Correlation between malnutrition and mortality in older patients aged ≥90 years with multimorbidity.

OBJECTIVES: Malnutrition is prevalent in geriatric patients and associated with poor prognosis. This study aimed to evaluate the incremental prognostic value of different nutritional assessment tools in patients (90 years and older) with multimorbidity in China. METHODS: Patients aged ≥90 years with multimorbidity from the Geriatric Research Center in Nanjing Jinling Hospital from January 1, 2008 to December 31, 2018 were analyzed. Patients were followed until December 31,2022. The nutrition status was assessed according to the mini nutritional assessment (MNA), the geriatric nutritional risk index (GNRI), and the prognostic nutritional index score (PNI), respectively. The outcome was all-cause death. Kaplan-Meier method was used to draw the survival curve, and univariate and multivariate Cox proportional risk regression analysis was used to explore the influencing factors of all-cause death in the patients. RESULTS: 160 participants aged 90(90,91) years were included. During a median follow-up of 5.41(3.12-7.64) years, 106(66.25 %) patients died. Deceased patients had lower MNA [20.75(16.75,23.00) vs. 26.00(24.00,26.00); p < 0.001], lower GNRI [96.21±8.75 vs. 100.94±6.80; p = 0.001] and lower PNI [46.16(40.77,49.57) vs. 47.75(45.36,51.53); p = 0.010] than did survivors. According to MNA, GNRI, and PNI score, 93(58.1 %), 72(45.0 %) and 41(25.6 %) of participants were at risk of malnutrition. Multivariate analysis revealed that malnutrition was independently associated with increased risk for mortality by MNA score (adjusted hazard ratio [HR] 2.502, 95 % confidence interval [CI] 1.561-4.009, p<0.001), GNRI score (adjusted HR 1.650, 95 % CI, 1.117-2.438, p = 0.012), and PNI score (adjusted HR 2.894, 95 % CI, 1.891-4.431, p<0.001). Furthermore, the inclusion of malnutrition indicators in the survival prediction model significantly improved the predictive power of mortality. CONCLUSION: The risk of malnutrition, as assessed by MNA, GNRI and PNI, in long-lived patients with multimorbidity is a strong independent predictor of mortality and adds significant prognostic information to the survival models.

Two-dimensional XY ferromagnetism above room temperature in Janus monolayer V2XN (X = P, As).

Two-dimensional (2D) XY magnets with easy magnetization planes support the nontrivial topological spin textures whose dissipationless transport is highly desirable for 2D spintronic devices. Here, we predicted that Janus monolayer V2XN (X = P, As) with a square lattice is a 2D-XY ferromagnet using first-principles calculations. Both magnetocrystalline anisotropy and magnetic shape anisotropy favor an in-plane magnetization, leading to an easy magnetization xy-plane in Janus monolayer V2XN. With the help of the Monte Carlo simulations, we observed the Berezinskii-Kosterlitz-Thouless (BKT) phase transition in monolayer V2XN with the transition temperature TBKT being above room temperature. In particular, monolayer V2AsN has a magnetic anisotropy energy (MAE) of 292.0 µeV per V atom and a TBKT of 434 K, which is larger than that of monolayer V2PN. Moreover, a tensile strain of 5% can further improve the TBKT of monolayer V2XN to be above 500 K. Our results indicated that Janus monolayer V2XN (X = P, As) can be candidate materials to realize high-temperature 2D-XY ferromagnetism for spintronics applications.

Direct and indirect optical absorptions of cubic BAs and BSb.

Recently, boron arsenide (BAs) has been measured with high thermal conductivity in the experiments, great encouragement for low-power photoelectric devices. Hence we systematically investigate the direct and indirect optical absorptions of BAs and BSb by using first-principles calculations. We obtain the absorption onset corresponding to the value of indirect bandgap by considering the phonon-assisted second-order indirect optical absorption. The temperature-dependent calculations also capture the redshift of absorption onset, enhancement, and smoothness of optical absorption spectra. Moreover, in order to introduce the first-order absorption in the visible range, the doping effect of congeners is studied without the assist of phonon. It is found that the decrease of local direct bandgap derives from either the decrease of bonding-antibonding repulsion of p orbital states by the heavier III group elements or the similar influence of lighter V group elements on the s orbital states. Thus, the doping of congeners can improve the visible optical absorptions.

Correlation between the Charlson comorbidity index and skeletal muscle mass/physical performance in hospitalized older people potentially suffering from sarcopenia.

BACKGROUND: Sarcopenia is a decrease in skeletal muscle mass, physical performance, and muscle strength in older people. In this study, we aimed to explore the correlation between comorbidity and skeletal muscle mass and physical performance in older people. METHODS: This retrospective study included 168 subjects. Their medical history, physical function, computed tomography (CT) chest scans, and blood tests for nutrition were evaluated. The patients were divided into two groups: (1) a low muscle mass group and (2) a normal muscle mass group. Multivariate analysis of variance was used to compare multiple sets of mean vectors. RESULTS: Overall, 72.02% of the subjects had a low skeletal muscle index (SMI) and low gait speed. The patients with low skeletal muscle mass and physical performance were older, had more serious comorbidities, and had longer average hospitalization periods and lower albumin and hemoglobin levels. Subjects with a high Charlson comorbidity index (CCI) were more likely to be in the sarcopenic group than in the non-sarcopenic group. In addition, there was a linear correlation between the CCI and SMI (r = - 0.549, P < 0.05), and between the CCI and gait speed (r = - 0.614, P < 0.05). The area under the curve (AUC) value for low skeletal muscle mass with the CCI was 0.879. CONCLUSIONS: We identified an independent association between comorbidity and skeletal muscle mass/physical performance by researching the correlation between the CCI and SMI/gait speed. Our results suggested that the CCI score may have important clinical diagnostic value for sarcopenia.

Minimally invasive puncture and drainage versus craniotomy: basal ganglia intracerebral hemorrhage in elderly patients.

The two most common surgical interventions for spontaneous intracerebral hemorrhage in the basal ganglia of patients more than 65 years old are either minimally invasive puncture and drainage or craniotomy. This study aimed to compare the curative effects of these two procedures in such patients. A retrospective study of patients older than years with spontaneous intracerebral hemorrhage was conducted between January 2012 and December 2015. Of the 86 patients, 47 received minimally invasive puncture and drainage and 39 underwent craniotomy. One year after surgery no statistically significant difference was observed between the two groups with respect to: evacuation rate of the hematoma five days after the operation, volume of residual hematoma, occurrence of rebleeding, development of infectious meningitis, length of hospitalization, fatality, or Glasgow Outcome Scale and Barthel Index scores. However, the amount of blood loss during the procedure (P < 0.001), total cost of hospitalization (P = 0.004), and incidence of epilepsy (P = 0.045) were significantly higher for the craniotomy group than the minimally invasive puncture and drainage group. It was found that, in patients older than 65 years with basal ganglia hemorrhage, minimally invasive puncture and drainage is less invasive, more cost efficient and induces less bleeding during surgery than craniotomy.

Role of epithelial Na+ channels in endothelial function.

An increasing number of mechano-sensitive ion channels in endothelial cells have been identified in response to blood flow and hydrostatic pressure. However, how these channels respond to flow under different physiological and pathological conditions remains unknown. Our results show that epithelial Na(+) channels (ENaCs) colocalize with hemeoxygenase-1 (HO-1) and hemeoxygenase-2 (HO-2) within the caveolae on the apical membrane of endothelial cells and are sensitive to stretch pressure and shear stress. ENaCs exhibited low levels of activity until their physiological environment was changed; in this case, the upregulation of HO-1, which in turn facilitated heme degradation and hence increased the carbon monoxide (CO) generation. CO potently increased the bioactivity of ENaCs, releasing the channel from inhibition. Endothelial cells responded to shear stress by increasing the Na(+) influx rate. Elevation of intracellular Na(+) concentration hampered the transportation of l-arginine, resulting in impaired nitric oxide (NO) generation. Our data suggest that ENaCs that are endogenous to human endothelial cells are mechano-sensitive. Persistent activation of ENaCs could inevitably lead to endothelium dysfunction and even vascular diseases such as atherosclerosis.

Clinical relevance of peroxisome proliferator-activated receptor-γ gene polymorphisms with sepsis.

BACKGROUND: Peroxisome proliferator-activated receptor-γ (PPARγ) is a regulator of inflammation. This study aimed to explore associations between PPARγ gene single-nucleotide polymorphisms (SNPs) and susceptibility to and clinical outcome of sepsis in the North China Han population. METHODS: This study included 303 patients with sepsis and 303 controls. We conducted genetic typing for 13 common PPARγ gene SNPs (improved multiplex ligation detection reaction), linkage disequilibrium mapping, and haplotype inference. Associations between SNP genotypes/haplotypes and sepsis susceptibility and outcome (septic shock, organ dysfunction, or death) were assessed using unconditional logistic regression analysis. RESULTS: For rs2972164, patients with genotypes CT/CT+TT had higher risk of sepsis than genotype CC (odds ratio [95% CI]: 1.74 [1.05-2.86], P = .03 and 1.72 [1.06-2.80], P = .026, respectively); the T allele was associated with increased sepsis risk compared with the C allele (1.64 [1.04-2.58], P = .033). For rs1801282, genotypes CG/CG+GG had lower risk of sepsis than genotype CC (0.55 [0.33-0.92], P = .024 and 0.57 [0.35-0.95], P = .03, respectively); the G allele was associated with decreased sepsis risk compared with the C allele (0.62 [0.39-1.01], P = .055). For rs4135275, genotypes AG/AG+GG had higher risk of severe organ dysfunction (multiple organ dysfunction syndrome score >8) than genotype AA (2.66 [1.16-6.09], P = .038 and 2.21 [1.00-4.85], P = .042, respectively). Haplotype TAT (rs2972164, rs4684846, and rs17036188) was associated with increased sepsis risk (1.66 [1.03-2.67], P = .038). CONCLUSIONS: No mutation was correlated with septic shock or death. PPARγ gene polymorphisms may play a role in the occurrence and progression of sepsis in the North China Han population.

Improved Point-Line Feature Based Visual SLAM Method for Indoor Scenes.

In the study of indoor simultaneous localization and mapping (SLAM) problems using a stereo camera, two types of primary features-point and line segments-have been widely used to calculate the pose of the camera. However, many feature-based SLAM systems are not robust when the camera moves sharply or turns too quickly. In this paper, an improved indoor visual SLAM method to better utilize the advantages of point and line segment features and achieve robust results in difficult environments is proposed. First, point and line segment features are automatically extracted and matched to build two kinds of projection models. Subsequently, for the optimization problem of line segment features, we add minimization of angle observation in addition to the traditional re-projection error of endpoints. Finally, our model of motion estimation, which is adaptive to the motion state of the camera, is applied to build a new combinational Hessian matrix and gradient vector for iterated pose estimation. Furthermore, our proposal has been tested on EuRoC MAV datasets and sequence images captured with our stereo camera. The experimental results demonstrate the effectiveness of our improved point-line feature based visual SLAM method in improving localization accuracy when the camera moves with rapid rotation or violent fluctuation.

RGB-D SLAM Based on Extended Bundle Adjustment with 2D and 3D Information.

In the study of SLAM problem using an RGB-D camera, depth information and visual information as two types of primary measurement data are rarely tightly coupled during refinement of camera pose estimation. In this paper, a new method of RGB-D camera SLAM is proposed based on extended bundle adjustment with integrated 2D and 3D information on the basis of a new projection model. First, the geometric relationship between the image plane coordinates and the depth values is constructed through RGB-D camera calibration. Then, 2D and 3D feature points are automatically extracted and matched between consecutive frames to build a continuous image network. Finally, extended bundle adjustment based on the new projection model, which takes both image and depth measurements into consideration, is applied to the image network for high-precision pose estimation. Field experiments show that the proposed method has a notably better performance than the traditional method, and the experimental results demonstrate the effectiveness of the proposed method in improving localization accuracy.

Enhanced monocular visual odometry integrated with laser distance meter for astronaut navigation.

Visual odometry provides astronauts with accurate knowledge of their position and orientation. Wearable astronaut navigation systems should be simple and compact. Therefore, monocular vision methods are preferred over stereo vision systems, commonly used in mobile robots. However, the projective nature of monocular visual odometry causes a scale ambiguity problem. In this paper, we focus on the integration of a monocular camera with a laser distance meter to solve this problem. The most remarkable advantage of the system is its ability to recover a global trajectory for monocular image sequences by incorporating direct distance measurements. First, we propose a robust and easy-to-use extrinsic calibration method between camera and laser distance meter. Second, we present a navigation scheme that fuses distance measurements with monocular sequences to correct the scale drift. In particular, we explain in detail how to match the projection of the invisible laser pointer on other frames. Our proposed integration architecture is examined using a live dataset collected in a simulated lunar surface environment. The experimental results demonstrate the feasibility and effectiveness of the proposed method.

Management of ROS and Regulatory Cell Death in Myocardial Ischemia-Reperfusion Injury.

Myocardial ischemia-reperfusion injury (MIRI) is fatal to patients, leading to cardiomyocyte death and myocardial remodeling. Reactive oxygen species (ROS) and oxidative stress play important roles in MIRI. There is a complex crosstalk between ROS and regulatory cell deaths (RCD) in cardiomyocytes, such as apoptosis, pyroptosis, autophagy, and ferroptosis. ROS is a double-edged sword. A reasonable level of ROS maintains the normal physiological activity of myocardial cells. However, during myocardial ischemia-reperfusion, excessive ROS generation accelerates myocardial damage through a variety of biological pathways. ROS regulates cardiomyocyte RCD through various molecular mechanisms. Targeting the removal of excess ROS has been considered an effective way to reverse myocardial damage. Many studies have applied antioxidant drugs or new advanced materials to reduce ROS levels to alleviate MIRI. Although the road from laboratory to clinic has been difficult, many scholars still persevere. This article reviews the molecular mechanisms of ROS inhibition to regulate cardiomyocyte RCD, with a view to providing new insights into prevention and treatment strategies for MIRI.

First-principles study of two-dimensional transition metal carbide Mn+1CnO2(M = Nb,Ta).

In the present work, the three stable MXenes Mn+1CnO2(M = Nb,Ta) are explored based on first-principles calculations. These materials are important derivatives of 2D materials and exhibit distinctive properties, holding vast potential in nanodevices. All these Mn+1CnO2(M = Nb,Ta) materials exhibit outstanding superconducting performance, with corresponding superconducting transition temperatures of 23.00 K, 25.00 K, and 29.00 K. Analysis reveals that the high superconducting transition temperatures of MXenes Mn+1CnO2(M = Nb,Ta) are closely associated with the high value of the logarithmic average of phonon frequencies,ωlog, and the strong electron-phonon coupling, attributed to the crucial contribution of low-frequency phonons. Additionally, we applied strain treatments of 2% and 4% to Mn+1CnO2(M = Nb,Ta), resulting in varying changes in superconducting transition temperatures under different strains.

Lunar rock investigation and tri-aspect characterization of lunar farside regolith by a digital twin.

Yutu-2 rover conducted an exciting expedition on the 41st lunar day to investigate a fin-shaped rock at Longji site (45.44°S, 177.56°E) by extending its locomotion margin on perilous peaks. The varied locomotion encountered, especially multi-form wheel slippage, during the journey to the target rock, established unique conditions for a fin-grained lunar regolith analysis regarding bearing, shear and lateral properties based on terramechanics. Here, we show a tri-aspect characterization of lunar regolith and infer the rock's origin using a digital twin. We estimate internal friction angle within 21.5°-42.0° and associated cohesion of 520-3154 Pa in the Chang'E-4 operational site. These findings suggest shear characteristics similar to Apollo 12 mission samples but notably higher cohesion compared to regolith investigated on most nearside lunar missions. We estimate external friction angle in lateral properties to be within 8.3°-16.5°, which fills the gaps of the lateral property estimation of the lunar farside regolith and serves as a foundational parameter for subsequent engineering verifications. Our in-situ spectral investigations of the target rock unveil its composition of iron/magnesium-rich low-calcium pyroxene, linking it to the Zhinyu crater (45.34°S, 176.15°E) ejecta. Our results indicate that the combination of in-situ measurements with robotics technology in planetary exploration reveal the possibility of additional source regions contributing to the local materials at the Chang'E-4 site, implying a more complicated geological history in the vicinity.

Carrier and phonon transport in 2D InSe and its Janus structures.

Recently, two-dimensional (2D) Indium Selenide (InSe) has been receiving much attention in the scientific community due to its reduced size, extraordinary physical properties, and potential applications in various fields. In this review, we discussed the recent research advancement in the carrier and phonon transport properties of 2D InSe and its related Janus structures. We first introduced the progress in the synthesis of 2D InSe. We summarized the recent experimental and theoretical works on the carrier mobility, thermal conductivity, and thermoelectric characteristics of 2D InSe. Based on the Boltzmann transport equation (BTE), the mechanisms underlying carrier or phonon scattering of 2D InSe were discussed in detail. Moreover, the structural and transport properties of Janus structures based on InSe were also presented, with an emphasis on the theoretical simulations. At last, we discussed the prospects for continued research of 2D InSe.

Apelin-13, a regulator of autophagy, apoptosis and inflammation in multifaceted bone protection.

Apelin/APJ is widely distributed in various tissues in the body and participates in the regulation of physiological and pathological mechanisms such as autophagy, apoptosis, inflammation, and oxidative stress. Apelin-13 is an adipokine family member with multiple biological roles and has been shown to be involved in the development and progression of bone diseases. In the process of osteoporosis and fracture healing, Apelin-13 plays an osteoprotective role by regulating the autophagy and apoptosis of BMSCs, and promotes the osteogenic differentiation of BMSCs. In addition, Apelin-13 also attenuates the progression of arthritis by regulating the inflammatory response of macrophages. In conclusion, Apelin-13 has an important connection with bone protection, which provides a new strategy for the clinical treatment of bone-related diseases.

Pyroptosis in spinal cord injury.

Spinal cord injury (SCI) often brings devastating consequences to patients and their families. Pathophysiologically, the primary insult causes irreversible damage to neurons and glial cells and initiates the secondary damage cascade, further leading to inflammation, ischemia, and cells death. In SCI, the release of various inflammatory mediators aggravates nerve injury. Pyroptosis is a new pro-inflammatory pattern of regulated cell death (RCD), mainly mediated by caspase-1 or caspase-11/4/5. Gasdermins family are pore-forming proteins known as the executor of pyroptosis and the gasdermin D (GSDMD) is best characterized. Pyroptosis occurs in multiple central nervous system (CNS) cell types, especially plays a vital role in the development of SCI. We review here the evidence for pyroptosis in SCI, and focus on the pyroptosis of different cells and the crosstalk between them. In addition, we discuss the interaction between pyroptosis and other forms of RCD in SCI. We also summarize the therapeutic strategies for pyroptosis inhibition, so as to provide novel ideas for improving outcomes following SCI.

Janus V2AsP monolayer : a ferromagnetic semiconductor with a narrow band gap, a high Curie temperature and controllable magnetic anisotropy.

The search and design of two-dimensional (2D) magnetic semiconductors for spintronics applications are particularly significant. In this work, we investigated the electronic and magnetic properties of Janus structure based on Dirac half-metallic vanadium phosphide (VP) monolayer (ML) by first-principles calculations. Due to the vertical symmetry breaking, Janus V2AsP ML becomes an intrinsic ferromagnetic semiconductor with a narrow band gap of 0.21 eV. We analyzed the electronic structure and origin of the in-plane easy axis in Janus V2AsP. The electron effective mass is anisotropic and only 0.129 m0along thex-direction. The Curie temperatureTcand magnetic anisotropy energy (MAE) of Janus V2AsP reach 490 K and 178 µeV per V atom, respectively. A uniaxial tensile stainɛxof 5% can increase its band gap and MAE to 0.39 eV and 210.6 µeV per V atom while maintaining itsTcbeing above room temperature. Moreover, the direction of the easy axis can be changed between the in-planex- andy-direction by a small uniaxial tensile strainɛxof 2%. Our study can motivate further research on the design the magnetic semiconductors in Janus structures based on 2D Dirac half-metals for spintronics applications.

The Age-Adjusted Charlson Comorbidity Index Predicts Prognosis in Elderly Cancer Patients.

Purpose: The age-adjusted Charlson comorbidity index (ACCI) is a useful measure of comorbidity to standardize the evaluation of elderly patients and has been reported to predict mortality in various cancers. To our best knowledge, no studies have examined the relationship between the ACCI and survival of elderly patients with cancer. Therefore, the primary objective of this study was to investigate the relationship between the ACCI and survival of elderly patients with cancer. Patients and Methods: A total of 64 elderly patients (>80 years) with cancer between 2011 and 2021 were enrolled in this study. According to the ACCI, the age-adjusted comorbidity index was calculated by weighting individual comorbidities; patients with ACCI<11 were considered the low-ACCI group, whereas those with ACCI≥11 were considered the high-ACCI group. The correlations between the ACCI score and survival outcomes were statistically analyzed. Results: There was a significant difference in overall survival (OS) and progression-free survival (PFS) between the high-ACCI group and the low-ACCI group (P<0.001). The median OS time of the high-ACCI group and the low-ACCI group were 13.9 (10.5-22.0) months and 51.9 (34.1-84.0) months, respectively. The 2-, 3-, and 5-year survival rates of the high-ACCI group were 28.1%, 18.8%, and 4.2%, respectively, whereas the 2-, 3-, and 5-year survival rates of the low-ACCI group were 77.3%, 66.4%, and 39.1%, respectively. Multivariate analysis showed that ACCI was independently associated with OS (HR=1.402, 95% CI: 1.226-1.604, P < 0.05) and PFS (HR=1.353, 95% CI: 1.085-1.688, P = 0.0073). Conclusion: The ACCI score is a significant independent predictor of prognosis in elderly patients with cancer.

Two-dimensional antiferromagnetic semiconductor T'-MoTeI from first principles.

Two-dimensional intrinsic antiferromagnetic semiconductors are expected to stand out in the spintronic field. The present work finds the monolayer T'-MoTeI is intrinsically an antiferromagnetic semiconductor by using first-principles calculation. Firstly, the dimerized distortion of the Mo atoms causes T'-MoTeI to have dynamic stability, which is different from the small imaginary frequency in the phonon spectrum of T-MoTeI. Secondly, T'-MoTeI is an indirect-bandgap semiconductor with 1.35 eV. Finally, in the systematic study of strain effects, there are significant changes in the electronic structure as well as the bandgap, but the antiferromagnetic ground state is not affected. Monte Carlo simulations predict that the Néel temperature of T'-MoTeI is 95 K. The results suggest that the monolayer T'-MoTeI can be a potential candidate for spintronics applications.

Zhurong reveals recent aqueous activities in Utopia Planitia, Mars.

The Mars' climate is cold and dry in the most recent epoch, and liquid water activities are considered extremely limited. Previous orbital data only show sporadic hydrous minerals in the northern lowlands of Mars excavated by large impacts. Using the short-wave infrared spectral data obtained by the Zhurong rover of China's Tianwen-1 mission, which landed in southern Utopia Planitia on Mars, we identify hydrated sulfate/silica materials on the Amazonian terrain at the landing site. These hydrated minerals are associated with bright-toned rocks, interpreted to be duricrust developed locally. The lithified duricrusts suggest that formation with substantial liquid water originates by either groundwater rising or subsurface ice melting. In situ evidence for aqueous activities identified at Zhurong's landing site indicates a more active Amazonian hydrosphere for Mars than previously thought.