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OBJECTIVE: To investigate changes in well-being measures for older Maori after moving from community to long-term care (LTC). METHODS: We undertook a retrospective cohort study of older Maori in New Zealand (NZ) who had received assessments for their health needs whilst living at home (interRAI-HC assessment) as well as a subsequent assessment after moving into a care facility (interRAI-LTCF). All interRAI-HC assessments from 01 July 2013 to 21 December 2018 were identified and matched to LTCF assessments that were undertaken at least 6 months later. Odds ratios (OR) and 95% confidence interval (CI) were calculated to determine the difference in proportion of variables of interest (indicative of movement, socialising, sleep and nutrition, alongside general physical and mental health status) between participants' HC and subsequent LTCF assessments. RESULTS: Changes in well-being measures were investigated among 1531 Maori (mean age 76.2 years, 61% female). Odds of having a fall (OR: 0.40 [95% CI 0.34, 0.48]), being lonely (OR: 0.13 [95% CI 0.09, 0.18]), sleeping difficulty (OR: 0.74 [95% CI 0.60, 0.91]) and fatigue (OR: 0.18 [95% CI 0.14, 0.23]) reduced on moving to LTC. However, the presence of depression (OR 3.96 [95% CI 2.58, 6.09]) and dependence with locomotion (OR 1.56 [95% CI 1.23, 1.97]) significantly increased when moving from home to LTC. CONCLUSION: Despite some indicators of functional and health-related decline, significant improvements are also apparent across multiple domains of well-being. Further investigation of resident and family perceptions of well-being in association with a move to LTC is warranted.
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Highly acidic citrus pomace (CP) is a byproduct of Pericarpium Citri Reticulatae production and causes significant environmental damage. In this study, a newly isolated acid-tolerant strain of Serratia sp. JS-043 was used to treat CP and evaluate the effect of reduced acid citrus pomace (RACP) in passivating heavy metals. The results showed that biological treatment could remove 97.56% of citric acid in CP, the organic matter in the soil increased by 202.60% and the catalase activity in the soil increased from 0 to 0.117 U g-1. Adding RACP into soil can increase the stabilization of Cu, Zn, As, Co, and Pb. Specifically, through the metabolism of strain JS-043, RACP was also involved in the stabilization of Zn and Pb, and Residual Fraction in the total pool of these metals increased by 10.73% and 10.54%, respectively. Finally, the genome sequence of Serratia sp. JS-043 was completed, and the genetic basis of its acid-resistant and acid-reducing characteristics was preliminarily revealed. JS-043 also contains many genes encoding proteins associated with heavy metal ion tolerance and transport. These findings suggest that JS-043 may be a high-potential strain to improve the quality of acidic organic wastes that can then be useful for soil bioremediation.
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Biodegradación Ambiental , Metales Pesados , Serratia , Microbiología del Suelo , Contaminantes del Suelo , Serratia/metabolismo , Serratia/genética , Metales Pesados/metabolismo , Contaminantes del Suelo/metabolismo , Concentración de Iones de Hidrógeno , CitrusRESUMEN
BACKGROUND: Gestational diabetes mellitus increases the risk of developing type 2 diabetes. The aim of this study is to compare cardiometabolic and renal outcomes for all women in New Zealand with gestational diabetes (2001-2010) with women without diabetes, 10-20 years following delivery. METHODS: A retrospective cohort study, utilizing a national dataset providing information for all women who gave birth between 1 January 2001 and 31 December 2010 (n = 604 398). Adolescent girls <15 years, women ≥50 years and women with prepregnancy diabetes were excluded. In total 11 459 women were diagnosed with gestational diabetes and 11 447 were matched (for age and year of delivery) with 57 235 unexposed (control) women. A national hospital dataset was used to compare primary outcomes until 31 May 2021. RESULTS: After controlling for ethnicity, women with gestational diabetes were significantly more likely than control women to develop diabetes-adjusted hazard ratio (HR) 20.06 and 95% confidence interval (CI) 18.46-21.79; a first cardiovascular event 2.19 (1.86-2.58); renal disease 6.34 (5.35-7.51) and all-cause mortality 1.55 (1.31-1.83), all p values <.0001. The HR and 95% CI remained similar after controlling for significant covariates: diabetes 18.89 (17.36-20.56), cardiovascular events 1.79 (1.52-2.12), renal disease 5.42 (4.55-6.45), and all-cause mortality 1.44 (1.21-1.70). When time-dependent diabetes was added to the model, significance remained for cardiovascular events 1.33 (1.10-1.61), p = .003 and renal disease 2.33 (1.88-2.88), p < .0001 but not all-cause mortality. CONCLUSIONS: Women diagnosed with gestational diabetes have an increased risk of adverse cardiometabolic and renal outcomes. Findings highlight the importance of follow-up screening for diabetes, cardiovascular risk factors, and renal disease.
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Enfermedades Cardiovasculares , Diabetes Mellitus Tipo 2 , Diabetes Gestacional , Enfermedades Renales , Embarazo , Adolescente , Femenino , Humanos , Diabetes Gestacional/diagnóstico , Diabetes Gestacional/epidemiología , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/epidemiología , Estudios Retrospectivos , Estudios de Cohortes , Nueva Zelanda/epidemiología , Enfermedades Renales/complicaciones , Enfermedades Cardiovasculares/diagnóstico , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/etiologíaAsunto(s)
Medicina , Humanos , Anciano , Nueva Zelanda , Grupo de Atención al Paciente , PublicacionesRESUMEN
Ethyl lactate is the most abundant ester in semi-solid rice baijiu fermentation, affecting the flavor of baijiu to a great extent. The present study aimed to investigate the spatial distribution and formation contributor of ethyl lactate by removing the microorganisms and extracellular enzymes from the upper, middle, and lower fermentation broth during the later fermentation stage. The removal of suspended substances by centrifugation did not affect the ethyl lactate content in the top and middle fermentation broth containing free cells, enzymes, and starch particles. After day 5 of fermentation, only the lower fermentation broth containing granular cells attached to the starch could continue to accumulate lactic acid, thereby increasing the ethyl lactate content. The results showed that the chemical reactions were the main contributor to the increased ethyl lactate content at the anaphase of fermentation rather than enzymatic catalysis or microbial metabolism. Sequencing of granular cells revealed the main lactic acid producers at different fermentation stages. Lactobacillus helveticus showed the highest abundance of 94.45-95.40% on day 5, which decreased to 29.58-30.20% on day 15, while Lactobacillus acetotolerans showed the highest abundance of 47.93-49.72% at day 15. Additionally, the granular cells were recovered and used for supplementary inoculation in the next batch, which significantly increased the ethyl lactate content. This study provided a novel strategy for improving the ethyl lactate content in semi-solid baijiu fermentation.
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Lactatos , Lactobacillus helveticus , Oryza , Fermentación , Oryza/metabolismo , Ácido Láctico/metabolismo , Almidón/metabolismoRESUMEN
The reduction of selenite [Se(â £)] by microorganisms is a green and efficient detoxification strategy. We found that Se(â £) inhibited exopolysaccharide and protein secretion by Lactiplantibacillus plantarum BSe and compromised cell integrity. In this study, L. plantarum BSe reduced Se(â £) by increasing related enzyme activity and electron transfer. Genomic analysis demonstrated that L. plantarum BSe should be able to reduce Se(â £). Further transcriptome analysis showed that L. plantarum BSe enhanced its tolerance to Se(â £) by upregulating the expression of surface proteins and transporters, thus reducing the extracellular Se(â £) concentration through related enzymatic reactions and siderophore-mediated pathways. Lactiplantibacillus plantarum BSe was able to regulate the expression of related genes involved in quorum sensing and a two-component system and then select appropriate strategies for Se(â £) transformation in response to varying environmental Se(â £) concentrations. In addition, azo reductase was linked to the reduction of Se(â £) for the first time. The present study established a multipath model for the reduction of Se(â £) by L. plantarum, providing new insights into the biological reduction of Se(â £) and the biogeochemical cycle of selenium.
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Ácido Selenioso , Selenio , Ácido Selenioso/metabolismo , Oxidación-Reducción , Genómica , Selenio/metabolismo , Transporte de ElectrónRESUMEN
BACKGROUND: Usual measures of blood pressure (BP) do not account for both the magnitude and duration of exposure to elevated BP over time. We aimed to demonstrate the effect of a novel time-weighted BP on cardiovascular outcomes using a post hoc analysis of two published randomized trials. HYPOTHESIS: Time-weighted blood pressure is associated with cardiovascular risk among patients with or without diabetes. METHODS: The limited-access ACCORD and SPRINT data sets were used for the current study. Time-weighted BP is obtained by dividing cumulative BP by the total follow-up time. Time-weighted BP burden above a threshold is also determined after deriving the time-weighted BP by re-zeroing the interpolated pressure values at two different hypertension thresholds (>140/90 and >130/80 mmHg). RESULTS: Eighteen thousand five hundred forty-one patients from the two clinical trials were enrolled in this study. A J-curve relation was observed between time-weighted BP and major cardiovascular events (MACE). The systolic blood pressure (SBP) burden independently predicted MACE across the two trials at different thresholds (ACCORD: SBP > 130 mmHg, HR = 1.05 [1.03-1.06]; SBP > 140 mmHg, HR = 1.06 [1.04-1.08]; SPRINT: SBP > 130 mmHg, HR = 1.04 [1.03-1.05]; SBP > 140 mmHg, HR = 1.05 [1.04-1.07]). Consistent results were found for diastolic blood pressure (DBP) burden (ACCORD: DBP > 80 mmHg, HR = 1.10 [1.06-1.15]; DBP > 90 mmHg, HR = 1.20 [1.11-1.30]. SPRINT: DBP > 80 mmHg, HR = 1.06 [1.02-1.09]; DBP > 90 mmHg, HR = 1.12 [1.06-1.18]). Significant associations were also observed for stroke, myocardial infarction, cardiovascular death, and all-cause mortality. CONCLUSION: Both time-weighted SBP and DBP independently influenced the risk of adverse cardiovascular events among patients with and without diabetes, regardless of the definition of hypertension (130/80 or <140/90 mmHg).
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Enfermedades Cardiovasculares , Diabetes Mellitus , Hipertensión , Humanos , Presión Sanguínea , Enfermedades Cardiovasculares/diagnóstico , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/etiología , Factores de Riesgo , Hipertensión/complicaciones , Hipertensión/diagnóstico , Hipertensión/epidemiología , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/epidemiología , Factores de Riesgo de Enfermedad CardiacaRESUMEN
Background: The Systolic Blood Pressure Intervention Trial (SPRINT) from the US and the Strategy of Blood Pressure Intervention in the Elderly Hypertensive Patients (STEP) trial from China have consistently demonstrated clinical benefits from intensive blood pressure (BP) treatment among elderly adults with hypertension. However, we have little data on the generalisability and potential implications of a scale-up of intensive BP treatment to all eligible elderly in the US and China. Methods: We used two nationally representative data sets from China (Health and Retirement Longitudinal Study (CHALRS), 2011-2012) and the US (National Health and Nutrition Examination Survey (NHANES), 2007-2012) and linked them with CHARLS follow-up data (2013) and the National Death Index (1999-2015), respectively. We estimated the percentage, number, and characteristics of elderly (≥60 years old) meeting the STEP and SPRINT eligibility criteria, and deaths that would be prevented or postponed with the implementation of intensive BP treatment. Results: Among the Chinese adults aged 60 years and over, 38.89% (95% confidence interval (CI) = 36.97-40.84) or 85.39 (95% CI = 81.14-89.64) million subjects met the STEP criteria, and 40.90 million (47.90%) adults were not taking antihypertensive medications. In the US, 23.77% (95% CI = 22.32%-25.28) or 12.46 (95% CI = 11.68-13.24) million elderly were eligible for the SPRINT, and 5.78 million (46.36%) were untreated. Overall, 0.07 (95% CI = 0.06-0.08) million deaths in the US and 0.31 (95% CI = 0.25-0.39) in China would be averted annually if intensive BP treatment was implemented, while 120 000 and 680 000 of hypotension cases would be identified yearly inthe US and China, respectively. Conclusions: A substantial percentage of Chinese and the US elderly meet the eligibility criteria for STEP and SPRINT. If intensive BP treatment was adopted, 70 000 and 310 000 deaths would be prevented or postponed yearly in the US and China, respectively.
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Hipertensión , Adulto , Humanos , Anciano , Persona de Mediana Edad , Presión Sanguínea , Estudios Transversales , Estudios Longitudinales , Encuestas Nutricionales , China/epidemiología , Hipertensión/tratamiento farmacológicoRESUMEN
Importance: Emerging evidence has consistently demonstrated that sodium-glucose cotransporter 2 (SGLT2) inhibitors reduce the risk of heart failure (HF) hospitalization and cardiovascular (CV) death among patients with HF. However, it remains unclear how long a patient needs to live to potentially benefit from SGLT2 inhibitors in this population. Objectives: To estimate the time to benefit from SGLT2 inhibitors among patients with HF. Design, Setting, and Participants: This comparative effectiveness study systematically searched PubMed for completed randomized clinical trials about SGLT2 inhibitors and patients with HF published until September 5, 2022; 5 trials with the year of publication ranging from 2019 to 2022 were eventually included. Statistical analysis was performed from April to October 2022. Intervention: Addition of SGLT2 inhibitors or placebo to guideline-recommended therapy. Main Outcomes and Measures: The primary outcome was the time to first event of CV death or worsening HF, which was broadly comparable across the included trials. Results: Five trials consisting of 21â¯947 patients with HF (7837 [35.7%] were female; mean or median age older than 65 years within each trial) were included. SGLT2 inhibitors significantly reduced the risk of worsening HF or CV death (hazard ratio [HR], 0.77 [95% CI, 0.73-0.82]). Time to first nominal statistical significance (P < .05) was 26 days (0.86 months), and statistical significance was sustained from day 118 (3.93 months) onwards. A mean of 0.19 (95% CI, 0.12-0.35) months were needed to prevent 1 worsening HF or CV death per 500 patients with SGLT2 inhibitors (absolute risk reduction [ARR], 0.002). Likewise, 0.66 (95% CI, 0.43-1.13) months was estimated to avoid 1 event per 200 patients with SGLT2 inhibitors (ARR, 0.005), 1.74 (95% CI, 1.07-2.61) months to avoid 1 event per 100 patients (ARR, 0.010), and 4.96 (95% CI, 3.18-7.26) months to avoid 1 event per 50 patients (ARR, 0.020). Further analyses indicated a shorter time to benefit for HF hospitalization and among patients with diabetes or HF with reduced ejection fraction. Conclusions and Relevance: In this comparative effectiveness research study of estimating the time to benefit from SGLT2 inhibitors among patients with HF, a rapid clinical benefit in reducing CV death or worsening HF was found, suggesting that their use may be beneficial for most individuals with HF.
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Diabetes Mellitus Tipo 2 , Insuficiencia Cardíaca , Inhibidores del Cotransportador de Sodio-Glucosa 2 , Humanos , Femenino , Anciano , Masculino , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Inhibidores del Cotransportador de Sodio-Glucosa 2/uso terapéutico , Insuficiencia Cardíaca/tratamiento farmacológico , Glucosa , Sodio , Ensayos Clínicos Controlados Aleatorios como AsuntoRESUMEN
This paper investigates the problem of buffer-aided relay selection to achieve reliable and secure communications in a two-hop amplify-and-forward (AF) network with an eavesdropper. Due to the fading of wireless signals and the broadcast nature of wireless channels, transmitted signals over the network may be undecodable at the receiver end or have been eavesdropped by eavesdroppers. Most available buffer-aided relay selection schemes consider either reliability or security issues in wireless communications; rarely is work conducted on both reliability and security issues. This paper proposes a buffer-aided relay selection scheme based on deep Q-learning (DQL) that considers both reliability and security. By conducting Monte Carlo simulations, we then verify the reliability and security performances of the proposed scheme in terms of the connection outage probability (COP) and secrecy outage probability (SOP), respectively. The simulation results show that two-hop wireless relay network can achieve reliable and secure communications by using our proposed scheme. We also performed comparison experiments between our proposed scheme and two benchmark schemes. The comparison results indicate that our proposed scheme outperforms the max-ratio scheme in terms of the SOP.
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Soaking aged fat pork is a special aging process in the production of Chi-aroma Baijiu considered to involve the formation of free radicals. This study aimed to investigate the free radicals' formation pathway in Chi-aroma Baijiu during aged fat pork soaking by using electron paramagnetic resonance (EPR) and spin trapping with 5,5-dimethyl-1-pyrrolin-n-oxide (DMPO). The alkyl radical adducts (DMPO-R) and hydroxyl radical adducts (DMPO-OH) were detected in Baijiu after soaking the fat pork for aging. During the preparation process of aged fat pork, alkoxy radicals adduct (DMPO-RO) were mainly detected since lipid oxidation. Oleic acid and linoleic acid, the two main unsaturated fatty acids in fat pork, produced alkoxy radicals in the oxidation process. The total amounts of spins in linoleic acid and oleic acid after 4-month oxidation treatment increased by 248.07 ± 26.65% and 34.17 ± 0.72% than 0-month. It indicated that the free radicals in aged Chi-aroma Baijiu were mainly derived from the two main unsaturated fatty acids in aged fat pork and linoleic acid had a stronger ability to produce free radicals than oleic acid. Alkoxy radicals (RO·) from fat pork reacted with ethanol in Baijiu to form alkyl radicals (R·). The peroxide bond of hydroperoxides from the oxidation of unsaturated fatty acid was cleaved to form hydroxyl radicals (·OH) that were transferred to Baijiu. The results provide theoretical guidance for the subsequent work of free radicals scavenging.
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Carne de Cerdo , Carne Roja , Animales , Porcinos , Odorantes , Radicales Libres/química , Espectroscopía de Resonancia por Spin del Electrón/métodos , Ácido Linoleico/química , Ácido Linoleico/metabolismo , Ácidos Grasos Insaturados/química , Ácidos Grasos Insaturados/metabolismo , Radical Hidroxilo , Ácidos Oléicos , Óxidos N-Cíclicos/química , Marcadores de SpinRESUMEN
Environmental pollution is complex, and co-exposure can accurately reflect the true environmental conditions that are important for assessment of human health. Cadmium (Cd) is a widespread toxicant that can cause acute kidney injury (AKI), while its combined effect with 2,2',4,4'-tetrabromodiphenyl ether (BDE-47) is not fully understood. Thus, we used an in vivo model where C57BL/6J mice were treated with low dietary intake of Cd (5 mg/kg/day) and/or BDE-47 (1 mg/kg/day) for 28 days to examine AKI, and in vitro experiments to investigate the possible mechanism. Results showed that Cd or BDE-47 caused pathological kidney damage, accompanied by elevated urea nitrogen (BUN) and urinary creatinine, as well as increased interleukin-1ß (IL-1ß) and tumor necrosis factor-α (TNF-α), and reduced IL-10 in kidney tissues. In vitro Cd or BDE-47 exposure decreased cell viability and induced cell swelling and blebbing of human embryonic kidney 293 (HEK-293) and renal tubular epithelial cell lines (HKCs), and changes in co-exposure was larger than that in Cd and BDE-47 treatment. Oxidative stress indicators of the reactive oxygen species (ROS) and malondialdehyde (MDA) were elevated, while the antioxidant superoxide dismutase (SOD) was decreased. Necrosis occurred with increased lactate dehydrogenase (LDH) release and propidium iodide (PI) staining, which was attenuated by the ROS scavenger N-acetyl-L-cysteine (NAC). Furthermore, necroptotic genes of receptor-interacting protein kinase-3 (RIPK3), classical mixed lineage kinase domain-like protein-dependent (MLKL), IL-1ß and TNF-α were up-regulated, whereas RIPK1 was down-regulated, which was attenuated by the RIPK3 inhibitor GSK872. These findings demonstrate that Cd or BDE-47 alone produces kidney toxicities, and co-exposure poses an additive effect, resulting in AKI via inducing oxidative stress and regulating RIPK3-dependent necroptosis, which offers a further mechanistic understanding for kidney damage, and the combined effect of environmental pollutants should be noticed.
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Lesión Renal Aguda , Cadmio , Humanos , Ratones , Animales , Cadmio/metabolismo , Especies Reactivas de Oxígeno/metabolismo , Éter/farmacología , Factor de Necrosis Tumoral alfa/metabolismo , Necroptosis , Células HEK293 , Ratones Endogámicos C57BL , Lesión Renal Aguda/metabolismo , Estrés Oxidativo , Éteres de Etila/farmacología , Proteína Serina-Treonina Quinasas de Interacción con Receptores/genética , Proteína Serina-Treonina Quinasas de Interacción con Receptores/metabolismo , Proteína Serina-Treonina Quinasas de Interacción con Receptores/farmacologíaRESUMEN
Although differential privacy metaverse data sharing can avoid privacy leakage of sensitive data, randomly perturbing local metaverse data will lead to an imbalance between utility and privacy. Therefore, this work proposed models and algorithms of differential privacy metaverse data sharing using Wasserstein generative adversarial networks (WGAN). Firstly, this study constructed the mathematical model of differential privacy metaverse data sharing by introducing appropriate regularization term related to generated data's discriminant probability into WGAN. Secondly, we established basic model and algorithm for differential privacy metaverse data sharing using WGAN based on the constructed mathematical model, and theoretically analyzed basic algorithm. Thirdly, we established federated model and algorithm for differential privacy metaverse data sharing using WGAN by serialized training based on basic model, and theoretically analyzed federated algorithm. Finally, based on utility and privacy metrics, we conducted a comparative analysis for the basic algorithm of differential privacy metaverse data sharing using WGAN, and experimental results validate theoretical results, which show that algorithms of differential privacy metaverse data sharing using WGAN maintaining equilibrium between privacy and utility.
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OBJECTIVES: An increasing proportion of older people live in Retirement Villages ('villages'). This population cites support for health-care issues as one reason for relocation to villages. Here, we examine whether relocation to villages is associated with a decline in hospitalisations. METHODS: Retrospective, before-and-after observational study. SETTING: Retirement villages, Auckland, New Zealand. PARTICIPANTS: 466 cognitively intact village residents (336 [72%] female); mean (SD) age at moving to village was 73.9 (7.7) years. Segmented linear regression analysis of an interrupted time-series design was used. MAIN OUTCOME MEASURES: all hospitalisations for 18 months pre- and postrelocation to village. SECONDARY OUTCOME: acute hospitalisations during the same time periods. RESULTS: The average hospitalisation rate (per 100 person-years) was 44.9 (95% confidence interval [CI] = 36.3-55.6) 18-10 months before village relocation, 58.9 (95% CI = 48.3-72.0) 9-1 months before moving, 47.9 (95% CI = 38.8-59.1) 1-9 months after moving and 62.4 (95% CI = 51.2-76.0) 10-18 months after moving. Monthly average hospitalisation rate (per 100 person-years) increased before relocation to village by an average of 1.2 (95% CI = 0.01-1.57, p = .04) per month from 18 to 1 month before moving, and there was a change in the level of the monthly average hospitalisation rate immediately after relocation (mean difference [MD] = -18.4 per 100 person-years, 95% CI = -32.8 to -4.1, p = .02). The trend change after village relocation did not differ significantly from that before moving. CONCLUSIONS: Although we cannot reliably claim causality, relocation to a retirement village is, for older people, associated with a significant but non-sustained reduction in hospitalisation.
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Hospitalización , Jubilación , Humanos , Femenino , Anciano , Masculino , Estudios Retrospectivos , Nueva Zelanda/epidemiologíaRESUMEN
AIMS: To examine the prognostic value of time in target range (TIR) with adverse outcomes and validate it with common blood pressure (BP) metrics among patients with Type 2 diabetes mellitus. METHODS: We performed a post hoc analysis of the ACCORD (Action to Control Cardiovascular Risk in Diabetes) trial. TIR for each subject was calculated using linear interpolation and an SBP target range of 110 to 130â¯mmHg. Cox models were used to assess the association of TIR and other BP metrics with the rate of clinical outcomes. RESULTS: A higher TIR (61.9-100.0â¯%) was associated with a 46â¯% reduction in major adverse cardiovascular events (MACE) (hazard ratio [HR]:0.54; 95â¯% CI: 0.43, 0.67) compared with TIR 0-22.9â¯%. Results were similar for stroke (0.19; 0.10, 0.36), myocardial infarction (0.67; 0.51, 0.89), heart failure (0.47; 0.33, 0.66), cardiovascular death (0.63; 0.42, 0.93) and all-cause mortality (0.70; 0.54, 0.91). Further analyses suggested a curvilinear association of TIR with MACE, and this association was independent with baseline, final SBP, mean SBP, or visit-to-visit SBP variability. CONCLUSIONS: Longer TIR is associated with lower cardiovascular risk and may add value as an outcome measure for hypertension control studies among patients with diabetes.
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Enfermedades Cardiovasculares , Diabetes Mellitus Tipo 2 , Hipertensión , Infarto del Miocardio , Humanos , Presión Sanguínea/fisiología , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Enfermedades Cardiovasculares/tratamiento farmacológico , Antihipertensivos/uso terapéutico , Antihipertensivos/farmacología , Hipertensión/complicaciones , Hipertensión/tratamiento farmacológico , Infarto del Miocardio/etiología , Factores de RiesgoRESUMEN
Introduction Physical activity (PA) in older people is associated with improved morbidity and mortality outcomes. Increasing numbers of older people are choosing to live in retirement villages, many of which promote themselves as providing opportunities for activity. Aim To explore the characteristics of PA village residents were undertaking and the associated individual and village factors. Methods Health, functional and wellbeing information was collected from 577 residents recruited from 34 villages in Auckland, New Zealand, using an International Resident Assessment Instrument and customised survey tools containing items on self-reported PA. Managers from villages completed a survey on village characteristics and facilities. Results The mean age (s.d.) of village residents was 82 (7) years, and 325 (56%) reporting doing one or more hours of PA in the 3 days prior to assessment. Moderate exercise was performed by 240 (42%) village residents, for a mean (s.d.) of 2.7 (3.4) h per week. The most common activities provided by villages included: bowls/petanque (22, 65%) and exercise classes (22, 65%), and walking was the most common activity undertaken (348, 60%). Factors independently associated with PA included individual factors (gender, fatigue, constipation, self-reported health, number of medications, moving to village for safety and security, utilising village fitness programme, use of the internet, and satisfaction with opportunities to be active) and village-related factors (access to unit, and ownership model). Discussion PA uptake is determined by many factors at both personal (physical and psychosocial) and environmental levels. Clinicians should focus on individualised PA promotion in those with identified risk factors for low levels of PA.
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Ejercicio Físico , Jubilación , Humanos , Anciano , Anciano de 80 o más Años , Caminata , Encuestas y Cuestionarios , AutoinformeRESUMEN
PURPOSE: Seasonal variation of acute diverticular disease is variably reported in observational studies. This study aimed to describe seasonal variation of acute diverticular disease hospital admissions in New Zealand. METHODS: A time series analysis of national diverticular disease hospitalisations from 2000 to 2015 was conducted among adults aged 30 years or over. Monthly counts of acute hospitalisations' primary diagnosis of diverticular disease were decomposed using Census X-11 times series methods. A combined test for the presence of identifiable seasonality was used to determine if overall seasonality was present; thereafter, annual seasonal amplitude was calculated. The mean seasonal amplitude of demographic groups was compared by analysis of variance. RESULTS: Over the 16-year period, 35,582 hospital admissions with acute diverticular disease were included. Seasonality in monthly acute diverticular disease admissions was identified. The mean monthly seasonal component of acute diverticular disease admissions peaked in early-autumn (March) and troughed in early-spring (September). The mean annual seasonal amplitude was 23%, suggesting on average 23% higher acute diverticular disease hospitalisations during early-autumn (March) than in early-spring (September). The results were similar in sensitivity analyses that employed different definitions of diverticular disease. Seasonal variation was less pronounced in patients aged over 80 (p = 0.002). Seasonal variation was significantly greater among Maori than Europeans (p < 0.001) and in more southern regions (p < 0.001). However, seasonal variations were not significantly different by gender. CONCLUSIONS: Acute diverticular disease admissions in New Zealand exhibit seasonal variation with a peak in Autumn (March) and a trough in Spring (September). Significant seasonal variations are associated with ethnicity, age, and region, but not with gender.
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Enfermedades Diverticulares , Hospitalización , Adulto , Humanos , Anciano de 80 o más Años , Estaciones del Año , Nueva Zelanda/epidemiologíaRESUMEN
Compared with the linear economy, the circular economy can solve the contradiction between social development and resource utilization, which has attracted wide attention. Although the relationship between transportation infrastructure and economic development has changed from traditional mode to spatial mode, the spatial effect of transportation infrastructure on regional circular economy is still unclear. By combining the policy changes for developing the circular economy in China, this study constructs a comprehensive index of circular economy development in the Guangdong-Hong Kong-Macao Greater Bay Area (GBA). Based on the time and space development of the circular economy in GBA, we analyze the spatial effect of transportation infrastructure on it. The results show that the regional circular economy in GBA has developed, but has not been decoupled from economic development. The development of the regional circular economy presents a positive spatial spillover effect, which is beneficial to the building of the regional recycling market. The improvement of transportation infrastructure has a positive impact on the circular economy of neighboring cities, but it may have the risk of inhibiting the development of the local circular economy. These findings provide policy recommendations for urban planners to coordinate the development of transportation infrastructure and circular economy.
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Desarrollo Económico , Transportes , China , Ciudades , Hong Kong , MacaoRESUMEN
Nitrates can stimulate the biosynthesis of hydrophilic yellow pigments (HYPs) in Monascus ruber CGMCC 10910. To explore the molecular mechanisms whereby nitrates (NaNO3 and NH4NO3) regulate HYP production, an integrated transcriptomic and proteomic analysis was conducted in this study. Nitrate addition led to an approximately 75% higher HYP production compared with the untreated group, especially compounds Y3 and Y4. Comparative transcriptomic analysis found that mpigsA, H, K, L, and P genes involved in yellow pigment biosynthesis were significantly upregulated. In addition, pigment biosynthesis-related (carbon catabolism, amino acid metabolism, polyketide synthesis, and fatty acid metabolism) genes were upregulated to provide precursors and energy for HYP biosynthesis and cell growth. Secretion-related (cytomembrane ergosterol biosynthetic, and transport) pathways were also noticeably regulated to accelerate transmembrane transport of HYPs. Meanwhile, proteomic analysis showed that nitrates improved the protein expression of hybrid polyketide synthase-nonribosomal peptide synthetase, oxidoreductase, glucoamylase, endo-1,4-beta-xylanase, O-acetylhomoserine, and isocitrate lyase to enhance HYP production. These findings demonstrated the regulatory mechanism of nitrates for enhancing HYP production in Monascus. KEY POINTS: ⢠Nitrates stimulated the biosynthesis of Monascus hydrophilic yellow pigments (HYPs) ⢠Nitrates affected transcriptional level of pigment biosynthesis- and transport genes ⢠Increased expression of hybrid PKS-NRPS and transporters promoted production of HYPs.
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Monascus , Nitratos , Fermentación , Nitratos/metabolismo , Pigmentos Biológicos , Monascus/metabolismo , Proteómica , TranscriptomaRESUMEN
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