Adipose Kiss1 controls aerobic exercise-related adaptive responses in adipose tissue energy homeostasis.

Kisspeptin signaling regulates energy homeostasis. Adiposity is the principal source and receiver of peripheral Kisspeptin, and adipose Kiss1 metastasis suppressor (Kiss1) gene expression is stimulated by exercise. However, whether the adipose Kiss1 gene regulates energy homeostasis and plays a role in adaptive alterations during prolonged exercise remains unknown. Here, we investigated the role of Kiss1 role in mice and adipose tissues and the adaptive changes it induces after exercise, using adipose-specific Kiss1 knockout (Kiss1adipoq-/-) and adeno-associated virus-induced adipose tissue Kiss1-overexpressing (Kiss1adipoq over) mice. We found that adipose-derived kisspeptin signal regulates lipid and glucose homeostasis to maintain systemic energy homeostasis, but in a sex-dependent manner, with more pronounced metabolic changes in female mice. Kiss1 regulated adaptive alterations of genes and proteins in tricarboxylic acid (TCA) cycle and oxidative phosphorylation (OxPhos) pathways in female gWAT following prolonged aerobic exercise. We could further show that adipose Kiss1 deficiency leads to reduced peroxisome proliferator-activated receptor gamma co-activator 1 alpha (PGC-1α) protein content of soleus muscle and maximum oxygen uptake (VO2 max) of female mice after prolonged exercise. Therefore, adipose Kisspeptin may be a novel adipokine that increases organ sensitivity to glucose, lipids, and oxygen following exercise.

Analysis of Clinical Outcome and Prognosis of C-reactive Protein Combined with Albumin in Patients with Acute Myocardial Infarction.

Objective: This study aims to assess the combined predictive value of C-reactive protein (CRP) and albumin (ALB) for major adverse cardiovascular events (MACE) post-percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI). Methods: We analyzed data from continuously enrolled AMI patients who underwent emergency PCI at the First Affiliated Hospital of Xinjiang Medical University over six years, employing logistic regression to derive a predictive equation for in-hospital mortality and out-of-hospital MACE events. Primary endpoints: In-hospital death and out-of-hospital major adverse cardiovascular events. The patients were followed up for 1, 3, 6, and 12 months after discharge. The average follow-up time was 41 months. Results: Among the 601 patients studied, we observed 16 in-hospital deaths and 131 out-of-hospital MACE events. Multivariate logistic regression analysis showed that the independent predictors of out-of-hospital MACE events were age (OR=1.067, 95% CI 1.013-1.124, P = .028), C-reactive protein (OR=1.012, 95% CI 1.000-1.025, P = .045) and albumin (OR=0.874, 95% CI 0.785-0.973, P = .014). Our multivariate logistic regression analysis identified age, CRP, and albumin as independent predictors, with the combined equation yielding an ROC curve area of 0.85, effectively stratifying patients into high-risk and low-risk groups. Subsequent follow-up results validated this risk stratification approach. Conclusion: The study underscores the efficacy of combining CRP and albumin levels as a predictive measure for in-hospital death and out-of-hospital MACE events in AMI patients post-PCI.

Prescription patterns and dosages of antiepileptic drugs in prevalent patients with epilepsy in Taiwan: A nationwide retrospective cross-sectional study.

OBJECTIVE: To evaluate the prescription patterns and prescribed daily dose (PDD)/defined daily dose (DDD) ratios of antiepileptic drugs (AEDs) in prevalent patients with epilepsy in Taiwan. MATERIALS AND METHODS: A nationwide retrospective cross-sectional study was conducted for prevalent patients with epilepsy in 2016 using the Taiwanese National Health Insurance Research Database. The prescription records of AEDs of all prevalent patients with epilepsy were retrieved. The mean PDDs and PDD/DDD ratios of AEDs in adult patients were obtained to evaluate dosing adequacy. A chi-square test and two-sample t test were used to analyze the differences in AED prescription patterns and dosages, respectively, among patients with different ages, sexes, comorbidities, and therapeutic approaches. RESULTS: A total of 118,937 prevalent patients with epilepsy were enrolled. The predominant therapeutic approach was monotherapy, especially in the elder adults, accounting for 82.9% of elder adult patients with epilepsy. The proportion of AED monotherapy was higher in patients with dementia (78.9%) and stroke (80.6%). The top three antiepileptic monotherapies were valproic acid (28.7%), levetiracetam (19.1%), and phenytoin (16.9%); however, oxcarbazepine (22.8%) was substituted for carbamazepine (3.9%) as monotherapy for patients aged 0-17 years. Among adult patients with epilepsy, the PDD/DDD ratio of each AED in monotherapy was less than 1.00. The mean PDD of each AED was higher in polytherapy than in monotherapy (p < 0.01), except for lacosamide. The mean PDDs of all evaluated AEDs in monotherapy were lower in elder adult patients than in younger adult patients, most of which reached statistical significance (p < 0.001). CONCLUSIONS: In Taiwan, valproic acid was the most prescribed AED for prevalent patients with epilepsy. The mean PDDs of most AEDs were lower than the DDDs developed by the World Health Organization.

[Blood lipid metabolic profile of overweight/obese boys aged 9-12 years].

OBJECTIVE: To study the features of blood lipid metabolic profile in overweight/obese boys aged 9-12 years and the possible mechanism of overweight/obesity in children. METHODS: According to body mass index (BMI), 72 boys, aged 9-12 years, were divided into a control group with 42 boys and an overweight/obesity group with 30 boys. Fasting venous blood samples were collected early in the morning. BMI, waist-hip ratio, body composition, and blood lipids were measured. Ultra-performance liquid chromatography-quadrupole time-of-flight mass spectrometry technique was used to analyze the serum lipid compounds. A statistical analysis and visualization of the data were performed. RESULTS: Compared with the control group, the overweight/obesity group had significantly higher waist-hip ratio, body fat percentage, and triglyceride level (P<0.05) and a significantly lower level of high-density lipoprotein cholesterol (P<0.05). The metabolomic analysis identified 150 differentially expressed lipid compounds between the two groups, mainly glycerolipids (40.7%), glycerophospholipids (24.7%), fatty acyls (10.7%), and sphingolipids (7.3%). The levels of most of glycerolipids were significantly upregulated in the overweight/obesity group, while those of most of glycerophospholipids and sphingolipids were downregulated in this group. Key lipids with differential expression were enriched into two KEGG metabolic pathways, i.e., ether lipid metabolism pathway and terpenoid backbone biosynthesis pathway (P<0.05), and might further affected the biosynthesis and metabolism of downstream coenzyme Q and other terpenoids (P=0.06). CONCLUSIONS: Disordered lipid metabolic profile is observed in overweight/obese boys aged 9-12 years, with increases in most glycerolipids and reductions in glycerophospholipids and sphingolipids. Overweight/obese boys may have disorders in ether lipid metabolism and biosynthesis of terpenoid and even coenzyme Q.

Synergistic effects of combination treatment using EGCG and suramin against the chikungunya virus.

Chikungunya is a severe disease that results from infection with the chikungunya virus (CHIKV), an arbovirus. Thus, we (1) explored a new approach to combining previously researched drugs that have shown the potential to inhibit CHIKV infection; and (2) demonstrated the antiviral effects of (-)-Epigallocatechin-3-gallate (EGCG) and the underlying mechanisms. Specifically, we used U2OS cells infected with CHIVK to assess the synergistic antiviral activities of EGCG and suramin. EGCG presented the ability to inhibit the viral RNA, progeny yield, and cytopathic effect (CPE) of CHIKV and also demonstrated the ability to protect against virus entry, replication, and release. Moreover, the results confirmed that EGCG and suramin can have synergistic effects against CHIKV strain S27 infection and two other clinical isolates of CHIKV. Our findings suggest that treatment with a combination of EGCG and suramin could provide a basis for the development of novel stretages against CHIKV infection.

Using a New Measurement to Evaluate Pain Relief Among Cancer Inpatients with Clinically Significant Pain Based on a Nursing Information System: A Three-Year Hospital-Based Study.

OBJECTIVE: Developing a new measurement index is the first step in evaluating pain relief outcomes. Although the percentage difference in pain intensity (%PID) is the most popular indicator, this indicator does not take into account the goal of pain relief. Therefore, the aims of this study were to develop a pain relief index (PRI) for outcome evaluation and to examine the index using demographic characteristics of cancer inpatients with clinically significant pain. DESIGN: Retrospective cohort study. SETTING: A national hospital. SUBJECTS: All cancer inpatients. METHODS: Pain intensity was assessed using a numerical rating scale, a faces pain scale or the Face, Legs, Activity, Cry, Consolability (FLACC) Behavioral Tool. Using a nursing information system, a pain score database containing data from 2011 through 2013 was analyzed. RESULTS: Cancer patients representing 93,812 hospitalizations were considered in this study. We focused on cancer patients for whom the worst pain intensity (WPI) was ≥ 4 points. PRI values of -62.02% to -72.55% were observed in the WPI ≥ 7 and 4 ≤ WPI ≤ 6 groups. Significant (P < 0.05) effects on PRI values were observed among patients who were > 65 years old, those who were admitted to the medicine or gynecology and those who had a hospital stay > 30 days. CONCLUSION: This hospital-based study demonstrated that the PRI is an effective and valid measure for evaluating outcome data using an electronic nursing information system. We will further define the meaningful range of percentage difference in PRI from various perspectives.

An increase in the incidence of hip fractures in Tangshan, China.

UNLABELLED: We determined the number and incidence of hip fractures in Tangshan, China, in 2010. Compared with data we reported in Tangshan from 1994, the crude and age-specific incidence increased significantly for both sexes, especially in women. Strategies are needed for effective fracture prevention in the future. INTRODUCTION: The aims of the study were to determine the incidence of cervical and trochanteric fractures of the proximal femur in Tangshan, China, in 2010 and to compare the incidence with data from 1994. METHODS: The orthopedic departments of 15 hospitals in Tangshan were visited in 2010; the medical records and radiographs of patients who had sustained cervical and trochanteric fractures were reviewed. The absolute number of admissions was collated and the incidence rate per 100,000 person years was calculated, adjusted by different age ranges, and gender. We then calculated the age-standardized incidence in 2010 as compared with those from 1994. RESULTS: The population of Tangshan in 2010 was determined to be 3,075,382 (1,558,173 males; 1,517,209 females); there were 1,509 cervical and trochanteric fractures (in 745 males and 764 females). The overall incidence was 47.8 and 50.4 fractures per 100,000 per year for men and women, respectively. Females showed a higher fracture incidence than males in those aged 55 years and over. Comparing the 2010 data with the 1994 findings, the incidence increased by 85% in men and by 306% in women; age-specific increases were observed in all female and male groups (except the 55-59 years age group). CONCLUSIONS: Compared with the results in 1994, the incidence of hip fracture has markedly increased in 2010 in Tangshan, China. It is necessary to implement a comprehensive policy for hip fracture prevention in our communities.

Intervention to reduce loneliness among older adults in the community: Making friends with volunteers.

AIM: This study aimed to examine the effects of providing a program that introduced volunteers to make friends with older adults to reduce loneliness and increase loneliness literacy. METHODS: Eight community development associations in Taiwan participated in the study. In the first stage, older people living alone or with only a spouse, or those with a family, but without substantial interactions, were screened for loneliness. Older adults with a higher risk of loneliness were given priority to be invited to participate in this intervention. This 3-month intervention program was designed by each community development association and delivered at the older adults' homes. A total of 87 older persons completed both waves of the interviews. RESULTS: Loneliness was reduced (UCLA-6 Loneliness Scale scores decreased from 13.5 to 11.6), and loneliness literacy improved (loneliness literacy scores increased from 38.9 to 42.0) compared with what it was before the program. In a generalized linear model, when controlling for covariates, loneliness was reduced, but not significantly (B = -0.934, P > 0.05), whereas loneliness literacy improved significantly for older participants (B = 2.088, P < 0.05). CONCLUSIONS: Making friends with older adults who are lonely might improve their loneliness literacy. Geriatr Gerontol Int 2024; 24: 240-245.

MRI brain structural and functional networks changes in Parkinson disease with REM sleep behavior disorders.

Background: Rapid eye movement sleep behavior disorder (RBD) is common in individuals with Parkinson's disease (PD). In spite of that, the precise mechanism underlying the pathophysiology of RBD among PD remains unclear. Objective: The aim of the present study was to analyze gray matter volumes (GMVs) as well as the changes of functional connectivity (FC) among PD patients with RBD (PD-RBD) by employing a combination of voxel-based morphometry (VBM) and FC methods. Methods: A total of 65 PD patients and 21 healthy control (HC) subjects were included in this study. VBM analyses were performed on all subjects. Subsequently, regions with significant different GMVs between PD patients with and without RBD (PD-nRBD) were selected for further analysis of FC. Correlations between altered GMVs and FC values with RBD scores were also investigated. Additionally, receiver operating characteristic (ROC) curves were employed for the evaluation of the predictive value of GMVs and FC in identifying RBD in PD. Results: PD-RBD patients exhibited lower GMVs in the left middle temporal gyrus (MTG) and bilateral cuneus. Furthermore, we observed higher FC between the left MTG and the right postcentral gyrus (PoCG), as well as lower FC between the bilateral cuneus (CUN) and the right middle frontal gyrus (MFG) among PD-RBD patients in contrast with PD-nRBD patients. Moreover, the GMVs of MTG (extending to the right PoCG) was positively correlated with RBD severity [as measured by REM Sleep Behavior Disorder Screening Questionnaire (RBDSQ) score]. Conversely, the FC value between the bilateral CUN and the right MTG in PD-RBD patients was negatively correlated with RBDSQ score. Conclusion: This study revealed the presence replace with GMV and FC changes among PD-RBD patients, which were closely linked to the severity of RBD symptoms. Furthermore, the combination of basic clinical characteristics, GMVs and FC values effectively predicted RBD for individuals with PD.

Freeze-Thaw Damage Mechanism Analysis of SBS Asphalt Mixture Containing Basalt Fiber and Lignocellulosic Fiber Based on Microscopic Void Characteristics.

Freeze-thaw effects pose the significant challenge to asphalt pavement durability, leading to various types of distress and deterioration. This study investigates the freeze-thaw damage mechanism of Styrene-Butadiene-Styrene (SBS) asphalt mixtures containing reinforcement fibers, specifically basalt fiber as well as lignocellulosic fiber, through a microscopic void characteristics analysis. This investigation aims to understand how the presence of basalt fiber as well as lignocellulosic fiber influences void characteristics for SBS asphalt mixtures during freeze-thaw cycles. A comprehensive experimental program was conducted for the void and mechanical characteristics, which involved the preparation of SBS asphalt mixtures containing basalt fiber as well as lignocellulosic fiber. The mechanical performances of the two types of asphalt mixtures decrease with more freeze-thaw cycles. The decline is faster initially and gradually slows down. Basalt-fiber-modified SMA-13 has higher air void content and mechanical properties compared to lignocellulosic-fiber-modified SMA-13, indicating that adding basalt fibers improves the mechanical performances of SMA-13 asphalt mixture. Both types of asphalt mixtures experience increasing damage with more freeze-thaw cycles, indicating irreversible damage. The stability damage levels are similar, but basalt-fiber-modified SMA-13 has lower splitting strength damage and stiffness modulus damage compared to lignocellulosic-fiber-modified SMA-13. This suggests that adding basalt fibers enhances the resistance to freeze-thaw damage. Surface wear of asphalt mixtures under repeated freeze-thaw cycles is a complex and dynamic process. Fractal theory can uncover the mechanism of surface wear, while describing surface wear behavior and void deformation characteristics using fractal dimension, angularity, roundness, and aspect ratio is a logical and effective approach. The findings provide insights into freeze-thaw damage mechanisms at the microscopic level, highlighting the effects of reinforcement fibers. They provide valuable insights that can be used to optimize the design and maintenance of asphalt pavements.

Evaluation and Correlation Analysis of the Rheological Properties of Ground Tire Rubber and Styrene Butadiene Styrene Compound-Modified Asphalt.

With the increase in highway traffic volume, many waste tires are being produced, which puts serious pressure on the global ecological environment. Processing waste tires into powder and adding them to asphalt is an important and effective way to solve this noticeable environmental challenge. In this paper, to produce ground tire rubber (GTR) and styrene-butadiene-styrene (SBS) compound-modified asphalt, GTR was put into SBS-modified asphalt (GTRSA). Subsequently, some ordinary property tests, frequency sweep tests, and multiple stress creep recovery tests were conducted to investigate the conventional properties and rheological properties of GTRSA. Moreover, the 2S2P1D (two springs, two parabolic elements, and one dashpot) model was adopted to analyze the consequences of adding GTR content on the rheological properties of GTRSA. Finally, the Pearson correlation coefficient was employed to reveal the connection between the conventional properties and the rheological properties. The results show that GTR has a great impact on improving the rutting resistance, thermo-sensitive performance, shear resistance capability, stress sensitivity, and creep recovery performance of GTRSA. Adding 20% GTR can improve the creep recovery rate to 80.8%. The 5 °C ductility index suggests that GTR makes a difference to the low-temperature properties. The rheological properties and conventional properties had a strong linear link.

Sensitivity and Reliability Analysis of Ultrasonic Pulse Parameters in Evaluating the Laboratory Properties of Asphalt Mixtures.

The ultrasonic test is a promising non-destructive testing technique for evaluating the properties of asphalt mixtures. To investigate the applicability and reliability of ultrasonic testing technology (UTT) in evaluating the performance of asphalt mixtures, ultrasonic tests, indirect tensile tests, compression tests, and dynamic modulus tests were carried out at various temperatures. Subsequently, the distribution characteristics of ultrasonic traveling parameters for asphalt mixtures were analyzed. The variation of ultrasonic pulse velocity and amplitude in dry and wet states with temperature was studied. Then, the correlation between the ultrasonic parameters and both the volume parameters and the mechanical performance parameters of asphalt mixtures was revealed, and the functional relationship between ultrasonic pulse velocity and compressive strength was established. Finally, the reliability of predicting high-frequency dynamic modulus by ultrasonic velocity was verified. The laboratory tests and analysis results indicate that both ultrasonic pulse velocity and amplitude in dry and wet conditions show a decreasing trend with an increase in temperature. Ultrasonic parameters are greatly influenced by asphalt content and mineral aggregate content of 9.5~13.2 mm and 13.2~16 mm. The dynamic modulus at a high-frequency load can be predicted by using ultrasonic velocity, and predicting the results for OGFC and SMA mixtures deduced by using the UPV at a high-frequency load have higher reliability.

Neural correlates of feigned memory impairment are distinguishable from answering randomly and answering incorrectly: an fMRI and behavioral study.

Previous functional magnetic resonance imaging (fMRI) studies have identified activation in the prefrontal-parietal-sub-cortical circuit during feigned memory impairment when comparing with truthful telling. Here, we used fMRI to determine whether neural activity can differentiate between answering correctly, answering randomly, answering incorrectly, and feigned memory impairment. In this study, 12 healthy subjects underwent block-design fMRI while they performed digit task of forced-choice format under four conditions: answering correctly, answering randomly, answering incorrectly, and simulated feigned memory impairment. There were three main results. First, six areas, including the left prefrontal cortex, the left superior temporal lobe, the right postcentral gyrus, the right superior parietal cortex, the right superior occipital cortex, and the right putamen, were significantly modulated by condition type. Second, for some areas, including the right superior parietal cortex, the right postcentral gyrus, the right superior occipital cortex, and the right putamen, brain activity was significantly greater in feigned memory impairment than answering randomly. Third, for the areas including the left prefrontal cortex and the right putamen, brain activity was significantly greater in feigned memory impairment than answering incorrectly. In contrast, for the left superior temporal lobe, brain activity was significantly greater in answering incorrectly than feigned memory impairment. The results suggest that neural correlates of feigned memory impairment are distinguishable from answering randomly and answering incorrectly in healthy subjects.

Correlation between Neutrophil-to-Lymphocyte Ratio and Pretreatment Magnetic Resonance Imaging and Their Predictive Significance in Cervical Carcinoma Patients Referred for Radiotherapy.

Objective: The aim of this study was to determine the correlation between neutrophil-to-lymphocyte ratio (NLR) and various tumor parameters assessed by pretreatment magnetic resonance imaging (MRI) and to evaluate their prognostic significance for cervical carcinoma treated with radiotherapy (RT). Methods: The study enrolled 78 patients with biopsy-proven squamous cell carcinoma (SCC) of primary cervical cancer (clinically staged IB2 to IVA) who were treated in the Department of Clinical Oncology of the University of Hong Kong-Shenzhen Hospital between August 2015 and May 2019. A retrospective analysis of patients with SCC was performed. Firstly, we investigated the correlations between NLR and MRI parameters. Then, univariate and multivariate analyses were performed to identify the prognostic factors for overall survival (OS) and progression-free survival (PFS). Kaplan-Meier curves were constructed for OS and PFS. Results: Higher NLR showed significant association with larger tumor diameter and parametrial invasion assessed by pretreatment MRI. Univariate analysis indicated that uterine body invasion, parametrial invasion, and NLR were associated with prognosis of cervical cancer. Multivariable analyses demonstrated that parametrial invasion and NLR higher than the cutoff were independently associated with shorter OS and PFS, whereas uterine body invasion showed a significantly unfavorable influence on OS but showed no significant effect on PFS. Using the three risk factors of NLR above cutoff, parametrial invasion, and uterine body invasion, patients were divided into three subgroups. The three-year OS rates of patients with zero risk factors, one risk factor, and two or three of these factors were 96%, 91%, and 42%, respectively (P < 0.001), showing a downward trend. Conclusions: Uterine body invasion, parametrial invasion, and NLR were significant prognostic factors for patients with cervical carcinoma treated with RT. These results may supplement FIGO staging to improve prognostic assessment of patients.

Novel Insight into the Role of the Kiss1/GPR54 System in Energy Metabolism in Major Metabolic Organs.

The Kiss1/GPR54 system is a multifunctional genetic system with an essential role in regulating energy balance and metabolic homeostasis. In the mammalian hypothalamus, two major populations of neurons, the rostral periventricular region of the third ventricle (RP3V) and the arcuate nucleus (ARC), produced kisspeptin. Kiss1ARC neurons input kisspeptin and glutamate to feeding-associated neurons to regulate energy intake and expenditure balance. Kisspeptin in the peripheral circulation is involved in lipid accumulation in adipose tissue. In the hepatic and pancreatic circuits, kisspeptin signaling affects insulin secretion, suggesting the critical role of the Kiss1/GPR54 system in regulating glucose and lipid metabolism. In addition, this review also predicts the role of the Kiss1/GPRS4 system in skeletal muscle in association with exercise performance. Recent studies have focused on the link between kisspeptin signaling and energy homeostasis, further investigation of potential function is warranted. Therefore, this review summarizes the role of the Kiss1/GPRS4 system in the major metabolic organs in relation to energy metabolism homeostasis, aiming to endow the reader with a critical and updated view of the Kiss1/GPR54 system in energy metabolism.

Effects of high-fat diet and treadmill running on the hypothalamic Kiss-1-GPR54 signaling pathway in male growing rats.

BACKGROUND: Kiss-1 neuron, one of the metabolic sensors in the hypothalamus, is necessary for puberty initiation. It acts through G protein-coupled receptor, known as GPR54. In this study, the mechanism of the hypothalamic Kiss-1-GPR54 signaling pathway in a high-fat diet and exercise was investigated in growing male rats. METHODS: A total of 135 3-week-old male weaned rats were kept on a high-fat diet (HFD) and exercise (60-70% [Formula: see text], 1 h/day, 5 days/week). They were randomly divided, as follows: control group (C); normal diet + exercise group (CE); HFD group (H); and HFD + exercise group (HE). Hypothalamus, testis, and serum samples of each group were collected on postnatal day (PND) 21 (early childhood), 43 (puberty), and 56 (maturity). Immunofluorescence, quantitative real-time PCR, hematoxylin and eosin staining, and chemiluminescent immunoassays were used in the study. ANOVA was used to analyze the effects of age (PNDs 21, 43, and 56), exercise (exercise and sedentariness), and diet (high-fat and normal) on the biological indices of rats. RESULTS: mRNA and protein expression of Kiss-1 and GPR54 in the hypothalamus gradually increased along with growth and peaked at PND 43, while those in serum testosterone increased and peaked at PND 56. The high-fat diet increased the expression of the Kiss-1-GPR54 system in the hypothalamus, whereas the serum testosterone decreased during different stages of growth. Exercise decreased the expression of Kiss-1 at PND 56 and increased it at PND 43. Meanwhile, it decreased testosterone and the deposition of lipid droplets in the testis at all ages of development. CONCLUSIONS: The expression of Kiss-1-GPR54 in male rats showed fluctuating changes during growth and development. The high-fat diet was able to upregulate the expression of the Kiss-1-GPR54 system in the hypothalamus. The exercise was able to correct the adverse effect of the high-fat diet on the Kiss-1-GPR54 signaling pathway in the hypothalamus and the function of the hypothalamic-pituitary-gonadal (HPG) axis, but had age-specific effects on the male rats' development.

Effectiveness of influenza vaccination in the elderly: a population-based case-crossover study.

BACKGROUND: There is limited information regarding the effectiveness of influenza vaccines for older adults. Particularly, controlling for healthy senior bias is challenging in observational studies. We aimed to assess the efficacy of influenza vaccination in the elderly while addressing potential healthy senior bias and whether it was related to virus-vaccine strains matching. METHOD: To control between-individual confounder, we used a case-crossover study design using Taiwan's National Health Insurance Research Dataset to analyse the association between influenza vaccination in older adults and the risk of hospitalisation for community-acquired pneumonia (CAP). Individuals were a 'case' in vaccinated years and a 'control' in unvaccinated years. The study periods were 2006/2007 and 2007/2008 seasons because virus-vaccine strains were matching in 2006/2007 season and unmatching in 2007/2008 season. Older adults were categorised into two groups: admitted for CAP during the pre-vaccination period (Admitted, n=311) and not hospital admitted for CAP (Non-admitted, n=572 432). The outcome was hospitalisation for CAP during the influenza period. Conditional logistic regression assessed influenza vaccine efficacy in reducing CAP. RESULTS: Influenza vaccination had no protective effects in Admitted group. However, because of the tiny numbers in Admitted group, we could draw very limited conclusions. Receiving an influenza vaccine significantly prevented CAP in Non-admitted group only during the vaccine-circulating strain-matched year (OR, 0.72; 95% CI, 0.64 to 0.83). In addition, there was no protective effect against CAP hospitalisation among individuals with a Charlson Comorbidity Index score over 2. CONCLUSION: Influenza vaccine efficacy was associated with vaccine-circulating strain-matched. When vaccine-circulating strains were all matching, receiving a shot reduced the probability of CAP hospitalisation by 28% in Non-admitted group. However, high comorbidity may reduce the vaccine efficacy. Therefore, it is necessary to educate older adults to receive annual influenza vaccination and in combination with non-pharmaceutical interventions to reduce the risk of CAP.

Protective effects of equol on the cartilage and subchondral bone in ovariectomized rats with osteoarthritis.

Objectives: This study aimed to determine the therapeutic effect of equol (EQ) on osteoporotic osteoarthritis (OP OA). Materials and Methods: Thirty-six 12-week-old female Sprague-Dawley rats were randomly divided into sham group, OP OA group, and EQ group (n=12). OP OA was induced by anterior cruciate ligament transection (ACLT) combined with ovariectomy (OVX). EQ was orally administrated (10 µg/g/day) after the operation for 12 weeks. The efficacy was evaluated by gross pathology and histopathologic evaluation. The underlying mechanism was investigated by immunohistochemical analysis, micro-computed tomography (micro-CT) scanning, and tartrate-resistant acid phosphatase (TRAP) staining. Results: EQ effectively retarded cartilage degeneration, decreased the levels of matrix metalloproteinases-13 (MMP-13), a disintegrin and metalloproteinase with thrombospondin motifs 5 (ADAMTS-5), nuclear factor-kappa B P65 (NF-κB P65) and caspase-3, and increased the levels of collagen type II (Col-II), Col-I, aggrecan (AGG), and inhibitor of NF-κB α (IκBα) in the cartilage. In addition, EQ increased bone mineral density, improved the microstructural parameters of the subchondral bone (SB), and decreased the number of osteoclasts. Conclusion: EQ exerted a chondroprotective effect on OP OA in rats, associated with inhibition of the NF-κB signaling pathway and chondrocyte apoptosis. Furthermore, EQ showed an osteoprotective effect on SB via inhibiting osteoclastic activities.

Analysis of trends and factors determining initial antiseizure medication choice for epilepsy in Taiwan.

PURPOSE: To evaluate the current trends and factors associated with the first anti-seizure medications (ASMs) prescribed for epilepsy in Taiwan. METHODS: Data for patients with epilepsy were collected from the National Health Insurance Research Database, a population-based claims database. We selected patients with newly diagnosed epilepsy from 2013 to 2016. Multivariate logistic regression was used to examine the factors associated with the selection of newer ASMs for the first prescription. RESULTS: A total of 73,891 patients with newly diagnosed epilepsy were eligible for the study, and the annual incidence was approximately 0.79 per 1,000 people. The five ASMs most prescribed for monotherapy were valproic acid, phenytoin, levetiracetam, gabapentin, and oxcarbazepine, accounting for nearly 90% of all ASMs. Valproic acid was the most-prescribed ASM (more than 30%), and levetiracetam has replaced phenytoin as the second choice since 2015. Factors associated with the selection of newer ASMs for the first prescription were patients' year of diagnosis, gender, socioeconomic level, and previous or existing comorbidities and the profiles of the care providers (accreditation level, service volume, geographic location, and degree of urbanization of the surrounding area). CONCLUSION: The data indicated that the trends in ASMs first prescribed for patients in Taiwan accorded with most of the international epilepsy treatment guidelines. However, there were some differences between our results and those in developed countries. In addition, we observed a large urban-rural disparity in the administration of ASMs.

Increased risk for sleep disorders in burn patients: A 14-year nationwide, population-based cohort study.

BACKGROUND: Burn is a major trauma that causes physical and psychosocial impairments, leading to sleep disorders. However, the data about risks for sleep disorders in patients over 3 years following burn injury are limited. AIM: To investigate the long-term risks for sleep disorders in patients after burn injury and identify the high-risk population. METHODS: A 14-year population-based cohort study was performed using data from the 2000-2013 Taiwan National Health Insurance Research Database (NHIRD) which was a valid representative sample of the total population. All diagnoses of medical records in NHIRD were made by physicians and coded according to the ICD-9-CM. Cases diagnosed with burns (ICD-9 CM: N-code 940-949 and E-code 890-899) were included. The control group (non-burn injury group) was comprised quadruple the number of cases matched by index date, sex and age. RESULTS: In 2000-2013, among the 10,289 burn patients included and followed-up after the index year, burn injury significantly increased the risks for sleep disorders (Hazard Ratio; HR = 1.36, p = 0.044), including insomnia (HR = 1.41, p = 0.036), sleep disturbance (HR = 2.39, p = 0.005) and sleep apnoea (HR = 1.38, p = 0.029). Compared with the control group, those who were women (HR = 1.73, p = 0.021), adolescents (HR = 5.45, p < 0.001), aged 19-24 years (HR = 1.36, p = 0.034), aged 25-44 years (HR = 1.67, p = 0.007), had low income (HR = 2.14, p = 0.001), and without a history of mental disorders (HR = 1.41, p = 0.024) had significantly higher risks for developing sleep disorders when suffered burn injury. CONCLUSION: Burn had long-term negative effects on sleep during both the first year of burn injury and the subsequent follow-up 14 years. It is important for physicians to long-term assess the sleep quality of burn patients regardless of the number of years after burn injury.