Obesity, multiple chronic conditions, and the relationship with physical function: Data from the national health and aging trends survey.

BACKGROUND: The population of older adults living with multiple chronic conditions (MCC) continues to grow. MCC is independently associated with functional limitation and obesity. The aim of our study was to evaluate the association between obesity and MCC, and secondarily, the combined presence of obesity and functional limitations with MCC. METHODS: We analyzed cross-sectional survey data from the National Health and Aging Trends Survey (NHATS) 2011 baseline data, a nationally representative Medicare beneficiary cohort of adults in the United States. We evaluated the coexistent prevalence of obesity and MCC overall, and by standard body mass index (BMI) categories. We then evaluated the prevalence of functional limitations (mobility, self-care, and household activities) and Fried-defined frailty status in persons with a BMI ≥ 30 kg/m2. Logistic regression was used to measure the association between MCC and BMI, and functional limitations and MCC among those with obesity. RESULTS: In the 6,600 participants, the prevalence of concurrent obesity and MCC was 30.4%. Of those with obesity, the prevalence of MCC was 84.0%, and were more likely to have MCC (adjusted OR: 2.17, 95% CI 1.86, 2.54) compared to a normal BMI. Obesity and functional limitations or frailty were more likely have MCC than individuals with obesity alone. CONCLUSIONS: We found that individuals with obesity is strongly associated with MCC and that functional limitations and frailty status have a greater association with having MCC than individuals with obesity without MCC. Future longitudinal analyses are needed to ascertain this relationship.

Individualized interventions and precision health: Lessons learned from a systematic review and implications for analytics-driven geriatric research.

Older adults are characterized by profound clinical heterogeneity. When designing and delivering interventions, there exist multiple approaches to account for heterogeneity. We present the results of a systematic review of data-driven, personalized interventions in older adults, which serves as a use case to distinguish the conceptual and methodologic differences between individualized intervention delivery and precision health-derived interventions. We define individualized interventions as those where all participants received the same parent intervention, modified on a case-by-case basis and using an evidence-based protocol, supplemented by clinical judgment as appropriate, while precision health-derived interventions are those that tailor care to individuals whereby the strategy for how to tailor care was determined through data-driven, precision health analytics. We discuss how their integration may offer new opportunities for analytics-based geriatric medicine that accommodates individual heterogeneity but allows for more flexible and resource-efficient population-level scaling.

Electrochemical Flash Fluorination and Radiofluorination.

A new method for rapid late-stage fluorination using the cation pool technique is presented. Fluorination and no-carrier-added radiofluorination of methyl (phenylthio) acetate, methyl 2-(methylthio) acetate, and methyl 2-(ethylthio) acetate were performed. The carbocations formed through electrochemical oxidation were stabilized by using a divided electrochemical cell and 2,2,2-trifluoroethanol (TFE) as the solvent at -20 °C. At the end of electrolysis, either stable-isotope [19F]fluoride or no-carrier-added radioactive [18F]fluoride was added to the reaction mixture to form the fluorinated or radiofluorinated product.

Electrochemical Fluorination and Radiofluorination of Methyl(phenylthio)acetate Using Tetrabutylammonium Fluoride (TBAF).

Electrochemical fluorination of methyl(phenylthio)acetate was achieved using tetrabutylammonium fluoride (TBAF). Electrochemical fluorination was performed under potentiostatic anodic oxidation using an undivided cell in acetonitrile containing TBAF and triflic acid. The influence of several parameters including: oxidation potential, time, temperature, sonication, TBAF concentration and triflic acid concentration on fluorination efficiency were studied. It was found that the triflic acid to TBAF concentration ratio plays a key role in the fluorination efficiency. Electrochemical fluorination resulted in formation of mono-fluorinated methyl 2-fluoro-2-(phenylthio)acetate verified by gas chromatography-mass spectrometry (GC-MS) and nuclear magnetic resonance (NMR) Spectroscopy. Under optimum conditions 44 ± 3% mono fluorination yield was obtained after a 30 min electrolysis. Electrochemical radiofluorination for the synthesis of methyl 2-[18F]fluoro-2-(phenothio) acetate was also achieved with the same optimized electrochemical cell parameters where TBAF was first passed through an anion exchange resin containing fluorine-18. A radiochemical fluorination efficiency of 7 ± 1% was achieved after 30 min of electrolysis.