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1.
Small ; : e2312206, 2024 Mar 14.
Artículo en Inglés | MEDLINE | ID: mdl-38483011

RESUMEN

Incorporating dilute doping and controlled synthesis provides a means to modulate the microstructure, defect density, and transport properties. Transmission electron microscopy (TEM) and geometric phase analysis (GPA) have revealed that hot-pressing can increase defect density, which redistributes strain and helps prevent unwanted Ge precipitates formation. An alloy of GeTe with a minute amount of indium added has shown remarkable TE properties compared to its undoped counterpart. Specifically, it achieves a maximum figure-of-merit zT of 1.3 at 683 K and an exceptional TE conversion efficiency of 2.83% at a hot-side temperature of 723 K. Significant zT and conversion efficiency improvements are mainly due to domain density engineering facilitated by an effective hot-pressing technique applied to lightly doped GeTe. The In-GeTe alloy exhibits superior TE properties and demonstrates notable stability under significant thermal gradients, highlighting its promise for use in mid-temperature TE energy generation systems.

2.
Artículo en Inglés | MEDLINE | ID: mdl-38349645

RESUMEN

BACKGROUND: Prognostic indices can enhance personalized predictions of health burdens. However, a simple, practical, and reproducible tool is lacking for clinical use. This study aimed to develop a machine learning-based prognostic index for predicting all-cause mortality in community-dwelling older individuals. METHODS: We utilized the Healthy Aging Longitudinal Study in Taiwan (HALST) cohort, encompassing data from 5 663 participants. Over the 5-year follow-up, 447 deaths were confirmed. A machine learning-based routine blood examination prognostic index (MARBE-PI) was developed using common laboratory tests based on machine learning techniques. Participants were grouped into multiple risk categories by stratum-specific likelihood ratio analysis based on their MARBE-PI scores. The MARBE-PI was subsequently externally validated with an independent population-based cohort from Japan. RESULTS: Beyond age, sex, education level, and BMI, 6 laboratory tests (low-density lipoprotein, albumin, aspartate aminotransferase, lymphocyte count, high-sensitivity C-reactive protein, and creatinine) emerged as pivotal predictors via stepwise logistic regression (LR) for 5-year mortality. The area under curves of MARBE-PI constructed by LR were 0.799 (95% confidence interval [95% CI]: 0.778-0.819) and 0.756 (95% CI: 0.694-0.814) for the internal and external validation data sets, and were 0.801 (95% CI: 0.790-0.811) and 0.809 (95% CI: 0.774-0.845) for the extended 10-year mortality in both data sets, respectively. Risk categories stratified by MARBE-PI showed a consistent dose-response association with mortality. The MARBE-PI also performed comparably with indices constructed with clinical health deficits and/or laboratory results. CONCLUSIONS: The MARBE-PI is considered the most applicable measure for risk stratification in busy clinical settings. It holds potential to pinpoint older individuals at elevated mortality risk, thereby aiding clinical decision-making.


Asunto(s)
Vida Independiente , Aprendizaje Automático , Humanos , Persona de Mediana Edad , Anciano , Pronóstico , Estudios Prospectivos , Estudios Longitudinales
3.
BMC Med ; 21(1): 413, 2023 10 31.
Artículo en Inglés | MEDLINE | ID: mdl-37907932

RESUMEN

BACKGROUND: Antenatal corticosteroids are considered the standard of care for pregnant women at risk for preterm birth, but studies examining their potential risks are scarce. We aimed to estimate the associations of antenatal corticosteroids with three severe adverse events: sepsis, heart failure, and gastrointestinal bleeding, in pregnant women. METHODS: Of 2,157,321 pregnant women, 52,119 at 24 weeks 0/7 days to 36 weeks 6/7 days of gestation were included in this self-controlled case series study during the study period of 2009-2018. We estimated incidence rates of three severe adverse events: sepsis, heart failure, and gastrointestinal bleeding. Conditional Poisson regression was used to calculate incidence rate ratios (IRRs) for comparing incidence rates of the adverse events in each post-treatment period compared to those during the baseline period among pregnant women exposed to a single course of antenatal corticosteroid treatment. RESULTS: Among 52,119 eligible participants who received antenatal corticosteroid treatment, the estimated incidence rates per 1000 person-years were 0.76 (95% confidence interval (CI): 0.69-0.83) for sepsis, 0.31 (95% CI: 0.27-0.36) for heart failure, and 11.57 (95% CI: 11.27-11.87) for gastrointestinal bleeding. The IRRs at 5 ~ 60 days after administration of antenatal corticosteroids were 5.91 (95% CI: 3.10-11.30) for sepsis and 4.45 (95% CI: 2.63-7.55) for heart failure, and 1.26 (95% CI: 1.02-1.55) for gastrointestinal bleeding; and the IRRs for days 61 ~ 180 were 2.00 (95% CI: 1.01-3.96) for sepsis, 3.65 (95% CI: 2.14-6.22) for heart failure, and 1.81 (95% CI: 1.56-2.10) for gastrointestinal bleeding. CONCLUSIONS: This nationwide population-based study suggests that a single course of antenatal corticosteroids is significantly associated with a 1.3- to 5.9-fold increased risk of sepsis, heart failure, and gastrointestinal bleeding in pregnant women. Maternal health considerations, including recommendations for adverse event monitoring, should be included in future guidelines for antenatal corticosteroid treatment.


Asunto(s)
Insuficiencia Cardíaca , Nacimiento Prematuro , Sepsis , Femenino , Embarazo , Recién Nacido , Humanos , Mujeres Embarazadas , Nacimiento Prematuro/epidemiología , Corticoesteroides/efectos adversos , Insuficiencia Cardíaca/epidemiología , Sepsis/epidemiología , Hemorragia Gastrointestinal
4.
Clin Transl Sci ; 16(12): 2565-2576, 2023 12.
Artículo en Inglés | MEDLINE | ID: mdl-37718472

RESUMEN

Oral corticosteroids (OCS) are commonly prescribed for acute, self-limited conditions, despite studies demonstrating toxicity. Studies evaluating longitudinal OCS prescribing in the general population are scarce and do not compare use across countries. This study investigated and compared OCS prescription patterns from 2009 to 2018 in the general populations of the United States, Taiwan, and Denmark. This international population-based longitudinal cohort study used nationwide claims databases (United States: Optum Clinformatics Data Mart; de-identified; Taiwan: National Health Insurance Research Database; and Denmark: National Prescription and Patient Registries/Danish National Patient Registry) to evaluate OCS prescribing. We classified annual OCS duration as short-term (1-29 days), medium-term (30-89 days), or long-term (≥90 days). Longitudinal change in annual prevalence of OCS use and physician prescribing patterns were reported. Among 54,630,437 participants, average annual percentage of overall OCS use was 6.8% in the United States, 17.5% in Taiwan, and 2.2% in Denmark during 2009-2018. Prevalence of OCS prescribing increased at an average annual rate of 0.1%-0.17%, mainly driven by short-term prescribing to healthy adults. One-quarter to one-fifth of OCS prescribing was associated with a diagnosis of respiratory infection. Family practice and internal medicine physicians were among the highest OCS prescribers across countries and durations. Age- and sex-stratified trends mirrored unstratified trends. This study provides real-world evidence of an ongoing steady increase in OCS use in the general populations of the United States, Taiwan, and Denmark. This increase is largely driven by short-term OCS prescribing to healthy adults, a practice previously viewed as safe but recently shown to incur substantial population-level risk.


Asunto(s)
Corticoesteroides , Adulto , Humanos , Estados Unidos/epidemiología , Prevalencia , Taiwán/epidemiología , Estudios Longitudinales , Corticoesteroides/efectos adversos , Dinamarca/epidemiología
5.
BMJ ; 382: e075835, 2023 08 02.
Artículo en Inglés | MEDLINE | ID: mdl-37532264

RESUMEN

OBJECTIVE: To investigate the associations between exposure to antenatal corticosteroids and serious infection in children during the first three, six, and 12 months of life. DESIGN: Nationwide cohort study. SETTING: National Health Insurance Research Database, Birth Reporting Database, and Maternal and Child Health Database, 1 January 2008 to 31 December 2019, to identify all pregnant individuals and their offspring in Taiwan. PARTICIPANTS: 1 960 545 pairs of pregnant individuals and their singleton offspring. 45 232 children were exposed and 1 915 313 were not exposed to antenatal corticosteroids. MAIN OUTCOME MEASURES: Incidence rates were estimated for overall serious infection, sepsis, pneumonia, acute gastroenteritis, pyelonephritis, meningitis or encephalitis, cellulitis or soft tissue infection, septic arthritis or osteomyelitis, and endocarditis during the first three, six, and 12 months of life in children exposed versus those not exposed to antenatal corticosteroids. Cox proportional hazards models were performed to quantify adjusted hazard ratios with 95% confidence intervals for each study outcome. RESULTS: The study cohort was 1 960 545 singleton children: 45 232 children were exposed to one course of antenatal corticosteroids and 1 915 313 children were not exposed to antenatal corticosteroids. The adjusted hazard ratios for overall serious infection, sepsis, pneumonia, and acute gastroenteritis among children exposed to antenatal corticosteroids were significantly higher than those not exposed to antenatal corticosteroids during the first six months of life (adjusted hazard ratio 1.32, 95% confidence interval 1.18 to 1.47, P<0.001, for overall serious infection; 1.74, 1.16 to 2.61, P=0.01, for sepsis; 1.39, 1.17 to 1.65, P<0.001, for pneumonia; and 1.35, 1.10 to 1.65, P<0.001, for acute gastroenteritis).Similarly, the adjusted hazard ratios for overall serious infection (P<0.001), sepsis (P=0.02), pneumonia (P<0.001), and acute gastroenteritis (P<0.001) were significantly higher from birth to 12 months of life. In the sibling matched cohort, the results were comparable with those observed in the whole cohort, with a significantly increased risk of sepsis in the first six (P=0.01) and 12 (P=0.04) months of life. CONCLUSIONS: This nationwide cohort study found that children exposed to one course of antenatal corticosteroids were significantly more likely to have an increased risk of serious infection during the first 12 months of life. These findings suggest that before starting treatment, the long term risks of rare but serious infection associated with antenatal corticosteroids should be carefully weighed against the benefits in the perinatal period.


Asunto(s)
Corticoesteroides , Nacimiento Prematuro , Humanos , Embarazo , Niño , Femenino , Estudios de Cohortes , Corticoesteroides/efectos adversos , Taiwán/epidemiología
6.
Asia Pac Allergy ; 13(1): 10-14, 2023 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-37389101

RESUMEN

Bronchiolitis is the most common seasonal viral respiratory disorder in infants. However, risk factors for the development of bronchiolitis, particularly during pregnancy, remain unclear. Methods: A questionnaire was administered to the parents of the hospitalized infants with acute bronchiolitis to obtain information regarding patients' medical, family, and prenatal exposure history. Logistic regression with adjustment was performed to evaluate risk factors associated with bronchiolitis in the infants. Results: Among the enrolled patients, 55 (36.7%) were diagnosed as having bronchiolitis, and the majority (89%) of the patients had moderate-to-severe bronchiolitis. The bronchiolitis group had lower C-reactive protein levels than did the control group. Fewer patients in the bronchiolitis group developed fever. However, hospital stays were longer in the bronchiolitis group than in the control group. Respiratory syncytial virus was the most detected virus (23/26, 88.6%) in the bronchiolitis group. Male sex (odds ratio [OR], 5.71; 95% confidence interval [CI], 2.02-16.12; P < 0.001), antibiotic usage during pregnancy (OR, 27.2; 95% CI, 1.12-660.84; P = 0.04), and viral infection (OR, 49.3; 95% CI, 9.01-270.26; P < 0.001) during the postnatal period were significantly associated with hospitalization for acute bronchiolitis in the infants. By contrast, pet exposure during the perinatal period was significantly and negatively associated with acute bronchiolitis (OR = 0.21, 95% CI = 0.07-0.69, P < 0.01). Conclusion: Environmental exposures during pregnancy may affect respiratory health in offspring, and effective strategies should be developed to prevent bronchiolitis in early life.

7.
Sci Rep ; 12(1): 11595, 2022 07 08.
Artículo en Inglés | MEDLINE | ID: mdl-35804185

RESUMEN

Frail older adults are vulnerable to stressors; thus, sleep related cognition impairment might more greatly affect frail than healthy older adults. In the present study, we investigated whether the association between sleep problems and cognition varies with physical frailty status (modified from Fried et al.). Participants 55 years and older who completed a baseline and follow-up questionnaire (median follow-up: 5.5 years), were included in the analysis. Sleep parameters were evaluated in an interview at the baseline. Cognitive decline was defined as a loss of 3 or more points on the Mini-Mental State Examination (MMSE) at follow-up. Associations between sleep problems and cognitive decline were examined using logistic regression and were stratified by baseline physical frailty status, adjusted for potential confounders. A short total sleep duration (< 5 vs. 7-9 h, odds ratio (OR) = 1.88, 95% confidence interval (CI) 1.18-3.00), excessive daytime sleepiness (OR = 1.49, 95% CI 1.04-2.13), low sleep efficiency (< 65% vs. ≥ 85%, OR = 1.62, 95% CI 1.07-2.46), and insomnia complaints (OR = 2.34, 95% CI 1.23-4.43) were associated with MMSE decline in physically robust. The association was stronger for the sleep summary score, which summarized abnormal sleep duration, excessive daytime sleepiness, and insomnia complaints ([Formula: see text] 2 vs. 0, OR = 3.79, 95% CI 2.10-6.85, p < 0.0001). Due to the low prevalence of frailty in this community-dwelling population, the statistical power to detect an association was low. More evidence is needed to clarify the role of sleep in the progression of cognitive decline in frail individuals.


Asunto(s)
Disfunción Cognitiva , Trastornos de Somnolencia Excesiva , Fragilidad , Trastornos del Inicio y del Mantenimiento del Sueño , Trastornos del Sueño-Vigilia , Anciano , Cognición , Disfunción Cognitiva/complicaciones , Disfunción Cognitiva/epidemiología , Trastornos de Somnolencia Excesiva/epidemiología , Anciano Frágil/psicología , Fragilidad/complicaciones , Fragilidad/epidemiología , Evaluación Geriátrica , Humanos , Sueño , Trastornos del Inicio y del Mantenimiento del Sueño/complicaciones , Trastornos del Inicio y del Mantenimiento del Sueño/epidemiología , Trastornos del Sueño-Vigilia/complicaciones , Trastornos del Sueño-Vigilia/epidemiología , Trastornos del Sueño-Vigilia/psicología
8.
Cancer Immunol Immunother ; 71(3): 705-718, 2022 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-34374812

RESUMEN

BACKGROUND: A major feature of the microenvironment in pancreatic ductal adenocarcinoma (PDAC) is the significant amount of extracellular matrix produced by pancreatic stellate cells (PSCs), which have been reported to enhance the invasiveness of pancreatic cancer cells and negatively impact the prognosis. METHODS: We analyzed the data from two publicly available microarray datasets deposited in the Gene Expression Omnibus and found candidate genes that were differentially expressed in PDAC cells with metastatic potential and PDAC cells cocultured with PSCs. We studied the interaction between PDAC cells and PSCs in vitro and verified our finding with the survival data of patients with PDAC from the website of The Human Protein Atlas. RESULTS: We found that PSCs stimulated PDAC cells to secrete S100A9, which attracted circulatory monocytes into cancer tissue and enhanced the expression of programmed death-ligand 1 (PD-L1) on macrophages. When analyzing the correlation of S100A9 and PD-L1 expression with the clinical outcomes of patients with PDAC, we ascertained that high expression of S100A9 and PD-L1 was associated with poor survival in patients with PDAC. CONCLUSIONS: PSCs stimulated PDAC cells to secrete S100A9, which acts as a chemoattractant to attract circulatory monocytes into cancer microenvironment and induces expression of PD-L1 on macrophages. High expression of S100A9 and PD-L1 was associated with worse overall survival in a cohort of patients with PDAC.


Asunto(s)
Calgranulina B/genética , Carcinoma Ductal Pancreático/etiología , Carcinoma Ductal Pancreático/metabolismo , Comunicación Celular , Neoplasias Pancreáticas/etiología , Neoplasias Pancreáticas/metabolismo , Células del Estroma/metabolismo , Biomarcadores , Calgranulina B/metabolismo , Fibroblastos Asociados al Cáncer/metabolismo , Fibroblastos Asociados al Cáncer/patología , Carcinoma Ductal Pancreático/mortalidad , Carcinoma Ductal Pancreático/patología , Comunicación Celular/genética , Comunicación Celular/inmunología , Línea Celular Tumoral , Movimiento Celular/efectos de los fármacos , Técnicas de Cocultivo , Medios de Cultivo Condicionados/farmacología , Susceptibilidad a Enfermedades , Perfilación de la Expresión Génica , Regulación Neoplásica de la Expresión Génica , Silenciador del Gen , Humanos , Clasificación del Tumor , Estadificación de Neoplasias , Neoplasias Pancreáticas/mortalidad , Neoplasias Pancreáticas/patología , Células Estrelladas Pancreáticas/metabolismo , Células Estrelladas Pancreáticas/patología , Pronóstico , Interferencia de ARN , Células del Estroma/patología , Microambiente Tumoral/genética , Microambiente Tumoral/inmunología
9.
JAMA Pediatr ; 175(7): 723-729, 2021 07 01.
Artículo en Inglés | MEDLINE | ID: mdl-33871562

RESUMEN

Importance: The adverse effects from the long-term use of oral corticosteroids are known, but, to our knowledge, few studies have reported the risk of corticosteroid bursts, particularly among children. Objective: To quantify the associations of corticosteroid bursts with severe adverse events, including gastrointestinal (GI) bleeding, sepsis, pneumonia, and glaucoma, in children. Design, Setting, and Participants: This study used data derived from the National Health Insurance Research Database in Taiwan from January 1, 2013, to December 31, 2017, on children younger than 18 years of age and used a self-controlled case series design. Data were analyzed from January 1 to July 30, 2020. Exposure: Oral corticosteroid bursts (defined as oral corticosteroid use for ≤14 days). Main Outcomes and Measures: Incidence rates were calculated of 4 severe adverse events (GI bleeding, sepsis, pneumonia, and glaucoma) in children who did or did not receive corticosteroid bursts. Conditional fixed-effect Poisson regression was used to estimate incidence rate ratios (IRRs) of severe adverse events within 5 to 30 days and 31 to 90 days after initiation of corticosteroid bursts. Results: Among 4 542 623 children, 23% (1 064 587; 544 268 boys [51.1%]; mean [SD] age, 9.7 [5.8] years) were prescribed a single corticosteroid burst. The most common indications were acute respiratory tract infections and allergic diseases. The incidence rate differences per 1000 person-years between children administered a single corticosteroid burst and those not prescribed corticosteroids were 0.60 (95% CI, 0.55-0.64) for GI bleeding, 0.03 (95% CI, 0.02-0.05) for sepsis, 9.35 (95% CI, 9.19-9.51) for pneumonia, and 0.01 (95% CI, 0.01-0.03) for glaucoma. The IRRs within 5 to 30 days after initiating corticosteroid bursts were 1.41 (95% CI, 1.27-1.57) for GI bleeding, 2.02 (95% CI, 1.55-2.64) for sepsis, 2.19 (95% CI, 2.13-2.25) for pneumonia, and 0.98 (95% CI, 0.85-1.13) for glaucoma; the IRRs within the subsequent 31 to 90 days were 1.10 (95% CI, 1.02-1.19) for GI bleeding, 1.08 (95% CI, 0.88-1.32) for sepsis, 1.09 (95% CI, 1.07-1.11) for pneumonia, and 0.95 (95% CI, 0.85-1.06) for glaucoma. Conclusions and Relevance: This study suggests that corticosteroid bursts, which are commonly prescribed for children with respiratory and allergic conditions, are associated with a 1.4- to 2.2-fold increased risk of GI bleeding, sepsis, and pneumonia within the first month after initiation of corticosteroid therapy that is attenuated during the subsequent 31 to 90 days.


Asunto(s)
Corticoesteroides/administración & dosificación , Corticoesteroides/efectos adversos , Administración Oral , Niño , Femenino , Hemorragia Gastrointestinal/inducido químicamente , Hemorragia Gastrointestinal/epidemiología , Glaucoma/inducido químicamente , Glaucoma/epidemiología , Humanos , Incidencia , Masculino , Neumonía/inducido químicamente , Neumonía/epidemiología , Sepsis/inducido químicamente , Sepsis/epidemiología , Taiwán/epidemiología
11.
Adv Mater ; 33(1): e2005612, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33215757

RESUMEN

Phase transition in thermoelectric (TE) material is a double-edged sword-it is undesired for device operation in applications, but the fluctuations near an electronic instability are favorable. Here, Sb doping is used to elicit a spontaneous composition fluctuation showing uphill diffusion in GeTe that is otherwise suspended by diffusionless athermal cubic-to-rhombohedral phase transition at around 700 K. The interplay between these two phase transitions yields exquisite composition fluctuations and a coexistence of cubic and rhombohedral phases in favor of exceptional figures-of-merit zT. Specifically, alloying GeTe by Sb2 Te3 significantly suppresses the thermal conductivity while retaining eligible carrier concentration over a wide composition range, resulting in high zT values of >2.6. These results not only attest to the efficacy of using phase transition in manipulating the microstructures of GeTe-based materials but also open up a new thermodynamic route to develop higher performance TE materials in general.

12.
BMC Public Health ; 18(1): 142, 2018 02 14.
Artículo en Inglés | MEDLINE | ID: mdl-29439694

RESUMEN

BACKGROUND: The effect of cardio-metabolic profile on the relationship of body mass index (BMI) with mortality is unclear. The aim of this study was to explore association between BMI and mortality at all ages, taking account of cardio-metabolic disorders. METHODS: We followed 377,929 individuals (≥ 20 years), who registered for health checkups in 1996-2007, until 2008 and found 9490 deaths. From multivariable Cox proportional hazards models we estimated mortality hazard ratios (HR) for those in high blood pressure, hyperglycemia, high waist circumference, dyslipidemia, and different BMIs categories (the underweight [< 18.5 kg/m2], low normal weight [18.5-21.9 kg/m2], normal weight [22-23.9 kg/m2, the referent], overweight [24-26.9 kg/m2], obese1 [27-29.9 kg/m2], and obese2 [≥ 30 kg/m2]). Population attributable risk (PAR) provided estimates of the population mortality burden attributable to high blood pressure, hyperglycemia, high waist circumference, dyslipidemia, and deviant BMIs. RESULTS: Higher blood pressure, hyperglycemia, high waist circumference, and dyslipidemia were significantly predictive of higher mortality for nearly all ages. Compared with the referent BMI, underweight (HR = 1.69, 95% confidence interval = 1.51-1.90) and low normal weight (HR = 1.19, 1.11-1.28) were significant mortality risks, while overweight (HR = 0.82, 0.76-0.89) and obese1 (HR = 0.88, 0.79-0.97) were protective against premature death. The mortality impact of obesity was largely attributable to cardio-metabolic profile and attenuated by age. The population mortality burden with high blood pressure (PAR = 7.29%), hyperglycemia (PAR = 5.15%), high waist circumference (PAR = 4.24%), and dyslipidemia (PAR = 5.66%) was similar to that in the underweight (PAR = 5.50%) or low normal weight (PAR = 6.04%) groups. Findings for non-smokers and by gender were similar. CONCLUSIONS: The effect of BMI on mortality varies with age and is affected by cardio-metabolic status. Compared to any deviant BMI, abnormal cardio-metabolic status has a similar or even greater health impact at both the individual and population levels.


Asunto(s)
Índice de Masa Corporal , Enfermedades Cardiovasculares/mortalidad , Enfermedades Metabólicas/mortalidad , Adulto , Distribución por Edad , Anciano , Femenino , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Modelos de Riesgos Proporcionales , Distribución por Sexo , Tasa de Supervivencia/tendencias , Taiwán/epidemiología , Adulto Joven
13.
J Geriatr Phys Ther ; 41(1): 14-19, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-28079633

RESUMEN

BACKGROUND AND PURPOSE: Current evidence suggests that grip strength and usual gait speed (UGS) are important predictors of instrumental activities of daily living (IADL) disability. Knowing the optimum cut points of these tests for discriminating people with and without IADL disability could help clinicians or researchers to better interpret the test results and make medical decisions. The purpose of this study was to determine the cutoff values of grip strength and UGS for best discriminating community-dwelling older adults with and without IADL disability, separately for men and women, and to investigate their association with IADL disability. METHODS: We conducted secondary data analysis on a national dataset collected in the Sarcopenia and Translational Aging Research in Taiwan (START). The data used in this study consisted of health data of 2420 community-dwelling older adults 65 years and older with no history of stroke and with complete data. IADL disability was defined as at least 1 IADL item scored as "need help" or "unable to perform." Receiver operating characteristics analysis was used to estimate the optimum grip strength and UGS cut points for best discriminating older adults with/without IADL disability. The association between each physical performance (grip strength and UGS) and IADL disability was assessed with odds ratios (ORs). RESULTS AND DISCUSSION: With IADL disability as the criterion, the optimal cutoff values of grip strength were 28.7 kg for men and 16.0 kg for women, and those for UGS were 0.76 m/s for men and 0.66 m/s for women. The grip strength test showed satisfactory discriminant validity (area under the curve > 0.7) in men and a strong association with IADL disability (OR > 4). Our cut points using IADL disability as the criterion were close to those indicating frailty or sarcopenia. CONCLUSIONS: Our reported cutoffs can serve as criterion-referenced values, along with those previously determined using different indicators, and provide important landmarks on the performance continua of older adults' grip strength and UGS. These landmarks could be useful in interpreting test results, monitoring changes in performance, and identifying individuals requiring timely intervention. For identifying older adults at risk of IADL disability, grip strength is superior to UGS.


Asunto(s)
Evaluación Geriátrica/métodos , Fuerza de la Mano/fisiología , Modalidades de Fisioterapia , Velocidad al Caminar/fisiología , Actividades Cotidianas , Anciano , Anciano de 80 o más Años , Evaluación de la Discapacidad , Personas con Discapacidad , Femenino , Humanos , Vida Independiente , Masculino , Curva ROC , Valores de Referencia , Factores de Riesgo , Sarcopenia
14.
PLoS One ; 11(11): e0165460, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-27832087

RESUMEN

Patients who suffer from subarachnoid hemorrhage (SAH) usually have long-term neurological impairments. Endogenous neurogenesis might play a potential role in functional recovery after SAH; however, the underlying neurogenesis mechanism is still unclear. We assessed the extent of neurogenesis in the subventricular zone (SVZ) to better understand the neurogenesis mechanism after SAH. We performed a rat model of SAH to examine the extent of neurogenesis in the SVZ and assessed functional effects of the neurotrophic factors in the cerebrospinal fluid (CSF) on neural stem cells (NSCs) after SAH. In this study, the proliferation, differentiation, and migratory capacities of NSCs in the SVZ were significantly increased on days 5 and 7 post SAH. Furthermore, treatment of cultured rat fetal NSCs with the CSF collected from rats on days 5 and 7 post SAH enhanced their proliferation, differentiation, and migration. Enzyme-linked immunosorbent assay (ELISA) of the CSF detected a marked increase in the concentration of brain-derived neurotrophic factor (BDNF). Treating the cultured NSCs with recombinant BDNF (at the same concentration as that in the CSF) or with CSF from SAH rats, directly, stimulated proliferation, differentiation, and migration to a similar extent. BDNF expression was upregulated in the SVZ of rats on days 5 and 7 post SAH, and BDNF release occurred from NSCs, astrocytes, and microglia in the SVZ. These results indicate that SAH triggers the expression of BDNF, which promotes the proliferation, differentiation, and migration of NSCs in the SVZ after SAH.


Asunto(s)
Factor Neurotrófico Derivado del Encéfalo/metabolismo , Ventrículos Laterales/citología , Células-Madre Neurales/citología , Neurogénesis , Hemorragia Subaracnoidea/metabolismo , Animales , Factor Neurotrófico Derivado del Encéfalo/análisis , Movimiento Celular , Proliferación Celular , Células Cultivadas , Ventrículos Laterales/metabolismo , Masculino , Células-Madre Neurales/metabolismo , Ratas Wistar , Regulación hacia Arriba
16.
PLoS One ; 8(11): e80209, 2013.
Artículo en Inglés | MEDLINE | ID: mdl-24244650

RESUMEN

BACKGROUND: Physical performance is a major determinant of health in older adults, and is related to lifestyle factors. Dietary fiber has multiple health benefits. It remains unclear whether fiber intake is independently linked to superior physical performance. We aimed to assess the association between dietary fiber and physical performance in older adults. METHODS: This was a cross-sectional study conducted with community-dwelling adults aged 55 years and older (n=2680) from the ongoing Healthy Aging Longitudinal Study (HALST) in Taiwan 2008-2010. Daily dietary fiber intake was assessed using a validated food frequency questionnaire. Physical performance was determined objectively by measuring gait speed, 6-minute walk distance, timed "up and go" (TUG), summary performance score, hand grip strength. RESULTS: Adjusting for all potential confounders, participants with higher fiber intake had significantly faster gait speed, longer 6-minute walk distance, faster TUG, higher summary performance score, and higher hand grip strength (all P <.05). Comparing with the highest quartile of fiber intake, the lowest quartile of fiber intake was significantly associated with the lowest sex-specific quartile of gait speed (adjusted OR, 2.18 in men [95% CI, 1.33-3.55] and 3.65 in women [95% CI, 2.20-6.05]), 6-minute walk distance (OR, 2.40 in men [95% CI, 1.38-4.17] and 4.32 in women [95% CI, 2.37-7.89]), TUG (OR, 2.42 in men [95% CI, 1.43-4.12] and 3.27 in women [95% CI, 1.94-5.52]), summary performance score (OR, 2.12 in men [95% CI, 1.19-3.78] and 5.47 in women [95% CI, 3.20-9.35]), and hand grip strength (OR, 2.64 in men [95% CI, 1.61-4.32] and 4.43 in women [95% CI, 2.62-7.50]). CONCLUSIONS: Dietary fiber intake was independently associated with better physical performance.


Asunto(s)
Envejecimiento/fisiología , Fibras de la Dieta/administración & dosificación , Fuerza de la Mano/fisiología , Resistencia Física/fisiología , Anciano , Estudios Transversales , Femenino , Marcha/fisiología , Evaluación Geriátrica , Humanos , Masculino , Persona de Mediana Edad , Oportunidad Relativa , Encuestas y Cuestionarios , Taiwán , Caminata/fisiología
18.
Chin J Physiol ; 52(6): 419-25, 2009 Dec 31.
Artículo en Inglés | MEDLINE | ID: mdl-20337149

RESUMEN

Thermal preconditioning may afford cardiovascular protection against oxidative injuries. However, hypertension and taychardia by sympathetic stimulation frequently occur during 420C whole body thermal preconditioning (TP). We aimed to develop a modified TP to achieve cardiovascular protection with to reduced cardiovascular stimulation in the rat. We used a progressive thermal preconditioning (PTP) with three-step 5-min immersion of male Wistar rats in 42 degrees C bath water. Treatment with phentolamine (alpha-adrenergic blocker), propranolol (beta-adrenergic blocker) and atropine (muscarinic cholinergic blocker) was used to evaluate the effect and mechanism of PTP on systemic hemodynamics. Protective function was evaluated by FeCl3-induced acute femoral arterial occlusion (TTO) and heat shock protein 70 expression. Our results show that TP enhanced body temperature, hypertension and tachycardia. However, PTP produced a similar increase in body temperature with significantly less enhancement of hypertension and tachycardia when compared with the TP group. TP- or PTP-induced increase of blood pressure and heart rate was inhibited by phentolamine and propranolol, respectively. PTP-induced attenuation of changes in hemodynamic parameters was via alpha- and beta-adrenergic inhibition. FeCl3 induced femoral arterial injury indicated by TTO at 416 +/- 51 sec in the control rats. After 24 h of TP or PTP treatment with or without adrenergic blocker treatment, TP or PTP upregulated similar femoral arterial heat shock protein 70 expression and significantly (P < 0.05) delayed FeCl3-induced femoral TTO to a similar degree. PTP may provide vascular protection against oxidative injuries with less activation in alpha-adrenergic receptor-mediated hypertension and beta-adrenergic receptor-mediated tachycardia.


Asunto(s)
Fenómenos Fisiológicos Cardiovasculares , Calor , Hipertensión/prevención & control , Receptores Adrenérgicos alfa/fisiología , Receptores Adrenérgicos beta/fisiología , Taquicardia/prevención & control , Animales , Temperatura Corporal/fisiología , Cloruros/efectos adversos , Modelos Animales de Enfermedad , Arteria Femoral/metabolismo , Compuestos Férricos/efectos adversos , Proteínas HSP70 de Choque Térmico/metabolismo , Frecuencia Cardíaca/fisiología , Hemodinámica/fisiología , Hipertensión/fisiopatología , Masculino , Ratas , Ratas Wistar , Taquicardia/fisiopatología , Enfermedades Vasculares/inducido químicamente , Enfermedades Vasculares/prevención & control
19.
J Agric Food Chem ; 56(14): 5494-9, 2008 Jul 23.
Artículo en Inglés | MEDLINE | ID: mdl-18578536

RESUMEN

The analysis of salbutamol in swine serum is the more practical basis for large scale surveillance programs in Taiwan. Objectives of the study were to develop a new assay and to compare with a commercially available kit in field test screens. A simple and reliable enzyme-linked immunosorbent assay (ELISA) to monitor the presence of beta-agonist, salbutamol, in 1,358 field samples of swine serum that were collected from local meat markets was described. The method proved to be suitable and sensitive for the detection of beta-agonist residues caused by growth promoting dosage. The limit of detection of the developed ELISA directly performed on diluted serum was 0.25 ng/mL. The application and the results of two ELISA kits (homemade and commercially available) for the screening of salbutamol were presented. For further confirmation, all samples that showed to be ELISA positive for salbutamol residues were analyzed by GC-MS. Adopting 1 ng/mL salbutamol as a cutoff value, the commercial beta-agonist ELISA had a sensitivity of 89.2% and a specificity of 86.7% versus GC-MS at a cutoff of 1 ng/mL. The homemade salbutamol ELISA had a sensitivity of 81.1% and a specificity of 98.6% and gave a low proportion of false-positive rate results. The reliability of the developed kit in terms of the percentage of false-positive rate results is evaluated. In conclusion, a sensitive, specific salbutamol ELISA has been developed that could serve as a rapid screening assay, and the detection of positive samples at the place of sampling can result in more effective control of the illegal use of beta-agonists.


Asunto(s)
Agonistas Adrenérgicos beta/sangre , Albuterol/sangre , Ensayo de Inmunoadsorción Enzimática , Porcinos/sangre , Animales , Cromatografía de Gases y Espectrometría de Masas , Juego de Reactivos para Diagnóstico , Sensibilidad y Especificidad , Taiwán
20.
Conf Proc IEEE Eng Med Biol Soc ; 2005: 3074-7, 2005.
Artículo en Inglés | MEDLINE | ID: mdl-17282893

RESUMEN

With the advancement of the imaging facility and image processing technique, computer assisted surgical planning and image guided technology have become increasingly used in neurosurgery. For MRI has the characteristic of multi-spectral image data., so knowledge-base techniques is widely used in brain MRI segmentation. Here we recognize the location of the tumor automatically and provide an accurate result by Estimation Maximization method. Simultaneously, promote the efficiency of reading image as well.

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