study (2013–2020). A total of 3,134 participants aged 53–87 years with a computable FI based on the osteoporotic fracture index during their initial visit. The FI was updated biennially during re-examinations and changes between the initial and last visits were categorized into four groups: (1) improved or maintained to non-frail, (2) worsened to pre-frail, (3) improved or maintained to pre-frail, and (4) worsened or maintained to frail. We used the Cox proportional hazards model, adjusted for age, sex, education, lifestyle factors, and diseases. During the follow-up, 218 participants died. Compared to those who were robust at the last visit, pre-frailty and frailty were associated with an increased risk of all-cause death. Of those who visited > 2 times, 62.3% improved or remained robust, and had a decreased risk of all-cause death. Those with > 63% of pre-frailty or frailty burden significantly higher risk of death, with > 60% increase compared to their non-frail counterparts. Maintaining or achieving robustness is associated with a decreased risk of mortality. To prevent premature death and extend healthy life expectancy, identifying biological aging through surrogate measures and implementing interventions to maintain or achieve a robust health status are needed.

A novel method for evaluating shale gas preservation conditions in an area on a regional scale

The Youjiang Basin is the main area of the Middle Devonian shale gas resources in southern China, with complex geological conditions, diverse stratigraphic structures, low level of exploration and limited hydrocarbon geological data. In this study, a method is proposed for evaluating the regional shale gas preservation conditions, by which it is easy to obtain information (using available data from regional geological maps) and to process data (processed by computer software). This method was applied to the evaluation of the preservation conditions of the Middle Devonian shale gas in the Youjiang Basin. Information extracted from geologic maps includes exposed stratum, magmatic rock distribution, stratigraphic occurrence and surface fracture distribution. Evaluation criteria for three indexes (stratigraphy index, dip angle index and fracture index) were established to classify the preservation conditions into five types from good to bad. Based on the calculated values of comprehensive index (CI), the comprehensive evaluation each area: 11621.23 km2 for CI of 0.7–1.0, 37162.67 km2 for CI of 0.5–0.7, 57784.43 km2 for CI of 0.3–0.5, 69303.77 km2 for CI of 0.1–0.3, and 69303.77 km2 for CI of 0.0–0.1, accounting for 3.19%, 10.19%, 15.84%, 18.99% and 51.80% of the whole area, respectively. These results are highly consistent with the actual exploration discoveries, showing that in the northern and central parts of the Guizhong Basin, the southern part of the Xidamingshan Uplift, and the northern part of the Qiannan Basin, there are large areas with good shale gas preservation conditions.

The Gas Production Characteristics of No. 3 Coal Seam Coalbed Methane Well in the Zhengbei Block and the Optimization of Favorable Development Areas

The characteristics and influencing factors of gas production in CBM wells are analyzed based on the field geological data and the productivity data of coalbed methane (CBM) wells in the Zhengbei block, and then the favorable areas are divided. The results show that the average gas production of No. 3 coal seam CBM wells in the study area is in the range of 0~1793 m3/d, with an average of 250.97 m3/d; 80% of the wells are less than 500 m3/d, and there are fewer wells above 1000 m3/d. The average gas production is positively correlated with gas content, critical desorption pressure, permeability, Young’s modulus, and Schlumberger ratio, and negatively correlated with fracture index, fault fractal dimension, Poisson’s ratio, and horizontal stress difference coefficient. The relationship between coal seam thickness and the minimum horizontal principal stress is not strong. The low-yield wells have the characteristics of multiple pump-stopping disturbances, unstable casing pressure control, overly rapid pressure reduction in the single-phase flow stage, sand and pulverized coal production, and high-yield water in the later stage during the drainage process. It may be caused by the small difference in compressive strength between the roof and floor and the coal seam, and the small difference in the Young’s modulus of the floor. The difference between the two high-yield wells is large, and the fracturing cracks are easily controlled in the coal seam and extend along the level. The production control factors from strong to weak are as follows: critical desorption pressure, permeability, Schlumberger ratio, fault fractal dimension, Young’s modulus, horizontal stress difference coefficient, minimum horizontal principal stress, gas content, Poisson’s ratio, fracture index, coal seam thickness. The type I development unit (development of favorable areas) of the Zhengbei block is interspersed with the north and south of the block on the plane, and the III development unit is mainly located in the east of the block and near the Z-56 well. The comprehensive index has a significant positive correlation with the gas production, and the prediction results are accurate.

Assessing the Clinical Effectiveness of an Exergame-Based Exercise Training Program Using Ring Fit Adventure to Prevent and Postpone Frailty and Sarcopenia Among Older Adults in Rural Long-Term Care Facilities: Randomized Controlled Trial.

Frailty and sarcopenia are geriatric syndromes of increasing concern and are associated with adverse health outcomes. They are more prevalent among long-term care facility (LTCF) users than among community dwellers. Exercise, especially multicomponent and progressive resistance training, is essential for managing these conditions. However, LTCFs, particularly in rural areas, face challenges in implementing structured exercise programs due to health care professional shortages. Moreover, older adults often become bored with repetitive exercise training and may lose interest over time. The Nintendo Switch Ring Fit Adventure (RFA) exergame is a novel exergame that combines resistance, aerobic, and balance exercises and offers a potential solution by boosting motivation in an immersive manner and reducing staff intervention needs. We aimed to evaluate the clinical effectiveness of an exergame-based exercise training program delivered via RFA (exergame-RFA) in improving muscle mass and functional performance among older adult LTCF users. This was a randomized controlled trial conducted from August 2022 to September 2023 and involved older adult LTCF users (aged ≥60 y) in rural southern Taiwan. Participants were randomized into an intervention group (exergame-RFA plus standard care) or a control group (standard care alone). The intervention, conducted seated with arm fit skills and trunk control exercises using the RFA, lasted 30 minutes twice weekly over 12 weeks. The primary outcomes measured were the Study of Osteoporotic Fractures index (serving as an indicator of frailty status) and the diagnostic criteria for sarcopenia (appendicular skeletal muscle mass index, handgrip strength, and gait speed). The secondary outcomes included functional performance (box and block test as well as maximum voluntary isometric contraction of the dominant upper extremity), muscle condition (muscle thickness measured using ultrasonography), activities of daily living (Kihon checklist), health-related quality of life (Short Form Health Survey-36), and cognitive function (brain health test). We used an intention-to-treat analysis, incorporating a simple imputation technique in statistical analysis. A mixed ANOVA, with time as a within-participant factor and intervention as a between-participant factor, was used to compare the training effects on outcomes. We recruited 96 individuals, of whom 60 (62%) underwent randomization. Of these 60 participants, 55 (92%) completed the study. Significant group×time interactions were observed in the intervention group in all primary outcomes (all P<.001, except P=.01 for handgrip strength) and most secondary outcomes, including maximum voluntary isometric contraction of the biceps (P=.004) and triceps brachii (P<.001) muscles, biceps muscle thickness measured using ultrasonography (P<.001), box and block test (P<.001), Kihon checklist (physical function: P=.01, mood status: P=.003, and total: P=.003), and brain health test (P<.001). The exergame-RFA intervention significantly improved muscle mass, strength, and functional performance among older adult users of rural LTCFs, offering a novel approach to addressing frailty and sarcopenia. ClinicalTrials.gov NCT05360667; https://clinicaltrials.gov/study/NCT05360667. RR2-10.3389/fmed.2022.1071409.

Evaluation of the Hydraulic Fracturing Tendencies of Consolidated Sandstone Reservoirs Based on the Catastrophe Theory

The evaluation of rock hydraulic fracturing tendency plays a crucial role in the selection of fracturing layers within reservoirs and the evaluation of post-compression capacity. The sandstone reservoirs in the Yihuang New Area have poor physical properties and are deeply buried. It is necessary to increase the production of oil and gas by hydraulic fracturing. Regarding the sandstones in the region, the following parameters were considered: combined compressive strength, bulk modulus, shear modulus, fracture index, horizontal-stress difference coefficient, and fracture toughness. In accordance with the catastrophe theory, a multi-level structure was established for the hydraulic fracturing-tendency evaluation of sandstone reservoirs, consisting of a target layer, a guide layer, and an indicator layer. A catastrophic model for evaluating the hydraulic fracturing tendency of sandstone reservoirs was established. The results are consistent with those obtained from the Analytic Hierarchy Process. However, the catastrophe theory significantly reduces subjective interference. The results indicate that when the hydraulic fracturing-tendency evaluation value is greater than 0.8, the reservoir can be fractured well; when the hydraulic fracturing-tendency evaluation value is between 0.7 and 0.8, the fracture reservoir is moderate; and when the hydraulic fracturing-tendency evaluation value is less than 0.7, the fractured reservoir is poor. The optimal fracture intervals for the Yi 70 well are 1320–1323 m, 1350–1355 m, and 1355–1360 m. The optimal fracture planes for the Yi 76 well are 1921–1925 m and 1925–1930 m. The optimal fracture planes for the Yi 10-1-26 well are 2487–2495 m, 2585–2587 m, and 2589–2591 m. The hydraulic fracturing-tendency model developed in this study has been applied to several well sections of sandstone reservoirs in the Yihuang New Area. Additionally, the model was compared with existing hydraulic fracturing-tendency evaluation models. The evaluation results are in agreement with the post-pressure capacity-monitoring data. The accuracy of the model presented in this study has been verified, as has its applicability to other sandstone reservoirs.

Experimental Investigation of Water Vapor Concentration on Fracture Properties of Asphalt Concrete.

The effect of moisture on the fracture resistance of asphalt concrete is a significant concern in pavement engineering. To investigate the effect of the water vapor concentration on the fracture properties of asphalt concrete, this study first designed a humidity conditioning program at the relative humidity (RH) levels of 2%, 50%, 80%, and 100% for the three types of asphalt concrete mixtures (AC-13C, AC-20C, and AC-25C).The finite element model was developed to simulate the water vapor diffusion and determine the duration of the conditioning period. The semi-circular bending (SCB) test was then performed at varying temperatures of 5 °C, 15 °C, and 25 °C to evaluate the fracture energy and tensile strength of the humidity-conditioned specimens. The test results showed that the increasing temperature and the RH levels resulted in a lower peak load but greater displacement of the mixtures. Both the fracture energy and tensile strength tended to diminish with the rising temperature. It was also found that moisture had a significant effect on the tensile strength and fracture energy of asphalt concrete. Specifically, as the RH level increased from 2% to 100% (i.e., the water vapor concentration rose from 0.35 g/m3 to 17.27 g/m3), the tensile strength of the three types of mixtures was reduced by 34.84% on average, which revealed that the water vapor led to the loss of adhesion and cohesion within the mixture. The genetic expression programming (GEP) model was developed to quantify the effect of water vapor concentrations and temperature on the fracture indices.

Shaking table test-based numerical study on post-buckling ULCF fracture behavior of partially concrete filled steel tubular piers

Steel structures may undergo local buckling deformation or ultra-low cycle fatigue (ULCF) fracture due to stress concentration under earthquake excitations, and the stress concentration may further develop after buckling deformation, thus leading to ULCF fracture. To investigate the post-buckling fracture behavior of partially concrete-filled steel tube (PCFST) piers under earthquake exactions, a new ULCF analysis method that integrates three fracture indexes of cyclic void growth model (CVGM) was proposed in this study based on a shaking table test of PCFST piers, and then the index for quantifying the buckling deformation of PCFST piers was developed to study the post-buckling ULCF mechanism. Finally, the effect of each design parameter on the ULCF fracture index was analyzed. The results indicate that all three indexes of CVGM can accurately predict the triggering time, crack location, and crack propagation of ULCF fracture after buckling. The failure mechanism of PCFST bridge piers experiencing post-buckling fracture is also revealed, i.e., under repeated lateral loads, the plastic hinge region at the pier bottom bulges, causing an expansion of the plastic region. Meanwhile, the cumulative rate of ULCF damage rapidly increases during the expansion process and slows down after the bulge reaches the maximum stable value until the cumulative damage value meets the fracture condition. In addition, the results of the parametric analyses indicate that the model with high ductility can undergo a greater number of cycles before localized instability failure, and thus is more likely to suffer ULCF fracture first.

Stress based fracture criteria for mixed-mode I/II delamination of unidirectional composite laminates

Mixed mode delamination is prone to occur in composite laminates subjected to complicated loading. In current study, the modified maximum principal stress (M-MPS) criterion and the modified maximum shear stress (M-MSS) criterion considering the effect of mode ratio on the critical distance are developed to predict the mixed mode delamination of unidirectional laminates. The accuracy of the proposed fracture criteria is validated by the comparison of the predicted fracture locus curve with extensive experimental data available in the literatures, a higher correlation is observed between the predicted results and the experimental data. Finally, comprehensive discussion on the capability of the proposed M-MPS and M-MSS criteria is conducted, a dimensionless parameter named fracture index composed of the difference of elastic properties and the difference of pure mode fracture toughness is proposed to reveal the fracture mechanisms of the unidirectional composites.

Groundwater vulnerability and risk assessment coupled with hydrogeochemical analysis in the Taza aquifer (Morocco)

This study assesses the vulnerability of aquifers to increased contamination, influenced by rapid peri-urbanization and deficient sanitary infrastructure. The research focuses on the Taza aquifer in northeastern Morocco, where we applied the DRASTIC and GOD models. We further enhanced the DRASTIC method by the addition of a Fracture Index (F) ‘’DRASTICF‘’ to incorporate the effects of tectonics and geological discontinuities on groundwater behavior. The vulnerability mapping was performed for two distinct dry and wet periods of 2016 and 2021 respectively. Moreover, the use of hydrogeochemical analysis of 22 groundwater samples helped to identify potential sources of pollution and to understand the hydrogeological process. The results indicate a dynamic in vulnerability between these two periods due to changes in the recharge parameter and groundwater depth. The comparison between obtained vulnerability maps and nitrate concentrations reveals vulnerable zones that closely resemble regions affected by nitrate pollution. This area is predominantly classified as of high vulnerability at 27 %, associated with an estimated pollution level of 36%. The findings underscore also the importance of integrating the fracture index into the assessment of aquifer vulnerability alongside the different models. This integration offers an enriched perspective for effectively managing risks associated with groundwater contamination. The risk maps of groundwater contamination were also established by overlapping the vulnerability map with the land use layer. The main hydrogeochemical facies determined in the Piper Diagram allowed classifying the waters as Ca–Mg–HCO3 type. The significant correlations indicated that groundwater mineralization in the study area originates from the dissolution of limestone and evaporated formations. The water quality within the study area shows substantial variability, ranging from excellent to unsuitable, primarily due to the leaching of fertilizers and wastewater.The different results can be very helpful to the farmers, and local authorities for better groundwater sustainable management.

Basic characterization of three kinds of bio-asphalt and research on the low-temperature performance of bio-asphalt mixtures

Bio-oil is a by-product of waste biomass treatment using high-pressure liquefaction, bio-enzymatic, or high-temperature thermal cracking techniques, and can alleviate the shortage of petroleum asphalt resources. This study investigated the production of bio-oil from selected raw materials, including corn stover, castor oil from castor beans, and epoxy vegetable oil from soybeans for the preparation of bio-asphalt. The properties and mechanisms of modification of the three modified bio-asphalts were explored by assessment of basic physical properties, gel permeation chromatography (GPC), temperature scanning (DSR), and thermogravimetric analysis, as well as Semi-Circular Bending (SCB), low-temperature bending, and fatigue tests. Bio-oil was found to improve the low-temperature cracking resistance of the asphalt mixtures, with the improvement further enhanced by changing the blending amount. The bio-oil was observed to negatively affect the low-temperature fatigue performance of the mixes, and the decrease in the n-value indicated that the bio-oil could make the asphalt mixtures less stress-sensitive under repeated loading, with improved anti-fatigue performance of bio-asphalt mixtures observed when the stress ratio was 0.5. Finally, the low-temperature cracking performance index of the corn stover bio-asphalt mixtures was correlated with the gray entropy. The use of the SCB fracture index was found to be more appropriate when using the semicircular bending test to characterize the low-temperature cracking performance of bio-asphalt mixtures.

Evaluation of fracture indices of warm mix asphalt (WMA) modified with nano-additive under pure shear and pure tear deformations

Cracks located on the road edge and curve are two pavement crack types that can reduce road safety. Providing a solution to control this type of crack can solve a large part of the concern in this case. This study innovatively bridges the research gap by evaluating the efficacy of nano-reduced graphene oxide powder (NRGOP) in enhancing the fracture resistance of warm mix asphalt (WMA) under various environmental conditions, a critical aspect previously unexplored in the pavement engineering literature. For this goal, asphalt mixtures containing different ratios of NRGOP were constructed. Then, a level of aging and damage induced by freeze–thaw were applied to the semicircular bend (SCB) and edge-notched disc bend (ENDB) specimens to understand how the changes in fracture strength, fracture crispiness, and fracture stiffness are under modes III and II (at + 15 °C and −15 °C). The finding revealed that the introduction of NRGOP increased the fracture properties of WMA mixtures, such as fracture energy (FEII or FEIII) and fracture toughness (KIIC or KIIIC), as well as fracture stiffness under pure shear and pure tear deformations. Laboratory findings at low temperatures showed that it is necessary to investigate KIIC and FEII for asphalt mixtures under non-conditions and freeze–thaw conditions. However, KIIC and FEIII were suggested for aging conditions. Therefore, in two-thirds of the results, FEII was critical, and in 100 % results, KIIIC was critical. At + 15 °C, KIIC and FEIII were more crucial for non-treated and freeze–thaw conditions, while KIIC and FEII were more critical for aging, respectively. Therefore, in two-thirds of the results, FEIII was critical, and in 100 % results, KIIC was critical. The results of this research provide insights to advance the socio-economics of pavements by controlling surface cracks in tropical and subtropical regions, which in turn increases ride quality, driver safety, and pavement maintenance costs.

Development and validation of machine learning models to predict frailty risk for elderly.

Early identification and intervention of the frailty of the elderly will help lighten the burden of social medical care and improve the quality of life of the elderly. Therefore, we used machine learning (ML) algorithm to develop models to predict frailty risk in the elderly. A prospective cohort study. We collected data on 6997 elderly people from Chinese Longitudinal Healthy Longevity Study wave 6-7 surveys (2011-2012, 2014). After the baseline survey in 1998 (wave 1), the project conducted follow-up surveys (wave 2-8) in 2000-2018. The osteoporotic fractures index was used to assess frailty. Four ML algorithms (random forest [RF], support vector machine, XGBoost and logistic regression [LR]) were used to develop models to identify the risk factors of frailty and predict the risk of frailty. Different ML models were used for the prediction of frailty risk in the elderly and frailty risk was trained on a cohort of 4385 elderly people with frailty (split into a training cohort [75%] and internal validation cohort [25%]). The best-performing model for each study outcome was tested in an external validation cohort of 6997 elderly people with frailty pooled from the surveys (wave 6-7). Model performance was assessed by receiver operating curve and F2-score. Among the four ML models, the F2-score values were similar (0.91 vs. 0.91 vs. 0.88 vs. 0.90), and the area under the curve (AUC) values of RF model was the highest (0.75), followed by LR model (0.74). In the final two models, the AUC values of RF and LR model were similar (0.77 vs. 0.76) and their accuracy was identical (87.4% vs. 87.4%). Our study developed a preliminary prediction model based on two different ML approaches to help predict frailty risk in the elderly. The presented models from this study can be used to inform healthcare providers to predict the frailty probability among older adults and maybe help guide the development of effective frailty risk management interventions. Detecting frailty at an early stage and implementing timely targeted interventions may help to improve the allocation of health care resources and to reduce frailty-related burden. Identifying risk factors for frailty could be beneficial to provide tailored and personalized care intervention for older adults to more accurately prevent or improve their frail conditions so as to improve their quality of life. The study has adhered to STROBE guidelines. No patient or public contribution.

Analysis of the Most Popular Online Ankle Fracture-Related Patient Education Materials.

Given the increasing accessibility of Internet access, it is critical to ensure that the informational material available online for patient education is both accurate and readable to promote a greater degree of health literacy. This study sought to investigate the quality and readability of the most popular online resources for ankle fractures. After conducting a Google search using 6 terms related to ankle fractures, we collected the first 20 nonsponsored results for each term. Readability was evaluated using the Flesch Reading Ease (FRE), Flesch-Kincaid Grade Level (FKGL), and Gunning Fog Index (GFI) instruments. Quality was evaluated using custom created Ankle Fracture Index (AFI). A total of 46 of 120 articles met the inclusion criteria. The mean FKGL, FRE, and GFI scores were 8.4 ± 0.5, 57.5 ± 3.2, and 10.5 ± 0.5, respectively. The average AFI score was 15.4 ± 1.4, corresponding to an "acceptable" quality rating. Almost 70% of articles (n = 32) were written at or below the recommended eighth-grade reading level. Most articles discussed the need for imaging in diagnosis and treatment planning while neglecting to discuss the risks of surgery or potential future operations. We found that online patient-facing materials on ankle fractures demonstrated an eighth-grade average reading grade level and an acceptable quality on content analysis. Further work should surround increasing information regarding risk factors, complications for surgery, and long-term recovery while ensuring that readability levels remain below at least the eighth-grade level.

Claims-Based Frailty Index and Its Relationship With Commonly Used Clinical Frailty Measures.

The relationship of claims-based frailty index (CFI), a validated measure to identify frail individuals using Medicare data, and frailty measures used in clinical practice has not yet been fully explored. We identified community-dwelling participants of the 2015 National Health and Aging Trends Study (NHATS) whose CFI scores could be calculated using linked Medicare claims. We calculated 9 commonly used clinical frailty measures from theirNHATS in-person examination: Study of Osteoporotic Fracture Index (SOF), FRAIL Scale, Frailty Phenotype, Clinical Frailty Scale (CFS), Vulnerable Elder Survey-13 (VES-13), Tilburg Frailty Indicator (TFI), Groningen Frailty Indicator (GFI), Edmonton Frail Scale (EFS), and 40-item Frailty Index (FI). Using equipercentile method, CFI scores were linked to clinical frailty measures. C-statistics and test characteristics of CFI to identify frailty asdefined by each clinical frailty measure were calculated. Of the 3963 older adults, 44.5% were ≥75 years, 59.4% were female, and 82.3% were non-Hispanic White. A CFI of 0.25 was equipercentile to the following clinical frailty measure scores: SOF 1.4, FRAIL 1.8, Phenotype 1.8, CFS 5.4, VES-13 5.7, TFI 4.6, GFI 5.0, EFS 6.0, and FI 0.26. The C-statistics of using CFI to identify frailty asdefined by each clinical measure were ≥0.70, except for CFS and VES-13. The optimal CFI cutpoints to identify frailty per clinical frailty measure ranged from 0.212 to 0.242, with sensitivity and specificity of 0.37-0.83 and 0.66-0.84, respectively. Understanding the relationship of CFI and commonly used clinical frailty measures can enhance the interpretability and potential utility of CFI.

Cementitious composites in aquatic environments, evaluation of fracture and mechanical behavior in long-term submerging in fresh and saltwater, and simulated splash zone conditions

Aquatic environments can be severely harsh, so structures need suitable materials to endure them. Among the materials promising for aquatic environments are cementitious composites; however, their ability to withstand degrading environments should be evaluated. This study aims to evaluate cementitious composite's mechanical and fracture behavior with seven mix designs in three aquatic environments submerged in fresh and saltwater and exposed to a simulated offshore tidal-splash regime. Environmental exposure durations were chosen as 28, 90, and 365 days. Cementitious composites were developed with glass, PVA, and PP fibers. The results show materials with different behaviors, from fully brittle (without fiber) to strain-hardening (made of PVA and PP fibers). In the simulated splash zone environment, up to 25% strength degradation is seen in the most severe conditions. Among the parameters, fracture indexes are reduced more severely. The failure patterns were investigated, some SEM photos were presented, and some statistical evaluations (including trends and correlations) were presented.

Dietary Sodium Restriction and Frailty among Middle-Aged and Older Adults: An 8-Year Longitudinal Study.

Frailty is a common geriatric syndrome. However, there is little information about the relationship between dietary sodium restriction (DSR) and frailty in later life. This study aimed to elucidate the relationship between DSR and frailty in middle-aged and older adults. The 8-year follow-up data from the Taiwan Longitudinal Study on Aging, including 5131 individuals aged ≥50 years, were analyzed using random-effects panel logit models. DSR was evaluated by assessing whether the participants were told by a physician to reduce or avoid sodium intake from food. Three indices were used to measure frailty: the Study of Osteoporotic Fractures (SOF) index, the Fried index, and the Fatigue, Resistance, Ambulation, Illness, and Loss of weight (FRAIL) index. Individuals with DSR were more likely to report frailty compared with those with non-DSR (SOF: adjusted odds ratio [AOR] = 1.82, 95% confidence interval [CI] = 1.46-2.27; Fried: AOR = 2.55, 95% CI = 1.64-3.98; FRAIL: AOR = 2.66, 95% CI = 1.89-3.74). DSR was associated with a higher likelihood of SBF (AOR = 2.61, 95% CI = 1.61-4.22). We identified a temporal trajectory in our study, noting significant participant reactions to both short- and mid-term DSR. Future research should address the balance between frailty risk and cardiovascular risk related to DSR.

Predicting the Effect of the Loading Rate on the Fracture Toughness of Hydraulic Asphalt Concrete Based on the Weibull Distribution.

The cracking problem of asphalt concrete panels is a crucial consideration in the design of hydraulic asphalt concrete seepage control bodies. Panels experiencing uneven rises or falls of water levels during impoundment may exhibit loading rate effects. Investigating the fracture toughness value of asphalt concrete under varying loading rates is essential. This study employs a statistical method to calculate the fracture index KIC, using the semi-circular bending test (SCB) to examine the effect of loading rates on the Type I fracture mode of hydraulic asphalt concrete. The data are analyzed using the two-parameter Weibull distribution curve, offering insights into the minimum number of KIC test specimens. The results indicate an increase in KIC with loading rate, with greater data dispersion at faster rates. The Weibull distribution curve successfully fits the fracture behavior under different loading rates, providing valuable predictions. This study estimates the minimum number of SCB test specimens to be nine, based on a confidence level of 0.95 and a relative deviation not exceeding 5%.

Cystic Fibrosis in Adults: A Paradigm of Frailty Syndrome? An Observational Study.

This study aimed to assess the main clinical and anamnestic characteristics of adult Cystic Fibrosis (CF) patients and to evaluate the association of frailty with the CF genotyping classification. In an observational cross-sectional study, all ambulatory CF patients over 18 years old who received a diagnosis at the Regional Cystic Fibrosis Center for adults were enrolled and assessed by spirometry for respiratory function, by ADL and IADL for functional status, and by the Study of Osteoporotic Fractures (SOF) Index for frailty. The study population consisted of 139 CF patients (mean age 32.89 ± 10.94 years old, 46% women). Most of the subjects were robust (60.4%). The pre-frail/frail group was more frequently females (p = 0.020), had a lower BMI (p = 0.001), worse respiratory function, a higher number of pulmonary exacerbations/years, cycles of antibiotic therapy, and hospitalization (all p < 0.001) with respect to robust patients. The pre-frail/frail subjects used more drugs and were affected by more CF-related diseases (all p < 0.001). In relation to logistic regression, the best predictor of the pre-frail/frail status was a low FEV1 level. The CF patients show similarities to older pre-frail/frail subjects, suggesting that CF might be considered an early expression of this geriatric syndrome. This finding could help to better define the possible progression of CF, but overall, it could also suggest the usefulness employing of some tools used in the management and therapy of frailty subjects to identify the more severe CF subjects.

Pure mode I fracture specification of molybdenum disulfide nanoparticles (MDS)-reinforced hot mix asphalt (HMA) under long-term conditions

Low and intermediate temperature cracking are two key factors for fracture and failure of hot mix asphalt (HMA), which impose huge costs on transportation departments and related agencies around the world. These two kinds of cracking may apear in the short- or long-term owing to states such as freezeing-thawing damage (FTD) and the aging mechanism. On the other hand, due to its unique features, nanomaterials are a suitable option for improving the mechanical features of bituminous mixes, which can affect the short-term performance and long-term performance. In this study, low and intermediate temperature fracture specification of Nano-molybdenum disulfide (MDS)-reinforced hot mix asphalt (HMA) under long-term conditions was evaluated. For this goal, two semi-circular bend (SCB) geometries comprising 90 degree and angled cracks, which were called symmetric SCB and classical-reinforced SCB-2, were made. Then, two various conditions, i.e. three freeze–thaw cycles and six days of aging operation were performed on various mixes in order to simulate the long-term performance of the bituminous mixes. Finally, the HMA samples with and without MDS were subjected to the three-point SCB test at the final temperatures of −15 °C and + 15 °C. The findings demonstrated that mixes comprising 0.3 % and 0.6 % MDS had more increased fracture energy (FE), fracture toughness (KIC), and stiffness under pure tension at low and medium temperatures (short-term and long-term fracture specification). In fact, MDS caused an increase in the fracture indices by increasing the maximum force (Pmax) and displacement at the time of fracture. At ± 15 °C and for the geometry comprising the 90 degree and 35 degree cracks, the HMA and Nano MDS-reinforced HMA mixes had more suitable flexibility under 3 FTC compared to 0 FTC; while, the flexibility of the HMA and Nano MDS-reinforced HMA mixes decreased under aging mechanism. In discussing the long-term performance of HMA mixture (with and without modifiers), the findings showed that applying three FTD's cycles to the mixes caused a decrease in KIC, FE, and Pmax. Also, reducing the stiffness of various mixes under 3 FTC, and increasing the flexibility of the mixes were other findings of this study. In addition, the simultaneous use of both SCB geometries comprising 90 degree and 35 degree cracks was proposed to study the fracture specification of bituminous mixes owing to the more inferior average FE and KIC. Finally, the application of 3FTC on bituminous mixes can more suitable simulate the long-term performance of asphalt pavement (compared to aging mechanism).

FRAILTY AND COGNITIVE IMPAIRMENT: RESULTS FROM A DIVERSE SAMPLE OF OLDER PERSONS RECEIVING HEMODIALYSIS

Abstract Persons who are receiving hemodialysis are at high risk for frailty and cognitive impairment. However, little is known about the overlap of these conditions in a diverse older hemodialysis population. Our goal is to examine frailty and cognition in a diverse sample of older adults receiving hemodialysis. Data was collected as part of a cross-sectional observational study examining mentation, mood, and mobility. Frailty was identified using the Study of Osteoporotic Fractures Index and cognition was assessed with the Montreal Cognitive Assessment (MoCA) (cut off score ≤ 26). Blind MoCAs were administered (cut off score ≤ 22) when appropriate. 35 participants (mean age = 73.9 ± 10.7) enrolled. 60% were males and 20% were Spanish-speaking. 20% identified as Asian, 23% as Black, and 23% as Hispanic/ Latino. Of note, four blind MoCAs in Spanish were administered. 83% had abnormal MoCA scores. 86% were frail or pre-frail. The majority of the sample (69%) had concurrent cognitive impairment and frailty or pre-frailty. In this diverse sample of older adults receiving hemodialysis, we found that both frailty and cognitive impairment are extremely common, with a large portion of the sample exhibiting both. This suggests that interventions targeting cognitive impairment or frailty should account for the frequent overlap of both conditions, particularly among historically underserved populations.