Health comparisons between active and inactive transport modes in urban adults with chronic conditions: A cross-sectional study.

An active transport mode provides an opportunity for integrating physical activity into one's daily life through walking, cycling, and the use of public transportation. The purpose of this study was to compare urban adults with chronic conditions who used active and inactive transport modes and to find differences in their health outcomes. A cross-sectional study was conducted from September 2019 to May 2020. Participants were urban adults who self-reported being overweight or obese, or having a diagnosis of chronic disease. Anonymous structured self-reported questionnaires were used for data collection, including the World Health Organization Quality-of-Life Scale, International Physical Activity Questionnaire Short-Form, and the frequency of eight modes of transportation. According to differences between the frequency score of weekly active and inactive transportation, participants were categorized into inactive, balanced, and active transport modes. In total, 617 valid responses were obtained. Participants who engaged in an active transport mode were found to have significantly less sedentary time, and better comprehensive, social, and environmental aspects of quality of life than those with an inactive transport mode. Engaging in active transportation and avoiding inactive transportation are recommended for urban adults with chronic diseases.

Risk factors related to age at diagnosis of pancreatic cancer: a retrospective cohort pilot study.

BACKGROUND: Increased pancreatic cancer incidence has been observed among younger than in older adults. This pilot study aimed to determine the feasibility of a large study that would compare the age at diagnosis of pancreatic cancer among patients with different risk factors. METHODS: We compared the age at diagnosis of pancreatic cancer between groups of pancreatic cancer patients exposed and not exposed to the identified risk factors. We estimated the age at which exposure started, average exposure quantity, and total years of exposure and investigated their relationships with age at diagnosis of pancreatic cancer. RESULTS: Sixteen out of 24 (67%) subjects carried known genetic factors and/or had smoking and/or drinking habits; however, an earlier age of pancreatic cancer diagnosis was not observed. Conversely, we found a significant correlation between the age at which alcohol consumption was started and the age at diagnosis of pancreatic cancer (r = 0.8124, P = 0.0043). CONCLUSIONS: Our pilot study suggested that a large study following this study design is feasible and that the following should be conducted in a large study: mediation analysis for disease-related factors, advanced genomic analysis for new candidate genes, and the correlation between age of first exposure to risk factors and pancreatic cancer onset.

The efficacy of commercial smartwatches with a blood pressure-monitoring feature: A pilot randomized controlled trial.

PURPOSE: The purpose was to explore the efficacy of a commercial smartwatch with a blood pressure-monitoring feature. DESIGN: A randomized controlled trial. METHODS: Sixty healthy young adults were recruited. Participants were randomly allocated to wear a commercial smartwatch, one with and one without a blood pressure-monitoring feature for 12 weeks. Data were collected using Omron HEM-907, Inbody 270S, and the International Physical Activity Questionnaire. FINDINGS: Results revealed a significant effect and group-by-time interaction on diastolic blood pressure. After 12 weeks in participants who wore a smartwatch with a blood pressure-monitoring feature, the systolic and diastolic blood pressure and resting heart rate had decreased. CONCLUSION: Using commercial smartwatches with a blood pressure-monitoring feature is a feasible approach to support self-management, increase awareness, and promote physical activity for health promotion, obesity and chronic disease prevention. CLINICAL RELEVANCE: Wearable technologies may be an innovative strategy for preventing high blood pressure by continuous self-monitoring and healthy behavior modifications.

Walking and cycling for health: A multi-group analysis of path models between genders.

AIMS: Walking and cycling are beneficial for urban adults' health. Transport and recreation are modifiable domains of major physical activity resources. The purposes of this study were to explore associations among psychological and environmental factors, walking and cycling behaviours and quality of life by developing a path model and comparing gender differences. DESIGN: A cross-sectional study. METHODS: Participants were community-dwelling healthy urban adults aged 20-65 years. Data were collected between September 2019 and June 2020 by self-reported questionnaires, including health beliefs, the neighbourhood environment, walking and cycling behaviours and the World Health Organization Quality-of-Life Scale. An ANCOVA, chi-squared tests, partial least squares-path model and a multi-group analysis were performed for statistical analyses. RESULTS: In total, 1294 valid responses were received, which included 41.27% men and 58.73% women. Men had lower walking behaviours and better self-efficacy than women. The developed path model indicated an acceptable model fit. Significant path coefficients were found among psychological and environmental factors, walking and cycling behaviours and quality of life. The path model between men and women found no significant differences in any path coefficients. Significant path coefficients of environmental factors with cycling behaviour and of walking behaviour with quality of life were found in men but not in women. CONCLUSION: Improving individuals' health beliefs, self-efficacy and perceived walkability and cyclability is a beneficial strategy for promoting physical activity. Walking and cycling behaviours are recommended to improve the quality of life of urban adult populations. IMPACTS: What problem did the study address? A large proportion of urban adult populations still have insufficient physical activity globally. It is essential that implications from an overall perspective of psychological and environmental factors and their interactions be integrated to develop efficient strategies for promoting physical activity and quality of life. What were the main findings? The developed path model with an acceptable model fit found that psychological and environmental factors were important in explaining urban adults' walking and cycling behaviours and quality of life. Differences were not found between men's and women's path models. Where and on whom will the research have impact? Improving urban adults' psychological and environmental factors might be an efficient strategy for promoting sufficient physical activity. Men's low engagement in walking behaviours should garner increased attention. Providing equal opportunities for both genders to engage in walking and cycling behaviours are recommended for health promotion in urban regions.

Accuracy of simultaneous measurement of serum biomarkers: Carbohydrate antigen 19-9, pancreatic elastase-1, amylase, and lipase for diagnosing pancreatic ductal adenocarcinoma.

BACKGROUND: Pancreatic cancer is difficult to diagnose early since tumor markers have low sensitivity and specificity. We simultaneously measured serum carbohydrate antigen (CA) 19-9, pancreatic elastase-1, lipase, and amylase, and evaluated the accuracy of a single marker or a combination of two, three, or four markers in the diagnosis of pancreatic ductal adenocarcinoma (PDAC). METHODS: Seventy-six patients with PDAC were included, and 75 patients with non-PDAC diseases were enrolled as the control group. Blood specimens were collected and analyzed for pancreatic elatase-1, CA19-9, amylase and lipase. Sensitivity, specificity, and accuracy for each individual marker and in combination were determined. RESULTS: In PDAC subjects, abnormal CA19-9 was seen most frequently at 80.3%, followed by pancreatic elastase-1 at 57.9%, lipase at 53.9%, and amylase at 51.3%. In non-PDAC subjects, the percentage of abnormal serum pancreatic elastase-1, CA19-9, lipase, and amylase were 50.7%, 41.3%, 40.0%, and 28.0%, respectively. The accuracy rate of amylase and CA19-9 results combined was 64.9% and was higher than the combination of other markers in the intersection set. In the union set, the group of amylase and CA19-9 combined and the group of lipase and CA19-9 combined had the highest accuracy at 66.2%. In the intersection and union set, the area under the curve of CA19-9 was the highest at 0.695. CONCLUSION: CA19-9 as a single marker is the most accurate in the clinical diagnosis of PDAC. Combination of lipase, amylase, or pancreatic elastase-1 results does not significantly increase the accuracy of PDAC diagnosis.

Synthesis and Evaluation of Novel 2-Pyrrolidone-Fused (2-Oxoindolin-3-ylidene)methylpyrrole Derivatives as Potential Multi-Target Tyrosine Kinase Receptor Inhibitors.

Signaling pathways of VEGFs and PDGFs are crucial in tumor angiogenesis, which is essential in solid tumor progression and metastasis. This study reports our strategy for designing and synthesizing a series of novel 2-pyrrolidone-fused (2-oxoindolin-3-ylidene)methylpyrrole derivatives as potential multi-target tyrosine kinase receptor inhibitors. The target compounds were obtained by condensation of 5-substituted oxindoles with N-substituted 2-pyrrolidone aldehyde 7 in satisfactory yields. Of these, 11 and 12 had the highest potency and, compared to sunitinib, showed: (1) significant increase in anti-proliferation of various cancer cells with a favorable selective index (SI); (2) higher inhibitory potency against both VEGFR-2 and PDGFRß. The molecular modeling results showed that, in terms of VEGFR-2 binding, the synthesized products had a similar binding mode to sunitinib but with tighter interaction.

Novel daidzein analogs and their in vitro anti-influenza activities.

A series of novel isoflavonoids were synthesized based on structural modifications of daidzein, an active ingredient of traditional Chinese medicine (TCM) and evaluated for their anti-influenza activity, in vitro, against H1N1 Tamiflu-resistant (H1N1 TR) virus in the MDCK cell line. Among them, 4-oxo-4H-1-benzopyran-8-carbaldehydes 11a-11g were most promising, and they demonstrated better activities and selectivities comparable to those the reference ribarivin, a nucleoside antiviral agent. 3-(4-Bromophenyl)-7-hydroxy-4-oxo-4H-1-benzopyran-8-carboxaldehyde (11c) displayed the best inhibitory activity (EC50 , 29.0 µM) and selectivity index (SI>10.3). Analysis of the structureactivity relationships (SAR) indicated that both the non-naturally-occurring Br-substituted B-ring and appropriate CHO and OH groups on the A-ring might be critical for the activity and selectivity against H1N1 TR influenza viruses.

Differential diagnosis of colorectal polyps with respect to similar capabilities of white light colonoscopy and narrow-band imaging.

PURPOSE: The responses of polyps to light essentially determine the diagnostic capability of an endoscopy system in differentiating adenomas from hyperplastic polyps. Compared with white light colonoscopy (WLC), narrow-band imaging (NBI) is expected to improve the diagnostic capability. The diagnostic capabilities of WLC and NBI are evaluated and compared based on the polyp responses. METHODS: The following WLC and NBI images were retrospectively reviewed and categorized: 195 images and polyps (89 WLC, 106 NBI) with the best visual quality were categorized in the best image group (BG), and 484 images of 242 polyps (both WLC and NBI) were categorized in the paired image group (PG). For each reflection of light used for WLC or NBI, the polyp responses were objectively expressed as reflection features. The reflection features were then used to establish a classification model for identifying adenomas. The diagnostic capability of reflection feature or classification model was measured by the area under the receiver operating characteristic curve (AUC). RESULTS: In both image groups, the diverse and heterogeneous features of the polyp responses enabled accurate identification of adenomas, regardless of the light source used for WLC and NBI. For differential diagnosis of adenomas and hyperplastic polyps, the WLC and NBI did not significantly differ in BG (AUC, 0.905 and 0.922, respectively; P = 0.690) or in PG (AUC, 0.782 and 0. 769, respectively; P = 0.755). CONCLUSIONS: Using WLC and NBI as classification models is effective in differential diagnosis of colorectal polyps and exhibited similar capabilities.

Synthesis and anti-influenza activities of novel baicalein analogs.

A series of novel flavones derivatives were synthesized based on modification of the active ingredients of a traditional Chinese medicine Scutellaria baicalensis GEORGI and screened for anti-influenza activity. The synthetic baicalein (flavone) analogs, especially with the B-rings substituted with bromine atoms, were much more potent than oseltamivir or ribavirin against H1N1 Tamiflu-resistant (H1N1 TR) virus and usually with more favorable selectivity. The most promising were 5b, 5c, 6b and 6c, all displaying an 50% effective concentration (EC50) at around 4.0-4.5 µM, and a selective index (SI=50% cytotoxic concentration (CC50)/EC50)>70. For seasonal H3N2-infected influenza virus, both 5a and 5b with SI >17.3 indicated superior to ribavirin. The flavonoids having both not-naturally-occurring bromo-substituted B-rings and appropriate hydroxyls positioning on the A-rings might be critical in determining the activity and selectivity against H1N1-Tamiflu-resistant infected influenza viruses.

Household physical activity and subjective well-being: An international comparison among East Asian older adult populations.

PURPOSE: Engaging in lifelong physical activity has multiple health benefits for older populations. Household physical activity occupies older adults' awake time, and they can be an important energy expenditure during the day. The purpose of this study was to investigate the association between older adults' household physical activity and subjective well-being in four East Asian societies. METHODS: The study design was a secondary data analysis. Data were retrieved from the module of Families 2016 in the database of the East Asian Social Survey. Participants were community-dwelling older adults with a mean age of 70.30±7.50 years and who lived in China, Japan, Korea, and Taiwan. Data were collected by interviews via structured questionnaires between 2016 and 2018. Descriptive analyses, independent t-tests, and an analysis of covariance were performed for the statistical analyses. RESULTS: In total, there were 3,432 valid responses. Participants who lived in Taiwan had significantly lower levels of total household physical activity than those living in other societies. Older adults' household physical activity was found to significantly differ by age, educational degree, gender, religion, marital status, occupation, and whether living alone. Older adults with high levels of household physical activity had significantly higher self-rated health and marital satisfaction than those with low levels. CONCLUSIONS: Household physical activity has potential benefits for subjective well-being across international older adult populations. Increasing household physical activity is recommended for older married couples to maintain marital satisfaction.

An Exploration of Sedentary Behavior, Physical Activity, and Quality of Life During the COVID-19 Outbreak.

Objectives: Staying physically active is a cost-efficient strategy for disease prevention during a pandemic. The purposes of this study were to explore precautionary behaviors, psychological factors associated with physical activity and sedentary behavior, and impacts of active and sedentary lifestyles on the quality of life in the early stage of the coronavirus disease 2019 (COVID-19) outbreak. Methods: Participants were community-dwelling adults aged over 20 years who had not been infected with COVID-19 and who lived in the United States. A study with a cross-sectional design was conducted between July and October 2020. Quantitative data were collected by a self-reported questionnaire. Results: In total, 467 valid responses were obtained. Participants who engaged in an active lifestyle had significantly higher scores on all domains of quality of life compared to those who engaged in an inactive lifestyle. Participants with a non-sedentary lifestyle had significantly higher scores of psychological and social domains of quality of life than those with a sedentary lifestyle. Conclusion: Engaging in an active lifestyle and avoiding a sedentary lifestyle are recommended when facing future, unpredictable pandemics similar to COVID-19.

Physicochemical Characterization, Biocompatibility, and Antibacterial Properties of CMC/PVA/Calendula officinalis Films for Biomedical Applications.

This study reports a carboxymethyl cellulose (CMC)/polyvinyl alcohol (PVA) composite film that incorporates Calendula officinalis (CO) extract for biomedical applications. The morphological, physical, mechanical, hydrophilic, biological, and antibacterial properties of CMC/PVA composite films with various CO concentrations (0.1%, 1%, 2.5%, 4%, and 5%) are fully investigated using different experiments. The surface morphology and structure of the composite films are significantly affected by higher CO concentrations. X-ray diffraction (XRD) and Fourier transform infrared spectrometry (FTIR) analyses confirm the structural interactions among CMC, PVA, and CO. After CO is incorporated, the tensile strength and elongation upon the breaking of the films decrease significantly. The addition of CO significantly reduces the ultimate tensile strength of the composite films from 42.8 to 13.2 MPa. Furthermore, by increasing the concentration of CO to 0.75%, the contact angle is decreased from 15.8° to 10.9°. The MTT [3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide] assay reveals that the CMC/PVA/CO-2.5% and CMC/PVA/CO-4% composite films are non-cytotoxic to human skin fibroblast cells, which is favorable for cell proliferation. Remarkably, 2.5% and 4% CO incorporation significantly improve the inhibition ability of the CMC/PVA composite films against Staphylococcus aureus and Escherichia coli. In summary, CMC/PVA composite films containing 2.5% CO exhibit the functional properties for wound healing and biomedical engineering applications.

The small-molecule TNF-alpha modulator, UTL-5g, reduces side effects induced by cisplatin and enhances the therapeutic effect of cisplatin in vivo.

We investigated a small-molecule modulator of tumor necrosis factor alpha (TNF-alpha), UTL-5g (also referred to as GBL-5g), as a potential chemoprotective agent against cisplatin-induced side effects including nephrotoxicity, hepatotoxicity and hematotoxicity. Pretreatment of UTL-5g i.p. in BDF1 mice reduced the levels of blood urea nitrogen (BUN) and creatinine induced by cisplatin treatment. The levels of both aspartate transaminase (AST) and alanine transaminase (ALT) in these animals were also reduced by UTL-5g. Pretreatment of UTL-5g did not significantly affect the number of white blood cells (WBC) under current experimental conditions, yet it markedly increased blood platelet counts by more than threefold. Therapeutic assessment in SCID mice inoculated with human HCT-15 tumor cells showed that UTL-5g did not attenuate the anti-tumor effect of cisplatin but increased the therapeutic efficacy of cisplatin. The LD50 of UTL-5g was determined to be > 2,000 mg/kg by an acute toxicity study. In summary, our studies showed that 1) UTL-5g significantly reduces nephrotoxicity and hepatotoxicity induced by cisplatin in mice, presumably by lowering the levels of TNF-alpha, 2) UTL-5g markedly increased blood platelet counts in mice and 3) UTL-5g treatment increased the therapeutic efficacy of cisplatin against HCT-15 cells inoculated in SCID mice.

Endoscopic ligation and resection for the treatment of small EUS-suspected gastric GI stromal tumors.

BACKGROUND: GI stromal tumors (GISTs), with their potential for malignant transformation, are usually treated by surgical intervention. Endoscopic treatment remains controversial. OBJECTIVE: The aim of this study was to investigate clinical outcomes associated with use of endoscopic ligation and resection for diagnosis and treatment of small EUS-suspected gastric GISTs. DESIGN: Prospective case series. SETTING: Academic medical center. PATIENTS: Eight patients with submucosal gastric tumors <2 cm in diameter suspected to be GISTs. INTERVENTIONS: Endoscopic ligation and resection. MAIN OUTCOME MEASUREMENTS: Clinical/technical feasibility, success, and adverse events. RESULTS: Seven patients with small EUS-suspected gastric GISTs were successfully treated by endoscopic ligation, with sloughing of residual tissue within 1 month. All were diagnosed pathologically with GISTs of low malignant potential. One additional patient required a second ligation to remove residual tumor, also diagnosed as a GIST with low malignant potential. No perforation, massive hemorrhage, or other complication requiring endoscopic or surgical intervention occurred. LIMITATIONS: Small number of patients (n = 8) and limited follow-up; risk of microscopically positive margins, which limits application to lesions strongly suspected to be benign. CONCLUSIONS: Endoscopic ligation and resection shows promise as a safe and feasible technique to treat small EUS-suspected gastric GISTs. Controlled clinical trials with more subjects and longer follow-up are needed to confirm the value and limitations of this method.