Genes Coding Research Articles

Association of multiple sclerosis with psychiatric disorders and homelessness among veterans in the United States Department of Veterans Affairs healthcare system.

To describe and compare the prevalence of psychosocial and psychiatric disorders among veterans with multiple sclerosis (MS) and a propensity-score-matched group of veterans without MS, and to identify sociodemographic and clinical characteristics associated with comorbid psychosocial and psychiatric problems among veterans with MS. Data were linked and extracted from the Veterans Affairs (VA) Homeless Operations Management and Evaluation System and the Corporate Data Warehouse. The total sample comprised 27,342 veterans in the VA healthcare system between January 1, 2022, and June 30, 2023, who met eligibility criteria for an MS diagnosis (n=13,671) and 1:1 propensity-score-matched sample of veterans who did not have MS (n=13,671). MS diagnosis, substance use disorder (SUD), mental illness, and homelessness were defined using standard ICD-10 codes. Covariates included sex, age, Charlson Comorbidity Index (CCI), and VA service-connected disability rating. A higher prevalence of mental illness among veterans with MS (33%) was found compared with those without MS (31%). Multivariable logistic regression models indicated MS was negatively associated with diagnoses of alcohol use disorder, stimulant use disorders, posttraumatic stress disorder, and schizophrenia/schizoaffective disorder but positively associated with diagnoses of cannabis use disorder and major depressive disorder. MS was not significantly related to homelessness. Disparities in psychosocial and psychiatric disorders among veterans with MS are described. This study provides novel insights regarding rates of homelessness, SUD, and mental illnesses among veterans with MS. Interdisciplinary approaches to identification and management of mental illness, SUD, and homelessness among veterans with MS are critically needed.

The application study of harmonization code in medical device adverse event reporting

BackgroundThe reporting of adverse events in medical devices (MD) is a starting point of post-market surveillance and the most common source of initial safety signals. Because MD adverse events (AE) occur globally and involve high-profile international public health crises, international regulators implanted standard codes for MDAE reporting. This study aimed to assess the application of MDAE terminology and codes by providing examples of virtual events.MethodsAn online survey was conducted among participants of the MD Training Program for Regulatory Authorities which provide International Medical Device Regulators Forum (IMDRF) adverse event terminology and codes, and six virtual MDAE cases.ResultsAll 29 of the 72 participants were regulators. In all cases, most participants selected the broad (level 1) codes rather than the detailed (level 2 or level 3) codes. While responders selected a variety of codes for all annexes in case 1, over 50% of responders selected the intended codes in case 6. The codes for cause investigation were chosen more frequently than other annexes for device problem, components, and health effect. No differences were observed in code selection amongst different stakeholders.ConclusionsWe identified the diversification in terminology and code selection for reporting MDAEs.

Road to net zero: Greenness of Leadership in Energy and Environmental Design and California Green Building Standards Code in the multifamily sector

AbstractThis study evaluates the effectiveness of Leadership in Energy and Environmental Design (LEED) and California Green Building Standards Code (CALGreen) sustainability programs in reducing greenhouse gas (GHG) emissions in multifamily buildings. We find that CALGreen effectively reduces GHG emissions by 7.2%–11.6%. However, among properties completed during the CALGreen period (on or after 2015), LEED‐certified properties exhibit 14.1%–20.8% higher GHG emissions compared to non‐LEED‐certified buildings. We attribute this result to the emphasis on theoretical design versus actual energy performance of those programs. Furthermore, our research reveals that LEED‐certified buildings completed before the implementation of CALGreen command a rent premium of 4.7%–5.4%. However, this LEED premium diminishes during the CALGreen period. Non‐LEED properties completed during the CALGreen period show limited evidence of rent premiums.

Utilisation of reservoir sediments for engineering applications

In this paper, a detailed characterisation of Tungabhadra (TB) reservoir sediment, such as physical, chemical, geotechnical, morphological and mineralogical attribute, is performed to identify the suitability of dredged sediment as engineering material. Characteristics of sediment is, however, compared with Indian Standard codes for specific engineering applications. Through this study, it is depicted that sediment obtained from the TB Dam reservoirs as such cannot be used for engineering purpose (such as a fill material for highway construction, as sand for concreting and plastering and as foundry sand and other applications); these sediments need prior treatment before using them for the above-mentioned applications. However, it can also be noted that to enhance the strength properties of sediment, air-cooled blast furnace slag (ABS) can be used as a stabiliser. On the other hand, ABS is treated as waste material in steel industry. Thus, it is concluded from this study that TB Dam sediment can be used for many engineering applications provided proper screening and stabilisation technique is adopted. Thus, the cost of dredging is converted into profit by selling the TB Dam sediments for engineering applications.

Review of Low Voltage Ride-Through Capabilities in Wind Energy Conversion System

The significance of low voltage ride-through (LVRT) capability in wind energy conversion systems (WECSs) is paramount for ensuring grid stability and reliability during voltage dips. This systematic review delves into the advancements, challenges, and methodologies associated with LVRT capabilities in WECSs. By synthesizing recent research findings, this review highlights technological innovations, control strategies, and regulatory requirements that influence LVRT performance. Key insights include the efficacy of various LVRT techniques, the role of grid codes in shaping LVRT standards, and the integration of advanced control algorithms to improve system resilience. The study offers a comprehensive understanding of the current landscape of LVRT in WECSs and pinpoints future research directions to optimize their performance in increasingly complex grid environments. During the LVRT process, the stator of a double-fed induction generator (DFIG) is directly linked to the power grid. When the external power grid experiences a failure, the stator flux produces a significant transient component, resulting in substantial overvoltage and overcurrent on the rotor side of the DFIG. Failure to implement preventative measures may result in damage to the converter, therefore compromising the safety and stability of how the power system functions.

Suppressive cancer nonstop extension mutations increase C-terminal hydrophobicity and disrupt evolutionarily conserved amino acid patterns

Nonstop extension mutations, a.k.a. stop-lost or stop-loss mutations, convert a stop codon into a sense codon resulting in translation into the 3’ untranslated region until the next in-frame stop codon, thereby extending the C-terminus of a protein. In cancer, only nonstop mutations in SMAD4 have been functionally characterized, while the impact of other nonstop mutations remain unknown. Here, we exploit our pan-cancer NonStopDB dataset and test all 2335 C-terminal extensions arising from somatic nonstop mutations in cancer for their impact on protein expression. In a high-throughput screen, 56.1% of the extensions effectively reduce protein abundance. Extensions of multiple tumor suppressor genes like PTEN, APC, B2M, CASP8, CDKN1B and MLH1 are effective and validated for their suppressive impact. Importantly, the effective extensions possess a higher hydrophobicity than the neutral extensions linking C-terminal hydrophobicity with protein destabilization. Analyzing the proteomes of eleven different species reveals conserved patterns of amino acid distribution in the C-terminal regions of all proteins compared to the proteomes like an enrichment of lysine and arginine and a depletion of glycine, leucine, valine and isoleucine across species and kingdoms. These evolutionary selection patterns are disrupted in the cancer-derived effective nonstop extensions.

The Chilean COVID-19 Genomics Network Biorepository: A Resource for Multi-Omics Studies of COVID-19 and Long COVID in a Latin American Population.

Although a lack of diversity in genetic studies is an acknowledged obstacle for personalized medicine and precision public health, Latin American populations remain particularly understudied despite their heterogeneity and mixed ancestry. This gap extends to COVID-19 despite its variability in susceptibility and clinical course, where ethnic background appears to influence disease severity, with non-Europeans facing higher hospitalization rates. In addition, access to high-quality samples and data is a critical issue for personalized and precision medicine, and it has become clear that the solution lies in biobanks. The creation of the Chilean COVID-19 Biorepository reported here addresses these gaps, representing the first nationwide multicentric Chilean initiative. It operates under rigorous biobanking standards and serves as one of South America's largest COVID cohorts. A centralized harmonization strategy was chosen and included unified standard operating procedures, a sampling coding system, and biobanking staff training. Adults with confirmed SARS-CoV-2 infection provided broad informed consent. Samples were collected to preserve blood, plasma, buffy coat, and DNA. Quality controls included adherence to the standard preanalytical code, incident reporting, and DNA concentration and absorbance ratio 260/280 assessments. Detailed sociodemographic, health, medication, and preexisting condition data were gathered. In five months, 2262 participants were enrolled, pseudonymized, and sorted by disease severity. The average Amerindian ancestry considering all participant was 44.0% [SD 15.5%], and this value increased to 61.2% [SD 19.5%] among those who self-identified as Native South Americans. Notably, 279 participants self-identified with one of 12 ethnic groups. High compliance (>90%) in all assessed quality controls was achieved. Looking ahead, our team founded the COVID-19 Genomics Network (C19-GenoNet) focused on identifying genetic factors influencing SARS-CoV-2 outcomes. In conclusion, this bottom-up collaborative effort aims to promote the integration of Latin American populations into global genetic research and welcomes collaborations supporting this endeavor. Interested parties are invited to explore collaboration opportunities through our catalog, accessible online.

Reprogramming the genetic code with flexizymes.

In the canonical genetic code, the 61 sense codons are assigned to the 20 proteinogenic amino acids. Advancements in genetic code manipulation techniques have enabled the ribosomal incorporation of nonproteinogenic amino acids (npAAs). The critical molecule for translating messenger RNA (mRNA) into peptide sequences is aminoacyl-transfer RNA (tRNA), which recognizes the mRNA codon through its anticodon. Because aminoacyl-tRNA synthetases (ARSs) are highly specific for their respective amino acid-tRNA pairs, it is not feasible to use natural ARSs to prepare npAA-tRNAs. However, flexizymes are adaptable aminoacylation ribozymes that can be used to prepare diverse aminoacyl-tRNAs at will using amino acids activated with suitable leaving groups. Regarding recognition elements, flexizymes require only an aromatic ring in either the leaving group or side chain of the activated amino acid, and the conserved 3'-end CCA of the tRNA. Therefore, flexizymes allow virtually any amino acid to be charged onto any tRNA. The flexizyme system can handle not only L-α-amino acids with side chain modifications but also various backbone-modified npAAs. This Review describes the development of flexizyme variants and discusses their structure and mechanism and their applications in genetic code reprogramming for the synthesis of unique peptides and proteins.

Progressive Collapse Analysis of G+10 RCC Building

This study important of the progressive collapse that final damage of the structure is not similar as the initial collapse of structure. The key parameters used story displacement in eleven-storey building of regular shape that has modelled and analyzed by the ETABS 2018 software by using the Indian standard codes. Then for the calculation of progressive collapse we use U.S General Service Administration (GSA 2016) guidelines. The demand capacity ratio (DCR) values of the neighboring member are taken into account after the damage the DCR values for regular structure must be with in (2). In this study the progressive collapse is considered in three different cases that is at corner, interior and at exterior columns.

Investigation of the TaOx unipolar switching memory on high efficiency computing

Memristor has shown great potential application for data storage, neuromorphic computing chip, and memory logic, but its bi-directional operation from setting in positive bias voltage region to resetting in a negative bias voltage region would introduce a complex control circuit. Herein, a memristor with the structure of Au/TaOx/F-doped SnO2 presents unipolar switching behavior, enabling the memristor to operate the set and reset processing in a single voltage direction. By comparison with bipolar switching memristor, using this unipolar switching memristor to operate the logic expression of the letter “D” based on American standard code for information interchange (ASCII) can reduce power consumption by 55.56 % while switching the logic state from “0” to “1” and then back to “0” can save up to 48 % of power consumption. This work provides a feasible method for the low power consumption computing as well as a road to simplify circuit design.

Primary Sequence and Three-Dimensional Structural Comparison between Malanin and Ricin, a Type II Ribosome-Inactivating Protein.

Malanin is a new type II ribosome-inactivating protein (RIP) purified from Malania oleifera, a rare, endangered tree is only found in the southwest of Guangxi Province and the southeast of Yunnan Province, China. The gene coding sequence of malanin was found from the cDNA library of M. oleifera seeds by employing the ten N-terminal amino acid sequences of malanin, DYPKLTFTTS for chain-A and DETXTDEEFN (X was commonly C) for chain-B. The results showed a 65% amino acid sequence homology between malanin and ricin by DNAMAN 9.0 software, the active sites of the two proteins were consistent, and the four disulfide bonds were in the same positions. The primary sequence and three-dimensional structures of malanin and ricin are likely to be very similar. Our studies suggest that the mechanism of action of malanin is expected to be analogous to ricin, indicating that it is a member of the type II ribosome-inactivating proteins. This result lays the foundation for further study of the anti-tumor activities of malanin, and for the application of malanin as a therapeutic agent against cancers.

Effects of Injected Current Streams on MHD Equilibrium Reconstruction of Local Helicity Injection Plasmas in a Spherical Tokamak

Open field line currents are intrinsic to DC helicity injection plasma startup and pose a challenge for inferring the plasma equilibrium with standard reconstruction analysis. Local helicity injection (LHI) is a type of DC helicity injection which uses small, modular current sources to drive force-free current along helical field lines to produce tokamak plasmas. MHD modeling and magnetic measurements during LHI indicate the injected current streams remain coherent as helical structures on the outboard edge of a core toroidal plasma that is tokamak-like in a toroidally averaged sense. To extract core plasma equilibrium properties, external magnetic diagnostics corrected for contributions from the injected current streams are fitted by a standard Grad-Shafranov equilibrium code. An iterative approach for estimating and subtracting the stream contributions from the diagnostic signals is described and applied to a model equilibrium database to reduce systematic errors introduced by the streams. Convergence is usually attained with 2 to 4 iterations, with derived equilibrium parameters matching the prescribed axisymmetric core values to within estimated experimental uncertainties. Accurate recovery of core parameters occurs when the ratio of the net toroidal windup current from the streams to the core plasma current is less than 0.2, which is typically satisfied in most experiments.

Effectiveness of Financial Literacy in interest in using QRIS application regarding the challenges of entrepreneurship

This research aims to determine the influence of financial literacy on interest in using QRIS on entrepreneurial behavior. The Indonesian Standard QRIS Quick Response Code service supports payment processes from bank and non-bank providers used in the community, making transactions easier. This payment system via QRIS can not only be done in large shopping centers but can also be used in food stalls, tourist attractions, street vendors, even people's markets or traditional markets if they use the QRIS logo. The data source used is primary data with a total of 50 respondents. The analytical method used is descriptive analysis and statistical analysis. From the test results, the results of this research analysis are in accordance with the proposed hypothesis and the direction of the coefficient is consistent, namely a positive effect of 3.058 with a significance of 0.004 which is supported by the data, so it can be concluded that the financial literacy variable has an influence on entrepreneurial behavior, so that an increase of 3.0% will resulting in an increase in the use of MSMEs in entrepreneurial behavior

Reconstruction of the Temperature Index Series of China in 1368–1911 based on REACHES database

This study reports the methodology for reconstructing anomalous temperature index series of China in 1368–1911 based on the REACHES database which digitizes the Chinese records quoted in the Compendium of Meteorological Records of China in the Last 3000 Years. The reconstruction adopts an ordinal scale index approach ranging from −2 (very cold) to 1 (warm). Based on the grading criteria, a total of 12,871 records were retrieved through a standard coding system established at REACHES. Sensitivity experiments were performed to test robustness of the index system and a reasonability test was conducted to develop an appropriate method for deriving areal mean temperature index. The reconstructed series were validated through comparison with early instrumental data from Global Historical Climatology Network which shows good correlations and reliability of the REACHES reconstructed index data. Annual and semi-annual (winter and summer) temperature index data series were released for the whole domain as well as the 3- and 15-subregion geographical domains in China.

Alternate RNA decoding results in stable and abundant proteins in mammals.

Amino acid substitutions may substantially alter protein stability and function, but the contribution of substitutions arising from alternate translation (deviations from the genetic code) is unknown. To explore it, we analyzed deep proteomic and transcriptomic data from over 1,000 human samples, including 6 cancer types and 26 healthy human tissues. This global analysis identified 60,024 high confidence substitutions corresponding to 8,801 unique sites in proteins derived from 1,990 genes. Some substitutions are shared across samples, while others exhibit strong tissue-type and cancer specificity. Surprisingly, products of alternate translation are more abundant than their canonical counterparts for hundreds of proteins, suggesting sense codon recoding. Recoded proteins include transcription factors, proteases, signaling proteins, and proteins associated with neurodegeneration. Mechanisms contributing to substitution abundance include protein stability, codon frequency, codon-anticodon mismatches, and RNA modifications. We characterize sequence motifs around alternatively translated amino acids and how substitution ratios vary across protein domains, tissue types and cancers. The substitution ratios are positively associated with intrinsically disordered regions and genetic polymorphisms in gnomAD, though the polymorphisms cannot account for the substitutions. Both the sequence and the tissue-specificity of alternatively translated proteins are conserved between human and mouse. These results demonstrate the contribution of alternate translation to diversifying mammalian proteomes, and its association with protein stability, tissue-specific proteomes, and diseases.

Association of the Area Deprivation Index With Dementia Basic Workup and Diagnosis in Central and Western Virginia: A Cross-Sectional Study.

The Area Deprivation Index (ADI) provides a validated and multidimensional metric of areal disadvantage. Our goals were to determine if the ADI influences the likelihood of receiving workup based on published guidelines and an etiologic diagnosis of dementia in Central and Western Virginia. We collected deidentified data from the electronic health record of individuals aged 50-105 years diagnosed with dementia at the University of Virginia (UVA) Medical Center (2016-2021) and at Carillion Clinic (2018-2021). Visit-specific ICD-10 codes were used to classify each dementia diagnosis as "disease-specific" (e.g., Alzheimer disease) or "general" (e.g., unspecified dementia). Following the American Academy of Neurology guidelines, we considered the evaluation performed as "adequate" if patients had vitamin B12, thyroid-stimulating hormone, and brain CT or magnetic resonance imaging within 6 months of the initial diagnosis. Census tract ADI was linked to study participants using the unique census tract identifier derived from the participants' home addresses at the time of diagnosis. Statistical modeling occurred under a Bayesian paradigm implemented using a standard code in R. The study included 13,431 individuals diagnosed with dementia at UVA (n = 7,152) and Carillion Clinic (n = 6,279). Of those, 32.5% and 20.4% received "disease-specific" diagnoses at UVA and Carillion Clinic and 8.2% and 20.4% underwent "adequate" workup, respectively. The adjusted relationship between census tract ADI and the likelihood of a disease-specific diagnosis was U-shaped: Residence in moderately disadvantaged areas was associated with the lowest likelihood of disease-specific diagnosis. Most patients diagnosed with dementia did not receive an adequate evaluation or an etiologic diagnosis. Those living in locations just above the national median ADI levels had the lowest likelihood of receiving an etiologic diagnosis, lower than those in the least and most deprived areas. Renewed awareness efforts among providers are needed to increase compliance with diagnostic guidelines.

Design study of gas-cooled fast reactor with natural uranium as fuel employing modified CANDLE shuffling strategy in the axial direction

Abstract This study investigated gas-cooled fast reactor performance utilizing natural uranium as the fuel employs modified constant axial shape of neutron flux, nuclide densities, and power shape during life of energy production (CANDLE) shuffling strategy in the axial direction. The performance has been carried out on a reactor with various power levels in the range of 2,700–3,100 MWt and refueling every 10 years of burnup. The main importance of the modified CANDLE (MCANDLE) is that it can utilize natural uranium as fuel without needs reprocessing or enrichment plant. During this work, the core has been partitioned into 10 regions of similar volume along the axial direction. The fuel was filled into the first region, then transported to the second region after 10 years of burnup, and then to the third region 10 years later. This technique was practiced to all 10 regions, and the fuel in the tenth region was discharged in the reactor core. 10 % of natural thorium, natural uranium and enriched nitride (15 N) were used as fuel input. The calculations were performed employing a standard reactor analysis code (SRAC). The collision probability method (PIJ) module of SRAC was used to calculate cell burnup, and the reactor core design calculations were done with the CITATION module of SRAC, which used JENDL-4.0 as a nuclear data library. The result shows that a high power level causes an increasing rate of burnup level and effective multiplication factor. The highest average discharge burnup level is about 31.3 % HM for case E and the lowest average discharge burnup is about 27.2 % HM for case A.

Accuracy of a Commercial Large Language Model (ChatGPT) to Perform Disaster Triage of Simulated Patients Using the Simple Triage and Rapid Treatment (START) Protocol: Gage Repeatability and Reproducibility Study.

The release of ChatGPT (OpenAI) in November 2022 drastically reduced the barrier to using artificial intelligence by allowing a simple web-based text interface to a large language model (LLM). One use case where ChatGPT could be useful is in triaging patients at the site of a disaster using the Simple Triage and Rapid Treatment (START) protocol. However, LLMs experience several common errors including hallucinations (also called confabulations) and prompt dependency. This study addresses the research problem: "Can ChatGPT adequately triage simulated disaster patients using the START protocol?" by measuring three outcomes: repeatability, reproducibility, and accuracy. Nine prompts were developed by 5 disaster medicine physicians. A Python script queried ChatGPT Version 4 for each prompt combined with 391 validated simulated patient vignettes. Ten repetitions of each combination were performed for a total of 35,190 simulated triages. A reference standard START triage code for each simulated case was assigned by 2 disaster medicine specialists (JMF and MV), with a third specialist (LC) added if the first two did not agree. Results were evaluated using a gage repeatability and reproducibility study (gage R and R). Repeatability was defined as variation due to repeated use of the same prompt. Reproducibility was defined as variation due to the use of different prompts on the same patient vignette. Accuracy was defined as agreement with the reference standard. Although 35,102 (99.7%) queries returned a valid START score, there was considerable variability. Repeatability (use of the same prompt repeatedly) was 14% of the overall variation. Reproducibility (use of different prompts) was 4.1% of the overall variation. The accuracy of ChatGPT for START was 63.9% with a 32.9% overtriage rate and a 3.1% undertriage rate. Accuracy varied by prompt with a maximum of 71.8% and a minimum of 46.7%. This study indicates that ChatGPT version 4 is insufficient to triage simulated disaster patients via the START protocol. It demonstrated suboptimal repeatability and reproducibility. The overall accuracy of triage was only 63.9%. Health care professionals are advised to exercise caution while using commercial LLMs for vital medical determinations, given that these tools may commonly produce inaccurate data, colloquially referred to as hallucinations or confabulations. Artificial intelligence-guided tools should undergo rigorous statistical evaluation-using methods such as gage R and R-before implementation into clinical settings.

Graft survival of major histocompatibility complex deficient stem cell-derived retinal cells

BackgroundGene editing of immunomodulating molecules is a potential transplantation strategy to control immune rejection. As we noticed the successful transplantation of retinal pigment epithelium (RPE) derived from embryonic stem cells of a cynomolgus monkey that accidentally lacked MHC class II (MHC-II) molecules, we hypothesized immune rejection could be evaded by suppressing MHC-II.MethodsGene editing by the Crispr/Cas9 system was performed in induced pluripotent stem cells derived from a cynomolgus monkey (miPSCs) for targeted deletion of the gene coding class II MHC trans-activator (CIITA). Then the CIITA-knocked out miPSCs were differentiated into RPE cells to generate miPSC-derived MHC-II knockout RPE. The MHC-II knockout or wild-type RPEs were transplanted into the eyes of healthy cynomolgus monkeys. All monkeys used in this study were male.ResultsHere we show when MHC-II knockout RPE are transplanted into monkey eyes, they show suppressed immunogenicity with no infiltration of inflammatory cells, leading to successful engraftment.ConclusionsOur results reasonably evidence the efficacy of MHC-II knockout iPSC-RPE transplants for clinical application.

Assess, Diagnose and Intervene: Are Hospital Based Out-patient Frailty Intervention Teams Perfectly Positioned to Prevent the Frailty Crisis?

Abstract Background This Frailty Intervention Team (FIT) is relatively novel in the sense that it is a hospital based multidisciplinary team (MDT) that provides an outpatient service to community based frail adults. Its main source of referral is from General Practitioners (GP)1, with the average Clinical Frailty Score of those assessed being 4.98 (4.91 men, 5.05 women) 1. Indicating that the mean service user is ‘Living with Mild Frailty’2. Our objective was to establish if this model of service provision is identifying any new diagnoses and what interventions it provides. Our overarching aim is to establish ‘what we are adding to the patient journey’. Methods 3 independent researchers came together to develop a database for the service that would record new diagnoses made, medical & non-medical interventions provided and frequency of on-wards referral. Standard definitions and codes were agreed upon, and the information inputted by patients facing staff on a daily basis. A descriptive data analysis of this database was carried out after the first quarter. Results 51 new patients were assessed in 4 months. Of these patients, 37.25% of cases received new diagnoses; Parkinson’s disease (15.68%), Orthostatic Hypotension (11.76%), Cognitive Impairment / Dementia (11.76%) and Idiopathic Normal Pressure Hydrocephalus (iNPH) (5.88%). Subsequently 62.74% had changes made to their medications. 96.08% of new service users received at least 1 non-medical intervention. Onward referral was made for 58.82% of service users, to a total of 22 organizations. The total amount of onward referrals made was 54. 51 new patients were assessed in 4 months. Conclusion A hospital-based frailty intervention team adds value to a patient’s journey as it is perfectly placed to make rapid diagnosis due to their MDT nature and access to diagnostics. Furthermore, it provides immediate intervention and appropriate onwards referral. Is this a model of service provision that should be made more readily available nationally?