Broad-Spectrum Supramolecularly Reloadable Antimicrobial Coatings.

Antimicrobial surfaces limit the spread of infectious diseases. To date, there is no antimicrobial coating that has widespread use because of short-lived and limited spectrum efficacy, poor resistance to organic material, and/or cost. Here, we present a paint based on waterborne latex particles that is supramolecularly associated with quaternary ammonium compounds (QACs). The optimal supramolecular pairing was first determined by immobilizing selected ions on self-assembled monolayers exposing different groups. The QAC surface loading density was then increased by using polymer brushes. These concepts were adopted to develop inexpensive paints to be applied on many different surfaces. The paint could be employed for healthcare and food production applications. Its slow release of QAC allows for long-lasting antimicrobial action, even in the presence of organic material. Its efficacy lasts for more than 90 washes, and importantly, once lost, it can readily be restored by spraying an aqueous solution of the QAC. We mainly tested cetyltrimethylammonium as QAC as it is already used in consumer care products. Our antimicrobial paint is broad spectrum as it showed excellent antimicrobial efficiency against four bacteria and four viruses.

Total magnesium intake and risk of frailty in older women.

BACKGROUND: An adequate magnesium intake might lower the risk of frailty through its role in muscle function. METHODS: We analysed data from 81 524 women aged ≥60 years participating in the Nurses' Health Study. Total magnesium intake was obtained from repeated food frequency questionnaires administered between 1984 and 2010 and self-reported information on supplementation. Frailty was defined as having at least three of the following five FRAIL scale criteria: fatigue, low strength, reduced aerobic capacity, having ≥5 chronic illnesses and weight loss ≥ 5%. The occurrence of frailty was assessed every 4 years from 1992 to 2018. Cox proportional hazards models adjusted for lifestyle factors, medication use and dietary factors were used to assess the association between magnesium intake and frailty. RESULTS: During a median follow-up of 16 years, we identified 15 477 incident cases of frailty. Women with a higher intake of total energy-adjusted magnesium had a decreased risk of frailty after adjustment for lifestyle factors, medication use and dietary factors. The relative risk (95% confidence interval) for Quintile 5 (Q5) versus Quintile 1 (Q1) was 0.88 (0.82, 0.94) (P-trend < 0.001). When only energy-adjusted magnesium from the diet was considered, the inverse association was stronger (Q5 vs. Q1: 0.68 [0.56, 0.82]; P-trend < 0.001). Those reaching the recommended daily allowance (RDA) of magnesium through diet had a 14% (9%, 19%) lower risk of frailty compared with those not meeting the RDA. CONCLUSIONS: Increased intake of foods rich in magnesium was associated with a decreased risk of frailty.

Numerical values and impact of hypertension in Spain.

In Spain, 33% of adults aged 30 to 79 years (10 million) were hypertensive in 2019. Among them, 68% were diagnosed, 57% received drug therapy, and effective therapeutic coverage (control) reached 33%. Both diagnosis and control show geographical and social disparities. Approximately 46 000 cardiovascular deaths per year are attributable to hypertension. In recent decades, the control of hypertension has increased, due to improvements in lifestyle measures and increased use of polytherapy, coinciding with a reduction in stroke mortality. There are several modifiable determinants of the lack of hypertension control: a) white-coat phenomenon affects 22% to 33% of treated individuals, partly due to the limited availability of ambulatory blood pressure monitoring (ABPM) (49%) and self-measured BP (SMBP) (78%); b) inadequate patient adherence to medication and healthy lifestyles (weight loss, the most effective measure, is the least used, ≈40%); and c) insufficient use of polytherapy (≈55%). The remaining challenges include: a) technological aspects, such as measuring BP with more accurate techniques (ABPM, SMBP) and using cardiovascular-risk estimation tools (eg, SCORE); b) clinical challenges, such as reducing therapeutic inertia (≈59%), involving patients in their own management (medication adherence, ≈62%) and effectively implementing clinical guidelines); and c) public health challenges, such as reducing the burden of obesity (≈24%), monitoring progress with updated surveys, and setting national BP control targets.

The actin cytoskeleton plays multiple roles in structural colour formation in butterfly wing scales.

Vivid structural colours in butterflies are caused by photonic nanostructures scattering light. Structural colours evolved for numerous biological signalling functions and have important technological applications. Optically, such structures are well understood, however insight into their development in vivo remains scarce. We show that actin is intimately involved in structural colour formation in butterfly wing scales. Using comparisons between iridescent (structurally coloured) and non-iridescent scales in adult and developing H. sara, we show that iridescent scales have more densely packed actin bundles leading to an increased density of reflective ridges. Super-resolution microscopy across three distantly related butterfly species reveals that actin is repeatedly re-arranged during scale development and crucially when the optical nanostructures are forming. Furthermore, actin perturbation experiments at these later developmental stages resulted in near total loss of structural colour in H. sara. Overall, this shows that actin plays a vital and direct templating role during structural colour formation in butterfly scales, providing ridge patterning mechanisms that are likely universal across lepidoptera.

Size Control of Carbon Xerogel Spheres as Key Factor Governing the H2O2 Selectivity in Metal-Free Bifunctional Electro-Fenton Catalysts for Tetracycline Degradation.

Carbon xerogel spheres co-doped with nitrogen and eco-graphene were synthesized using a typical solvothermal method. The results indicate that the incorporation of eco-graphene enhances the electrochemical properties, such as the current density (JK) and the selectivity for the four transferred electrons (n). Additionally, nitrogen doping has a significant effect on the degradation efficiency, varying with the size of the carbon xerogel spheres, which could be attributed to the type of nitrogenous group doped in the carbon material. The degradation efficiency improved in the nanometric spheres (48.3% to 61.6%) but decreased in the micrometric-scale spheres (58.6% to 53.4%). This effect was attributed to the N-functional groups present in each sample, with N-CNS-5 exhibiting a higher percentage of graphitic nitrogen (35.7%) compared to N-CMS-5 (15.3%). These findings highlight the critical role of sphere size in determining the type of N-functional groups present in the sample. leading to enhanced degradation of pollutants as a result of the electro-Fenton process.

Ultraprocessed foods, unprocessed or minimally processed foods, and risk of frailty in a cohort of United States females.

BACKGROUND: Ultraprocessed foods (UPFs) and poor diet quality have been associated with frailty but existing studies had relatively short follow-up time. It is also unclear whether the association of UPF was primarily due to its correlation with poorer diet quality. OBJECTIVES: We examined the association between unprocessed or minimally processed foods (UMFs) and UPF and risk of frailty and explored whether the association with UPF was mainly driven by poor diet quality. METHODS: In total, 63,743 nonfrail females aged 60+ y from the Nurses' Health Study (cohort study) were followed up for ≥26 y. Diet was assessed every 4 y by food frequency questionnaires. UPF and UMF intakes were calculated using the Nova classification. Diet quality was estimated using the Alternate Healthy Eating Index (AHEI) 2010. The association of UMF and UPF with risk of frailty was examined using multivariable adjusted Cox proportional hazard model. RESULTS: During the follow-up period, we recorded 15,187 incident cases of frailty. The hazard ratio (HR) of frailty for the highest compared with the lowest quintile of UMFs (servings per day) was 0.86 (95% CI: 0.83, 0.95; P-trend < 0.001). However, this was no longer statistically significant after adjustment for AHEI-2010. UPFs (servings per day) was directly associated with risk of frailty, even after adjustment for AHEI-2010 (1.31; 95% CI: 1.23, 1.39; P-trend < 0.001). Among those at the highest category of the AHEI-2010, UPFs remained directly associated with frailty (HR comparing top with bottom quintile: 1.40; 95% CI:1.24, 1.57; P-trend < 0.001). For UPF components, we found a higher frailty risk with each serving per day of artificial and sugar-sweetened beverages; fat, spreads, and condiments; yogurt and dairy-based desserts; and other UPFs. However, processed whole grains were not associated with frailty. CONCLUSIONS: Higher intake of UPF is associated with a higher risk of frailty in older females. This is not explained by a lower diet quality contributed by UPFs.

Cellulose-based materials in tailoring a novel defective titanium­carbon­phosphorus hybrid composites for highly efficient photocatalytic activity.

Until now, black titania has attracted much interest as a potential photocatalyst. In this contribution, we report the first demonstration of the effective strategy to fundamentally improve the photocatalytic performance using a novel sustainable defective titanium­carbon-phosphorous (TCPH) hybrid nanocomposite. The prepared TCPH was used for photocatalytic degradation of the main organic pollutants, which is methyl orange (MO) dye. The physico-chemical properties of as-prepared samples were characterized by various techniques to observe the transformations after carbonization and the interaction between different composite phases. The existence of Ti+3 and oxygen vacancies at the surface, and a notable increase in surface area, are all demonstrated by TCPH, together with the distinct core-shell structure. These unique properties exhibit excellent photocatalytic performance due to the boosted charge transport and separation. The highest degradation efficiency of methyl orange (MO) was attained in the case of TCPH when compared with titanium-cellulose-phosphorous (TCeP) and titanium­carbon-phosphorous (TCPN). Accordingly, the highest degradation efficiency was achieved by applying the optimal operational conditions of 1 g/L of TCPH catalyst, 10 mg/L of MO, pH of 7 and the temperature at 25 ± 3 °C after 3 min under LED lamp (365 nm) with light intensity 100 mW/cm2. The degradation mechanism was investigated, and the trapping tests showed the dominance of hydroxyl radicals in the degradation of MO. TCPH showed high stability under a long period of operation in five consecutive cycles, which renders the highly promising on an industrial scale. The fabrication of highly active defective titanium­carbon-phosphorous opens new opportunities in various areas, including water splitting, and CO2 reduction.

Plant-Based Diets and Risk of Multimorbidity: The Health and Retirement Study.

BACKGROUND: Plant-based diets have gained attention due to their beneficial effects against major chronic diseases, although their association with multimorbidity is mostly unknown. OBJECTIVES: We examined the association between the healthful (hPDI) and unhealthful plant-based diet indices (uPDI) with multimorbidity among middle-aged and older adults from the United States. METHODS: Data on 4262 adults aged >50 y was obtained from the 2012-2020 Health and Retirement Study (HRS) and 2013 Health Care and Nutrition Study (HCNS). Food consumption was collected at baseline with a food frequency questionnaire and 2 PDIs were derived: the hPDI, with positive scores for healthy plant foods and reverse scores for less healthy plant foods and animal foods; and the uPDI, with only positive scoring for less healthy plant foods. Complex multimorbidity, defined as ≥3 coexistent conditions, was ascertained from 8 self-reported conditions: hypertension, diabetes, cancer, chronic lung disease, heart disease, stroke, arthritis, and depression. Cox proportional hazards models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS: After a median follow-up of 7.8 y, we documented 1202 incident cases of multimorbidity. Compared with the lowest quartile, higher adherence to the hPDI was inversely associated with multimorbidity (HR for quartile 3: 0.77; 95% CI: 0.62, 0.96 and HR for quartile 4: 0.79; 95% CI, 0.63, 0.98; P-trend = 0.02). In addition, a 10-point increment in the hPDI was associated with a 11% lower incidence of multimorbidity (95% CI: 1, 20%). No significant associations were found for the uPDI after adjusting for sociodemographic and lifestyle factors. CONCLUSIONS: Higher adherence to the hPDI was inversely associated with multimorbidity among middle-aged and older adults. Plant-based diets that emphasize consumption of high-quality plant foods may help prevent the development of complex multimorbidity.

Effect of a diabetes-specific formula in non-diabetic inpatients with stroke: a randomized controlled trial.

BACKGROUND/OBJECTIVES: In patients with acute stroke, the presence of hyperglycaemia has been associated with higher morbidity and less neurological recovery. The aim of the study was to evaluate the impact of a diabetes specific enteral nutrition (EN) formula on glycaemia, comorbidities and mortality in patients admitted with a first episode of stroke who received complete EN. METHODS: This was a prospective randomised controlled trial. Patients with acute stroke did not have diagnosis of diabetes mellitus and required nasogastric tube feeding. This study has been registered with code NCT03422900. The patients were randomised into two arms: an isocaloric isoprotein formula (control group (CG), 27 patients) vs a diabetes-specific formula (low glycaemic index carbohydrates, fibre (80% soluble) and higher lipid content) (experimental group (EG), 25 patients). Pre-EN blood glucose, hyperglycaemia during EN treatment, HbA1c, insulin use, oral route recovery, length of stay (LOS) and mortality at 30 days were collected. The complications of enteral nutrition during admission were collected as well. RESULTS: 52 patients were included, 50% females, with an age of 77.44(11.48) years; 34 (65.4%) had ischaemic stroke, with a Rankin score of 0(0-2), and a National Institute of Health Stroke Scale (NIHSS) of 19 (15-22). In CG, there were more cases of hyperglycaemia on the 5th day post-NE (13(65%) vs7(35%), p < 0.01). CG showed an OR of 7.58(1.49-39.16) (p = 0.02) for the development of hyperglycaemia. There were no differences in LOS between groups (12(8.5) days vs 14(23) days, p = 0.19) or in the death rate (10(37%) vs 10(40%), p = 0.8), although differences were found in terms of oral route recovery (EG: 11(44%) patients vs CG: 5(18.5%) patients, p = 0.04) (OR (EG): 5.53(1.25-24.47); p = 0.02). CONCLUSIONS: The use of a diabetes-specific enteral formula in non-diabetic patients admitted with acute stroke reduced the risk of developing hyperglycaemia and improved the rate of oral route recovery. Registered under ClinicalTrials.gov Identifier no. NCT03422900.

Association between diet quality and malnutrition: pooled results from two population-based studies in older adults.

BACKGROUND: The role of diet quality on malnutrition in older adults is uncertain, due the paucity of the research conducted and the use of use of screening tools that did not consider phenotypic criteria of malnutrition. OBJECTIVE: To evaluate the association of two indices of diet quality, namely the Mediterranean Diet Adherence Screener (MEDAS) and the Alternative Healthy Eating Index (AHEI-2010), with malnutrition among community-dwelling older adults in Spain. METHODS: Cross-sectional analysis of data from 1921 adults aged ≥ 60 years from the Seniors-ENRICA-1 (SE-1) study, and 2652 adults aged ≥ 65 years from the Seniors-ENRICA-2 (SE-2) study. Habitual food consumption was assessed through a validated diet history. Malnutrition was defined according to the Global Leadership Initiative on Malnutrition (GLIM) phenotypic criteria. Statistical analyses were performed with logistic regression with adjustment for socioeconomic and lifestyle variables as well as for total energy and protein intake. RESULTS: The prevalence of malnutrition in the SE-1 study was 9.5% (95% confidence interval: 8.2 to 10.9) and 11.7% (10.5 to 13.9) in the SE-2. Adherence to the MEDAS score was associated with lower prevalence of malnutrition [pooled odds ratio for high (≥ 9 points) vs. low adherence (< 7 points): 0.64 (0.48-0.84); p-trend < 0.001]. Higher adherence to the AHEI-2010 also showed an inverse association with malnutrition (pooled odds ratio for quartile 4 vs. 1: 0.65 (0.49-0.86); p-trend 0.006). Among the individual components, higher consumption of fish and long-chain n-3 fatty acids in MEDAS and AHEI-2010, and of vegetables and nuts and legumes in AHEI-2010, and lower intake of trans-fat and sugar-sweetened beverages and fruit juice in AHEI-2010 were independently associated with lower odds of malnutrition. CONCLUSION: Adherence to high diet-quality patterns was associated with lower frequency of malnutrition among older adults. CLINICAL TRIAL REGISTRY: ClinicalTrials.gov identifier: NCT02804672. June 17, 2016.; ClinicalTrials.gov NCT03541135. May 30, 2018.

Modeling and experimental analysis of CO2 methanation reaction using Ni/CeO2 monolithic catalyst.

In this study, the effect of the cell density of monolithic catalysts was investigated and further mathematically modeled on cordierite supports used in CO2 methanation. Commercial cordierite monoliths with 200, 400, and 500 cpsi cell densities were coated by immersion into an ethanolic suspension of Ni/CeO2 active phase. SEM-EDS analysis confirmed that, owing to the low porosity of cordierite (surface area < 1 m2 g-1), the Ni/CeO2 diffusion into the walls was limited, especially in the case of low and intermediate cell density monoliths; thus, active phase was predominantly loaded onto the channels' external surface. Nevertheless, despite the larger exposed surface area in the monolith with high cell density, which would allow for better distribution and accessibility of Ni/CeO2, its higher macro-pore volume resulted in some introduction of the active phase into the walls. As a result, the catalytic evaluation showed that it was more influenced by increments in volumetric flow rates. The low cell density monolith displayed diffusional control at flow rates below 500 mL min-1. In contrast, intermediate and high cell density monoliths presented this behavior up to 300 mL min-1. These findings suggest that the interaction reactants-catalyst is considerably more affected by a forced non-uniform flow when increasing the injection rate. This condition reduced the transport of reactants and products within the catalyst channels and, in turn, increased the minimum temperature required for the reaction. Moreover, a slight diminution of selectivity to CH4 was observed and ascribed to the possible formation of hot spots that activate the reverse water-gas shift reaction. Finally, a mathematical model based on fundamental momentum and mass transfer equations coupled with the kinetics of CO2 methanation was successfully derived and solved to analyze the fluid dynamics of the monolithic support. The results showed a radial profile with maximum fluid velocity located at the center of the channel. A reactive zone close to the inlet was obtained, and maximum methane production (4.5 mol m-3) throughout the monolith was attained at 350 °C. Then, linear streamlines of the chemical species were developed along the channel.

The Hearing Function and Ambulatory Blood Pressure in Older Adults.

OBJECTIVE: To examine the association between hearing function, assessed with pure-tone average (PTA) of air conduction thresholds, and 24-hour ambulatory blood pressure (BP) in older adults. STUDY DESIGN: Cross-sectional study. SETTING: A total of 1404 community-dwelling individuals aged ≥65 years from the Seniors-ENRICA cohort were examined. METHODS: Hearing loss was defined as PTA > 40-AudCal hearing loss decibels (dB-aHL) in the better ear for standard frequency (0.5, 1, and 2 kHz), speech frequency (0.5, 1, 2, and 4 kHz), and high frequency (3, 4, and 8 kHz). Circadian BP patterns were calculated as the percentage decline in systolic BP during the night, and participants were classified as dipper, nondipper, and riser. Ambulatory hypertension was defined as BP ≥ 130/80 mm Hg (24 hour), ≥135/85 (daytime), and ≥120/70 (nighttime) or on antihypertensive treatment. Analyses were performed with linear- and logistic-regression models adjusted for the main confounders. RESULTS: In multivariable analyses, the PTA was associated with higher nighttime systolic BP [ß coefficient per 20 dB-aHL increment standard frequency (95% confidence interval, CI): 2.41 mm Hg (0.87, 3.95); ß (95% CI) per 20 dB-aHL increment speech frequency 2.17 mm Hg (0.70, 3.64)]. Among hypertensive patients, hearing loss at standard and high-frequency PTA was associated with the riser BP pattern [odds ratio: 2.01 (95% CI, 1.03-3.93) and 1.45 (1.00-2.09), respectively]; also, hearing loss at standard PTA was linked to uncontrolled nighttime BP [1.81 (1.01-3.24)]. CONCLUSION: PTA was associated with higher nighttime BP, and hearing loss with a riser BP pattern and uncontrolled BP in older hypertensives.

Specific dairy foods and risk of frailty in older women: a prospective cohort study.

BACKGROUND: Dairy contains a complex mixture of lipids, proteins, and micronutrients. Whether habitual dairy consumption is associated with health benefits is not well established. Since dairy is high in nutrients that are potentially protective against frailty, the association between dairy products and the risk of frailty is of interest. METHODS: We analyzed data from 85,280 women aged ≥ 60 years participating in the Nurses' Health Study. Consumption of milk, yogurt, and cheese was obtained from repeated food frequency questionnaires administered between 1980 and 2010. Frailty was defined as having at least three of the following five criteria from the FRAIL scale: fatigue, low strength, reduced aerobic capacity, having ≥ 5 chronic illnesses, and a weight loss of ≥ 5%. The occurrence of frailty was assessed every four years from 1992 to 2018. Cox proportional hazard models were used to examine the association between the intake of dairy foods and frailty. RESULTS: During follow-up we identified 15,912 incident cases of frailty. Consumption of milk or yogurt was not associated with the risk of frailty after adjustment for lifestyle factors, medication use, and overall diet quality. Cheese consumption was positively associated with risk of frailty [relative risk (95% confidence interval) for one serving/day increment in consumption: 1.10 (1.05, 1.16)]. Replacing one serving/day of milk, yogurt, or cheese with one serving/day of whole grains, nuts, or legumes was associated with a significant lower risk of frailty, while replacing milk, yogurt, or cheese with red meat or eggs was associated with an increased risk. When milk was replaced with a sugar-sweetened or artificially sweetened beverage, a greater risk of frailty was observed, while replacing milk with orange juice was associated with a lower risk of frailty. CONCLUSIONS: The results suggest that the association between milk, yogurt, and cheese and frailty partly depends on the replacement product. Habitual consumption of milk or yogurt was not associated with risk of frailty, whereas cheese consumption may be associated with an increased risk.

Application of artificial intelligence for the optimization of advanced oxidation processes to improve the water quality polluted with pharmaceutical compounds.

Sulfamethoxazole and metronidazole are emerging pollutants commonly found in surface water and wastewater. These compounds have a significant environmental impact, being necessary in the design of technologies for their removal. Recently, the advanced oxidation process has been proven successful in the elimination of this kind of compounds. In this sense, the present work discusses the application of UV/H2O2 and ozonation for the degradation of both molecules in single and binary systems. Experimental kinetic data from O3 and UV/H2O2 process were adequately described by a first and second kinetic model, respectively. From the ANOVA analysis, it was determined that the most statistically significant variables were the initial concentration of the drugs (0.03 mmol L-1) and the pH = 8 for UV/H2O2 system, and only the pH (optimal value of 6) was significant for degradation with O3. Results showed that both molecules were eliminated with high degradation efficiencies (88-94% for UV/H2O2 and 79-98% for O3) in short reaction times (around 30-90 min). The modeling was performed using a quadratic regression model through response surface methodology representing adequately 90 % of the experimental data. On the other hand, an artificial neural network was used to evaluate a non-linear multi-variable system, a 98% of fit between the model and experimental data was obtained. The identification of degradation byproducts was performed by high-performance liquid chromatography coupled to a time mass detector. After each process, at least four to five stable byproducts were found in the treated water, reducing the mineralization percentage to 20% for both molecules.

Cefiderocol: early clinical experience for multi-drug resistant gram-negative infections.

Multi-drug resistant gram-negative bacteria present a significant global health threat. Cefiderocol (CFDC), a siderophore cephalosporin, has shown potential in combating this threat, but with the currently available data, its role in therapy remains poorly defined. This multi-center, retrospective cohort study evaluated the real-world application of CFDC across six U.S. medical centers from January 2018 to May 2023. Patients aged ≥18 years and who had received ≥72 hours of CFDC were included. The primary outcome was a composite of clinical success: survival at 30 days, absence of symptomatic microbiologic recurrence at 30 days following CFDC treatment initiation, and resolution of signs and symptoms. Secondary outcomes included time to CFDC therapy and on-treatment non-susceptibility to CFDC. A total of 112 patients were included, with median (interquartile range [IQR]) APACHE II scores of 15 (19-18). Clinical success was observed in 68.8% of patients, with a mortality rate of 16.1% and comparable success rates across patients infected with carbapenem-resistant gram-negative infections. The most common isolated organisms were Pseudomonas aeruginosa (61/112, 54.5%, of which 55/61 were carbapenem-resistant) and carbapenem-resistant Acinetobacter baumannii (32/112, 28.6%). Median (IQR) time to CFDC therapy was 77 (14-141) hours. Two patients experienced a non-anaphylactic rash as an adverse drug reaction. On-treatment non-susceptibility to CFDC was found in six patients, notably due to P. aeruginosa and A. baumannii.IMPORTANCECFDC was safe and clinically effective as a monotherapy or in combination in treating a variety of carbapenem-resistant gram-negative infections. Further prospective studies are warranted to confirm these findings.

Animal and vegetable protein intake and malnutrition in older adults: a multicohort study.

OBJECTIVES: Malnutrition is a global concern in older adults, as it negatively affects morbidity and mortality. While higher animal protein intake may help prevent and treat malnutrition, it might also increase the risk of chronic diseases and death. Conversely, vegetable protein intake might have a lower anabolic effect and not be as effective to improve nutritional status. We studied whether animal and vegetable protein intake are associated with changes in nutritional status in older adults. DESIGN: We used pooled data from two Spanish cohorts: the Seniors-ENRICA 1 and Seniors-ENRICA 2. SETTINGS AND PARTICIPANTS: 2,965 community-dwelling adults aged 62-92 years. MEASUREMENTS: Protein intake was estimated at baseline via an electronic, validated diet history. Nutritional status was assessed at baseline and after 2.6 years with the GLIM (Global Leadership Initiative on Malnutrition) phenotypic criteria: weight loss, low body mass index, and reduced muscle mass. The odds of improvements in nutritional status were assessed with logistic regression models, extensively adjusted for potential confounders. RESULTS: Higher animal and vegetable protein intake were associated with improvements in nutritional status [odds ratios (95% confidence intervals) per 0.25 g/kg/day were 1.15 (1.00, 1.32) and 1.77 (1.35, 2.32), respectively]. Cereal protein intake drove most of the latter association [2.07 (1.44, 2.98)]. Replacing 0.25 g/kg/day of total animal protein, meat, or fish protein (but not dairy or egg protein) with vegetable protein was associated with improvements in nutritional status [1.54 (1.13, 2.09), 1.70 (1.20, 2.41), and 1.77 (1.18, 2.64), respectively]. CONCLUSIONS: Higher animal and, especially, vegetable protein intake were associated with improvements in nutritional status in older adults. Replacing total animal protein, meat, or fish protein with vegetable protein may help improve malnutrition.

Facile Synthesis of Carbon-Based Inks to Develop Metal-Free ORR Electrocatalysts for Electro-Fenton Removal of Amoxicillin.

The electro-Fenton process is based on the generation of hydroxyl radicals (OH•) from hydroxide peroxide (H2O2) generated in situ by an oxygen reduction reaction (ORR). Catalysts based on carbon gels have aroused the interest of researchers as ORR catalysts due to their textural, chemical and even electrical properties. In this work, we synthesized metal-free electrocatalysts based on carbon gels doped with graphene oxide, which were conformed to a working electrode. The catalysts were prepared from organic-gel-based inks using painted (brush) and screen-printed methods free of binders. These new methods of electrode preparation were compared with the conventional pasted method on graphite supports using a binder. All these materials were tested for the electro-Fenton degradation of amoxicillin using a homemade magnetite coated with carbon (Fe3O4/C) as a Fenton catalyst. All catalysts showed very good behavior, but the one prepared by ink painting (brush) was the best one. The degradation of amoxicillin was close to 90% under optimal conditions ([Fe3O4/C] = 100 mg L-1, -0.55 V) with the catalyst prepared using the painted method with a brush, which had 14.59 mA cm-2 as JK and a H2O2 electrogeneration close to 100% at the optimal voltage. These results show that carbon-gel-based electrocatalysts are not only very good at this type of application but can be adhered to graphite free of binders, thus enhancing all their catalytic properties.

Association Between Speech Reception Threshold in Noise and Multimorbidity: The UK Biobank Study.

OBJECTIVE: To investigate the association between hearing function, as approached with the functional auditory capacity, and multimorbidity. STUDY DESIGN: Cross-sectional study. SETTING: The UK Biobank was established from 2006 to 2010 in the United Kingdom. This cross-sectional analysis included 165,524 participants who provided baseline information on hearing function. METHODS: Functional auditory capacity was measured with a digit triplet test. Three categories were defined according to the speech reception threshold in noise (SRTn): normal (SRTn < -5.5 dB signal-to-noise ratio [SNR]), insufficient (SRTn ≥ -5.5 to ≤ -3.5 dB SNR) and poor hearing function (SRTn > -3.5 dB SNR). To define multimorbidity, 9 chronic diseases were considered, including chronic obstructive pulmonary disease, dementia, Parkinson's disease, stroke, cancer, depression, osteoarthritis, coronary heart disease, and diabetes; multimorbidity was defined as the coexistence of 2 or more in the same individual. Analyses were conducted using logistic models adjusted for relevant confounders. RESULTS: Among the study participants, 54.5% were women, and the mean (range) age was 56.7 (39-72) years. The prevalence of insufficient and poor hearing function and multimorbidity was 13% and 13.2%, respectively. In comparison with having a normal SRTn, the odds ratio (95% confidence interval) of multimorbidity associated with insufficient SRTn was 1.13 (1.08-1.18), and with poor SRTn was 1.25 (1.14-1.37). CONCLUSION: Insufficient and poor hearing function was associated with multimorbidity. This association suggests common biological pathways for many of the considered morbidities.

A wearable device perspective on the standard definitions of disability progression in multiple sclerosis.

INTRODUCTION: Multiple sclerosis (MS) is a leading cause of disability among young adults, but standard clinical scales may not accurately detect subtle changes in disability occurring between visits. This study aims to explore whether wearable device data provides more granular and objective measures of disability progression in MS. METHODS: Remote Assessment of Disease and Relapse in Central Nervous System Disorders (RADAR-CNS) is a longitudinal multicenter observational study in which 400 MS patients have been recruited since June 2018 and prospectively followed up for 24 months. Monitoring of patients included standard clinical visits with assessment of disability through use of the Expanded Disability Status Scale (EDSS), 6-minute walking test (6MWT) and timed 25-foot walk (T25FW), as well as remote monitoring through the use of a Fitbit. RESULTS: Among the 306 patients who completed the study (mean age, 45.6 years; females 67%), confirmed disability progression defined by the EDSS was observed in 74 patients, who had approximately 1392 fewer daily steps than patients without disability progression. However, the decrease in the number of steps experienced over time by patients with EDSS progression and stable patients was not significantly different. Similar results were obtained with disability progression defined by the 6MWT and the T25FW. CONCLUSION: The use of continuous activity monitoring holds great promise as a sensitive and ecologically valid measure of disability progression in MS.