ABSTRACT
Importance: Avoiding high protein intake in older adults with chronic kidney disease (CKD) may reduce the risk of kidney function decline, but whether it can be suboptimal for survival is not well known. Objective: To estimate the associations of total, animal, and plant protein intake with all-cause mortality in older adults with mild or moderate CKD and compare the results to those of older persons without CKD. Design, Setting, and Participants: Data from 3 cohorts (Study on Cardiovascular Health, Nutrition and Frailty in Older Adults in Spain 1 and 2 and the Swedish National Study on Aging and Care in Kungsholmen [in Sweden]) composed of community-dwelling adults 60 years or older were used. Participants were recruited between March 2001 and June 2017 and followed up for mortality from December 2021 to January 2024. Those with no information on diet or mortality, with CKD stages 4 or 5, or undergoing kidney replacement therapy and kidney transplant recipients were excluded. Data were originally analyzed from June 2023 to February 2024 and reanalyzed in May 2024. Exposures: Cumulative protein intake, estimated via validated dietary histories and food frequency questionnaires. Main Outcomes and Measures: The study outcome was 10-year all-cause mortality, ascertained with national death registers. Chronic kidney disease was ascertained according to estimated glomerular filtration rates, urine albumin excretion, and diagnoses from medical records. Results: The study sample consisted of 8543 participants and 14 399 observations. Of the 4789 observations with CKD stages 1 to 3, 2726 (56.9%) corresponded to female sex, and mean (SD) age was 78.0 (7.2) years. During the follow-up period, 1468 deaths were recorded. Higher total protein intake was associated with lower mortality among participants with CKD; adjusted hazard ratio (HR) for 1.00 vs 0.80 g/kg/d was 0.88 (95% CI, 0.79-0.98); for 1.20 vs 0.80 g/kg/d, 0.79 (95% CI, 0.66-0.95); and for 1.40 vs 0.80 g/kg/d, 0.73 (95% CI, 0.57-0.92). Associations with mortality were comparable for plant and animal protein (HRs, 0.80 [95% CI, 0.65-0.98] and 0.88 [95% CI, 0.81-0.95] per 0.20-g/kg/d increment, respectively) and for total protein intake in participants younger than 75 years vs 75 years or older (HRs, 0.94 [95% CI, 0.85-1.04] and 0.91 [95% CI, 0.85-0.98] per 0.20-g/kg/d increment in total protein intake, respectively). However, the hazards were lower among participants without CKD than in those with CKD (HRs, 0.85 [95% CI, 0.79-0.92] and 0.92 [95% CI, 0.86-0.98] per 0.20-g/kg/d increment, respectively; P = .02 for interaction). Conclusions and Relevance: In this multicohort study of older adults, higher intake of total, animal, and plant protein was associated with lower mortality in participants with CKD. Associations were stronger in those without CKD, suggesting that the benefits of proteins may outweigh the downsides in older adults with mild or moderate CKD.
Subject(s)
Dietary Proteins , Renal Insufficiency, Chronic , Humans , Aged , Male , Female , Renal Insufficiency, Chronic/mortality , Sweden/epidemiology , Dietary Proteins/administration & dosage , Aged, 80 and over , Middle Aged , Spain/epidemiology , Cohort Studies , Cause of DeathABSTRACT
OBJECTIVE: Falls and fear of falling (FoF) are relevant contributors to disability and institutionalization among older adults. The aim was to examine the association between multimorbidity and falls/FoF among community-dwelling older adults, exploring the mediating effect of physical function and the use of sleeping pills and pain relievers. DESING: Longitudinal analyses. SETTING AND PARTICIPANTS: A total of 1824 adults aged ≥65 years from the Seniors-ENRICA II cohort (Spain). METHODS: Multimorbidity was defined as having ≥2 diseases from a predefined list of 13 chronic conditions extracted from clinical records. Falls were self-reported and FoF was estimated using the Short Falls Efficacy Scale International. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were estimated for the association between multimorbidity/duration of multimorbidity and incident falls/FoF using logistic regression models. The mediating effects of physical function, the use of sleeping pills, and pain relievers were explored using the Karlson Holm Breen method. RESULTS: Multimorbidity was associated with a higher risk of falls (OR, 1.44; 95% CI, 1.14-1.82) and FoF (OR, 1.88; 95% CI, 1.48-2.39). Positive dose-response associations were found between the duration of multimorbidity and the risk of falls (P-trend = .003) and FoF (P-trend = .001). Physical function mediated 5.67% and 5.25% of these associations, respectively, and the use of sleeping pills explained a larger proportion of the associations (9.27% and 11.61%). Last, the mediation effect of pain relievers on the association between multimorbidity and falls was 3.05% and 9.31% in the multimorbidity-FoF association. CONCLUSIONS AND IMPLICATIONS: Multimorbidity was associated with a higher risk of falls/FoF among Spanish community-dwelling older adults. Use of sleeping pills was a relevant mediator, suggesting that interventions on sleep problems have the potential to reduce the burden of falls/FoF and their consequences among older adults with multimorbidity.
ABSTRACT
Bio-carbon-manganese composites obtained from olive mill wastewater were successfully prepared using manganese acetate as the manganese source and olive wastewater as the carbon precursor. The samples were characterized chemically and texturally by N2 and CO2 adsorption at 77 K and 273 K, respectively, by X-ray photoelectron spectroscopy (XPS) and X-ray diffraction. Electrochemical characterization was carried out by cyclic voltammetry (CV) and linear sweep voltammetry (LSV). The samples were evaluated in the electro-Fenton degradation of tetracycline in a typical three-electrode system under natural conditions of pH and temperature (6.5 and 25 °C). The results show that the catalysts have a high catalytic power capable of degrading tetracycline (about 70%) by a three-electron oxygen reduction pathway in which hydroxyl radicals are generated in situ, thus eliminating the need for two catalysts (ORR and Fenton).
ABSTRACT
The species included in the ESKAPE group (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa and the genus Enterobacter) have a high capacity to develop antimicrobial resistance (AMR), a health problem that is already among the leading causes of death and could kill 10 million people a year by 2050. The generation of new potentially therapeutic molecules has been insufficient to combat the AMR "crisis", and the World Health Organization (WHO) has stated that it will seek to promote the development of rapid diagnostic strategies. The physicochemical properties of metallic nanoparticles (MNPs) have made it possible to design biosensors capable of identifying low concentrations of ESKAPE bacteria in the short term; other systems identify antimicrobial susceptibility, and some have been designed with dual activity in situ (bacterial detection and antimicrobial activity), which suggests that, in the near future, multifunctional biosensors could exist based on MNPs capable of quickly identifying bacterial pathogens in clinical niches might become commercially available. This review focuses on the use of MNP-based systems for the rapid and accurate identification of clinically important bacterial pathogens, exhibiting the necessity for exhaustive research to achieve these objectives. This review focuses on the use of metal nanoparticle-based systems for the rapid and accurate identification of clinically important bacterial pathogens.
Subject(s)
Biosensing Techniques , Klebsiella pneumoniae , Metal Nanoparticles , Staphylococcus aureus , Metal Nanoparticles/chemistry , Humans , Klebsiella pneumoniae/drug effects , Staphylococcus aureus/drug effects , Acinetobacter baumannii/drug effects , Pseudomonas aeruginosa/drug effects , Enterococcus faecium , Drug Resistance, Bacterial , Anti-Bacterial Agents/pharmacology , Bacteria/drug effects , Early Diagnosis , Enterobacter/drug effectsABSTRACT
In recent years, there has been a growing interest in utilizing spinel ferrite and their nanocomposites as Fenton-like catalysts. The use of these materials offers numerous advantages, including ability to efficiently degrade pollutants and potential for long-term and repeated use facilitated by their magnetic properties that make them easily recoverable. The remarkable catalytic properties, stability, and reusability of these materials make them highly attractive for researchers. This paper encompasses a comprehensive review of various aspects related to the Fenton process and the utilization of spinel ferrite and their composites in catalytic applications. Firstly, it provides an overview of the background, principles, mechanisms, and key parameters governing the Fenton reaction, along with the role of physical field assistance in enhancing the process. Secondly, it delves into the advantages and mechanisms of H2O2 activation induced by different spinel ferrite and their composites for the removal of organic pollutants, shedding light on their efficacy in environmental remediation. Thirdly, the paper explores the application of these materials in various Fenton-like processes, including Fenon-like, photo-Fenton-like, sono-Fenton-like, and electro-Fenton-like, for the effective removal of different types of contaminants. Furthermore, it addresses important considerations such as the toxicity, recovery, and reuse of these materials. Finally, the paper presents the challenges associated with H2O2 activation by these materials, along with proposed directions for future improvements.
Subject(s)
Ferric Compounds , Hydrogen Peroxide , Iron , Catalysis , Hydrogen Peroxide/chemistry , Ferric Compounds/chemistry , Iron/chemistry , Nanocomposites/chemistry , Aluminum Oxide , Magnesium OxideABSTRACT
Antimicrobial surfaces limit the spread of infectious diseases. To date, there is no antimicrobial coating that has widespread use because of short-lived and limited spectrum efficacy, poor resistance to organic material, and/or cost. Here, we present a paint based on waterborne latex particles that is supramolecularly associated with quaternary ammonium compounds (QACs). The optimal supramolecular pairing was first determined by immobilizing selected ions on self-assembled monolayers exposing different groups. The QAC surface loading density was then increased by using polymer brushes. These concepts were adopted to develop inexpensive paints to be applied on many different surfaces. The paint could be employed for healthcare and food production applications. Its slow release of QAC allows for long-lasting antimicrobial action, even in the presence of organic material. Its efficacy lasts for more than 90 washes, and importantly, once lost, it can readily be restored by spraying an aqueous solution of the QAC. We mainly tested cetyltrimethylammonium as QAC as it is already used in consumer care products. Our antimicrobial paint is broad spectrum as it showed excellent antimicrobial efficiency against four bacteria and four viruses.
Subject(s)
Quaternary Ammonium Compounds , Quaternary Ammonium Compounds/chemistry , Quaternary Ammonium Compounds/pharmacology , Anti-Infective Agents/pharmacology , Anti-Infective Agents/chemistry , Paint , Surface Properties , Latex/chemistry , Latex/pharmacology , Microbial Sensitivity Tests , Bacteria/drug effectsABSTRACT
BACKGROUND: An adequate magnesium intake might lower the risk of frailty through its role in muscle function. METHODS: We analysed data from 81 524 women aged ≥60 years participating in the Nurses' Health Study. Total magnesium intake was obtained from repeated food frequency questionnaires administered between 1984 and 2010 and self-reported information on supplementation. Frailty was defined as having at least three of the following five FRAIL scale criteria: fatigue, low strength, reduced aerobic capacity, having ≥5 chronic illnesses and weight loss ≥ 5%. The occurrence of frailty was assessed every 4 years from 1992 to 2018. Cox proportional hazards models adjusted for lifestyle factors, medication use and dietary factors were used to assess the association between magnesium intake and frailty. RESULTS: During a median follow-up of 16 years, we identified 15 477 incident cases of frailty. Women with a higher intake of total energy-adjusted magnesium had a decreased risk of frailty after adjustment for lifestyle factors, medication use and dietary factors. The relative risk (95% confidence interval) for Quintile 5 (Q5) versus Quintile 1 (Q1) was 0.88 (0.82, 0.94) (P-trend < 0.001). When only energy-adjusted magnesium from the diet was considered, the inverse association was stronger (Q5 vs. Q1: 0.68 [0.56, 0.82]; P-trend < 0.001). Those reaching the recommended daily allowance (RDA) of magnesium through diet had a 14% (9%, 19%) lower risk of frailty compared with those not meeting the RDA. CONCLUSIONS: Increased intake of foods rich in magnesium was associated with a decreased risk of frailty.
Subject(s)
Frailty , Magnesium , Humans , Female , Frailty/epidemiology , Magnesium/administration & dosage , Aged , Middle Aged , Risk FactorsABSTRACT
VPS13A disease and Huntington's disease (HD) are two basal ganglia disorders that may be difficult to distinguish clinically because they have similar symptoms, neuropathological features, and cellular dysfunctions with selective degeneration of the medium spiny neurons of the striatum. However, their etiology is different. VPS13A disease is caused by a mutation in the VPS13A gene leading to a lack of protein in the cells, while HD is due to an expansion of CAG repeat in the huntingtin (Htt) gene, leading to aberrant accumulation of mutant Htt. Considering the similarities of both diseases regarding the selective degeneration of striatal medium spiny neurons, the involvement of VPS13A in the molecular mechanisms of HD pathophysiology cannot be discarded. We analyzed the VPS13A distribution in the striatum, cortex, hippocampus, and cerebellum of a transgenic mouse model of HD. We also quantified the VPS13A levels in the human cortex and putamen nucleus; and compared data on mutant Htt-induced changes in VPS13A expression from differential expression datasets. We found that VPS13A brain distribution or expression was unaltered in most situations with a decrease in the putamen of HD patients and small mRNA changes in the striatum and cerebellum of HD mice. We concluded that the selective susceptibility of the striatum in VPS13A disease and HD may be a consequence of disturbances in different cellular processes with convergent molecular mechanisms already to be elucidated.
ABSTRACT
Carbon xerogel spheres co-doped with nitrogen and eco-graphene were synthesized using a typical solvothermal method. The results indicate that the incorporation of eco-graphene enhances the electrochemical properties, such as the current density (JK) and the selectivity for the four transferred electrons (n). Additionally, nitrogen doping has a significant effect on the degradation efficiency, varying with the size of the carbon xerogel spheres, which could be attributed to the type of nitrogenous group doped in the carbon material. The degradation efficiency improved in the nanometric spheres (48.3% to 61.6%) but decreased in the micrometric-scale spheres (58.6% to 53.4%). This effect was attributed to the N-functional groups present in each sample, with N-CNS-5 exhibiting a higher percentage of graphitic nitrogen (35.7%) compared to N-CMS-5 (15.3%). These findings highlight the critical role of sphere size in determining the type of N-functional groups present in the sample. leading to enhanced degradation of pollutants as a result of the electro-Fenton process.
ABSTRACT
Vivid structural colours in butterflies are caused by photonic nanostructures scattering light. Structural colours evolved for numerous biological signalling functions and have important technological applications. Optically, such structures are well understood, however insight into their development in vivo remains scarce. We show that actin is intimately involved in structural colour formation in butterfly wing scales. Using comparisons between iridescent (structurally coloured) and non-iridescent scales in adult and developing H. sara, we show that iridescent scales have more densely packed actin bundles leading to an increased density of reflective ridges. Super-resolution microscopy across three distantly related butterfly species reveals that actin is repeatedly re-arranged during scale development and crucially when the optical nanostructures are forming. Furthermore, actin perturbation experiments at these later developmental stages resulted in near total loss of structural colour in H. sara. Overall, this shows that actin plays a vital and direct templating role during structural colour formation in butterfly scales, providing ridge patterning mechanisms that are likely universal across lepidoptera.
Subject(s)
Actin Cytoskeleton , Actins , Butterflies , Pigmentation , Wings, Animal , Animals , Butterflies/metabolism , Butterflies/physiology , Butterflies/ultrastructure , Wings, Animal/ultrastructure , Wings, Animal/metabolism , Actin Cytoskeleton/metabolism , Actin Cytoskeleton/ultrastructure , Actins/metabolism , Color , Animal Scales/metabolism , Animal Scales/ultrastructureABSTRACT
Until now, black titania has attracted much interest as a potential photocatalyst. In this contribution, we report the first demonstration of the effective strategy to fundamentally improve the photocatalytic performance using a novel sustainable defective titaniumcarbon-phosphorous (TCPH) hybrid nanocomposite. The prepared TCPH was used for photocatalytic degradation of the main organic pollutants, which is methyl orange (MO) dye. The physico-chemical properties of as-prepared samples were characterized by various techniques to observe the transformations after carbonization and the interaction between different composite phases. The existence of Ti+3 and oxygen vacancies at the surface, and a notable increase in surface area, are all demonstrated by TCPH, together with the distinct core-shell structure. These unique properties exhibit excellent photocatalytic performance due to the boosted charge transport and separation. The highest degradation efficiency of methyl orange (MO) was attained in the case of TCPH when compared with titanium-cellulose-phosphorous (TCeP) and titaniumcarbon-phosphorous (TCPN). Accordingly, the highest degradation efficiency was achieved by applying the optimal operational conditions of 1 g/L of TCPH catalyst, 10 mg/L of MO, pH of 7 and the temperature at 25 ± 3 °C after 3 min under LED lamp (365 nm) with light intensity 100 mW/cm2. The degradation mechanism was investigated, and the trapping tests showed the dominance of hydroxyl radicals in the degradation of MO. TCPH showed high stability under a long period of operation in five consecutive cycles, which renders the highly promising on an industrial scale. The fabrication of highly active defective titaniumcarbon-phosphorous opens new opportunities in various areas, including water splitting, and CO2 reduction.
Subject(s)
Carbon , Cellulose , Phosphorus , Titanium , Titanium/chemistry , Carbon/chemistry , Catalysis , Phosphorus/chemistry , Cellulose/chemistry , Azo Compounds/chemistry , Nanocomposites/chemistry , Photochemical ProcessesABSTRACT
BACKGROUND: The role of diet quality on malnutrition in older adults is uncertain, due the paucity of the research conducted and the use of use of screening tools that did not consider phenotypic criteria of malnutrition. OBJECTIVE: To evaluate the association of two indices of diet quality, namely the Mediterranean Diet Adherence Screener (MEDAS) and the Alternative Healthy Eating Index (AHEI-2010), with malnutrition among community-dwelling older adults in Spain. METHODS: Cross-sectional analysis of data from 1921 adults aged ≥ 60 years from the Seniors-ENRICA-1 (SE-1) study, and 2652 adults aged ≥ 65 years from the Seniors-ENRICA-2 (SE-2) study. Habitual food consumption was assessed through a validated diet history. Malnutrition was defined according to the Global Leadership Initiative on Malnutrition (GLIM) phenotypic criteria. Statistical analyses were performed with logistic regression with adjustment for socioeconomic and lifestyle variables as well as for total energy and protein intake. RESULTS: The prevalence of malnutrition in the SE-1 study was 9.5% (95% confidence interval: 8.2 to 10.9) and 11.7% (10.5 to 13.9) in the SE-2. Adherence to the MEDAS score was associated with lower prevalence of malnutrition [pooled odds ratio for high (≥ 9 points) vs. low adherence (< 7 points): 0.64 (0.48-0.84); p-trend < 0.001]. Higher adherence to the AHEI-2010 also showed an inverse association with malnutrition (pooled odds ratio for quartile 4 vs. 1: 0.65 (0.49-0.86); p-trend 0.006). Among the individual components, higher consumption of fish and long-chain n-3 fatty acids in MEDAS and AHEI-2010, and of vegetables and nuts and legumes in AHEI-2010, and lower intake of trans-fat and sugar-sweetened beverages and fruit juice in AHEI-2010 were independently associated with lower odds of malnutrition. CONCLUSION: Adherence to high diet-quality patterns was associated with lower frequency of malnutrition among older adults. CLINICAL TRIAL REGISTRY: ClinicalTrials.gov identifier: NCT02804672. June 17, 2016.; ClinicalTrials.gov NCT03541135. May 30, 2018.
Subject(s)
Diet, Mediterranean , Malnutrition , Humans , Aged , Male , Female , Cross-Sectional Studies , Malnutrition/epidemiology , Malnutrition/diagnosis , Spain/epidemiology , Middle Aged , Aged, 80 and over , Diet/methods , Independent Living/trendsABSTRACT
BACKGROUND: Plant-based diets have gained attention due to their beneficial effects against major chronic diseases, although their association with multimorbidity is mostly unknown. OBJECTIVES: We examined the association between the healthful (hPDI) and unhealthful plant-based diet indices (uPDI) with multimorbidity among middle-aged and older adults from the United States. METHODS: Data on 4262 adults aged >50 y was obtained from the 2012-2020 Health and Retirement Study (HRS) and 2013 Health Care and Nutrition Study (HCNS). Food consumption was collected at baseline with a food frequency questionnaire and 2 PDIs were derived: the hPDI, with positive scores for healthy plant foods and reverse scores for less healthy plant foods and animal foods; and the uPDI, with only positive scoring for less healthy plant foods. Complex multimorbidity, defined as ≥3 coexistent conditions, was ascertained from 8 self-reported conditions: hypertension, diabetes, cancer, chronic lung disease, heart disease, stroke, arthritis, and depression. Cox proportional hazards models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS: After a median follow-up of 7.8 y, we documented 1202 incident cases of multimorbidity. Compared with the lowest quartile, higher adherence to the hPDI was inversely associated with multimorbidity (HR for quartile 3: 0.77; 95% CI: 0.62, 0.96 and HR for quartile 4: 0.79; 95% CI, 0.63, 0.98; P-trend = 0.02). In addition, a 10-point increment in the hPDI was associated with a 11% lower incidence of multimorbidity (95% CI: 1, 20%). No significant associations were found for the uPDI after adjusting for sociodemographic and lifestyle factors. CONCLUSIONS: Higher adherence to the hPDI was inversely associated with multimorbidity among middle-aged and older adults. Plant-based diets that emphasize consumption of high-quality plant foods may help prevent the development of complex multimorbidity.
Subject(s)
Diet, Vegetarian , Multimorbidity , Humans , Male , Female , Middle Aged , Aged , United States/epidemiology , Risk Factors , Retirement , Chronic Disease/epidemiology , Diet, Healthy/statistics & numerical data , Diet, Plant-BasedABSTRACT
In Spain, 33% of adults aged 30 to 79 years (10 million) were hypertensive in 2019. Among them, 68% were diagnosed, 57% received drug therapy, and effective therapeutic coverage (control) reached 33%. Both diagnosis and control show geographical and social disparities. Approximately 46 000 cardiovascular deaths per year are attributable to hypertension. In recent decades, the control of hypertension has increased, due to improvements in lifestyle measures and increased use of polytherapy, coinciding with a reduction in stroke mortality. There are several modifiable determinants of the lack of hypertension control: a) white-coat phenomenon affects 22% to 33% of treated individuals, partly due to the limited availability of ambulatory blood pressure monitoring (ABPM) (49%) and self-measured BP (SMBP) (78%); b) inadequate patient adherence to medication and healthy lifestyles (weight loss, the most effective measure, is the least used, ≈40%); and c) insufficient use of polytherapy (≈55%). The remaining challenges include: a) technological aspects, such as measuring BP with more accurate techniques (ABPM, SMBP) and using cardiovascular-risk estimation tools (eg, SCORE); b) clinical challenges, such as reducing therapeutic inertia (≈59%), involving patients in their own management (medication adherence, ≈62%) and effectively implementing clinical guidelines); and c) public health challenges, such as reducing the burden of obesity (≈24%), monitoring progress with updated surveys, and setting national BP control targets.
ABSTRACT
BACKGROUND/OBJECTIVES: In patients with acute stroke, the presence of hyperglycaemia has been associated with higher morbidity and less neurological recovery. The aim of the study was to evaluate the impact of a diabetes specific enteral nutrition (EN) formula on glycaemia, comorbidities and mortality in patients admitted with a first episode of stroke who received complete EN. METHODS: This was a prospective randomised controlled trial. Patients with acute stroke did not have diagnosis of diabetes mellitus and required nasogastric tube feeding. This study has been registered with code NCT03422900. The patients were randomised into two arms: an isocaloric isoprotein formula (control group (CG), 27 patients) vs a diabetes-specific formula (low glycaemic index carbohydrates, fibre (80% soluble) and higher lipid content) (experimental group (EG), 25 patients). Pre-EN blood glucose, hyperglycaemia during EN treatment, HbA1c, insulin use, oral route recovery, length of stay (LOS) and mortality at 30 days were collected. The complications of enteral nutrition during admission were collected as well. RESULTS: 52 patients were included, 50% females, with an age of 77.44(11.48) years; 34 (65.4%) had ischaemic stroke, with a Rankin score of 0(0-2), and a National Institute of Health Stroke Scale (NIHSS) of 19 (15-22). In CG, there were more cases of hyperglycaemia on the 5th day post-NE (13(65%) vs7(35%), p < 0.01). CG showed an OR of 7.58(1.49-39.16) (p = 0.02) for the development of hyperglycaemia. There were no differences in LOS between groups (12(8.5) days vs 14(23) days, p = 0.19) or in the death rate (10(37%) vs 10(40%), p = 0.8), although differences were found in terms of oral route recovery (EG: 11(44%) patients vs CG: 5(18.5%) patients, p = 0.04) (OR (EG): 5.53(1.25-24.47); p = 0.02). CONCLUSIONS: The use of a diabetes-specific enteral formula in non-diabetic patients admitted with acute stroke reduced the risk of developing hyperglycaemia and improved the rate of oral route recovery. Registered under ClinicalTrials.gov Identifier no. NCT03422900.
Subject(s)
Blood Glucose , Enteral Nutrition , Hyperglycemia , Stroke , Humans , Female , Male , Enteral Nutrition/methods , Aged , Stroke/therapy , Prospective Studies , Blood Glucose/analysis , Blood Glucose/metabolism , Food, Formulated , Aged, 80 and over , Length of Stay , Insulin/therapeutic use , Glycated Hemoglobin/analysis , Inpatients , Glycemic Index , Diabetes Mellitus/therapy , Treatment OutcomeABSTRACT
BACKGROUND: Ultraprocessed foods (UPFs) and poor diet quality have been associated with frailty but existing studies had relatively short follow-up time. It is also unclear whether the association of UPF was primarily due to its correlation with poorer diet quality. OBJECTIVES: We examined the association between unprocessed or minimally processed foods (UMFs) and UPF and risk of frailty and explored whether the association with UPF was mainly driven by poor diet quality. METHODS: In total, 63,743 nonfrail females aged 60+ y from the Nurses' Health Study (cohort study) were followed up for ≥26 y. Diet was assessed every 4 y by food frequency questionnaires. UPF and UMF intakes were calculated using the Nova classification. Diet quality was estimated using the Alternate Healthy Eating Index (AHEI) 2010. The association of UMF and UPF with risk of frailty was examined using multivariable adjusted Cox proportional hazard model. RESULTS: During the follow-up period, we recorded 15,187 incident cases of frailty. The hazard ratio (HR) of frailty for the highest compared with the lowest quintile of UMFs (servings per day) was 0.86 (95% CI: 0.83, 0.95; P-trend < 0.001). However, this was no longer statistically significant after adjustment for AHEI-2010. UPFs (servings per day) was directly associated with risk of frailty, even after adjustment for AHEI-2010 (1.31; 95% CI: 1.23, 1.39; P-trend < 0.001). Among those at the highest category of the AHEI-2010, UPFs remained directly associated with frailty (HR comparing top with bottom quintile: 1.40; 95% CI:1.24, 1.57; P-trend < 0.001). For UPF components, we found a higher frailty risk with each serving per day of artificial and sugar-sweetened beverages; fat, spreads, and condiments; yogurt and dairy-based desserts; and other UPFs. However, processed whole grains were not associated with frailty. CONCLUSIONS: Higher intake of UPF is associated with a higher risk of frailty in older females. This is not explained by a lower diet quality contributed by UPFs.
Subject(s)
Diet , Food Handling , Frailty , Humans , Female , Middle Aged , Frailty/epidemiology , Frailty/etiology , United States/epidemiology , Aged , Cohort Studies , Risk Factors , Fast Foods/adverse effects , Proportional Hazards Models , Food, ProcessedABSTRACT
In this study, the effect of the cell density of monolithic catalysts was investigated and further mathematically modeled on cordierite supports used in CO2 methanation. Commercial cordierite monoliths with 200, 400, and 500 cpsi cell densities were coated by immersion into an ethanolic suspension of Ni/CeO2 active phase. SEM-EDS analysis confirmed that, owing to the low porosity of cordierite (surface area < 1 m2 g-1), the Ni/CeO2 diffusion into the walls was limited, especially in the case of low and intermediate cell density monoliths; thus, active phase was predominantly loaded onto the channels' external surface. Nevertheless, despite the larger exposed surface area in the monolith with high cell density, which would allow for better distribution and accessibility of Ni/CeO2, its higher macro-pore volume resulted in some introduction of the active phase into the walls. As a result, the catalytic evaluation showed that it was more influenced by increments in volumetric flow rates. The low cell density monolith displayed diffusional control at flow rates below 500 mL min-1. In contrast, intermediate and high cell density monoliths presented this behavior up to 300 mL min-1. These findings suggest that the interaction reactants-catalyst is considerably more affected by a forced non-uniform flow when increasing the injection rate. This condition reduced the transport of reactants and products within the catalyst channels and, in turn, increased the minimum temperature required for the reaction. Moreover, a slight diminution of selectivity to CH4 was observed and ascribed to the possible formation of hot spots that activate the reverse water-gas shift reaction. Finally, a mathematical model based on fundamental momentum and mass transfer equations coupled with the kinetics of CO2 methanation was successfully derived and solved to analyze the fluid dynamics of the monolithic support. The results showed a radial profile with maximum fluid velocity located at the center of the channel. A reactive zone close to the inlet was obtained, and maximum methane production (4.5 mol m-3) throughout the monolith was attained at 350 °C. Then, linear streamlines of the chemical species were developed along the channel.
Subject(s)
Carbon Dioxide , Cerium , Nickel , Catalysis , Nickel/chemistry , Carbon Dioxide/chemistry , Cerium/chemistry , Methane , Models, TheoreticalABSTRACT
El síndrome de burnout, también conocido como síndrome del desgaste o agotamiento físico y mental, constituye un problema de gran repercusión social en nuestros días. Objetivo. Identificar las dimensiones del síndrome de Burnout en estudiantes universitarios de la Carrera de Contaduría y Finanzas. Materiales y Método. Se desarrolló bajo un diseño observacional de corte transversal. En este sentido, un total de 161 estudiantes participaron en la investigación. Se utilizó el Maslach Burnout Inventory for Educators. Resultados. Los participantes al ser clasificados en las diferentes dimensiones del síndrome burnout mostraron como regularidad diferencias significativas (p<1.056e-06), (p<1.199e-10), (p<1.309e-13) con 74 (46%) y 57 (35%), 85 (53%) y 47 (29%) y 91 (56%) y 39 (24%) para los niveles bajo y alto de las dimensiones agotamiento emocional, cinismo e ineficacia profesional, respectivamente. No se encontraron asociaciones estadísticas entre las dimensiones del síndrome y las variables edad, género y estado civil de los participantes. Conclusión. Existen diferencias significativas entre los valores de las dimensiones del síndrome de burnout en estudiantes de la Carrera de Contaduría y Finanzas; la mayor cantidad de participantes clasifican en los niveles bajo y alto de las tres dimensiones. Por otro lado, no se observaron asociaciones estadísticas al clasificar a los participantes según edad, género y estado civil. Estos hallazgos brindan información relevante sobre la prevalencia de las dimensiones del síndrome de burnout en estudiantes, lo que puede ser útil para el desarrollo de estrategias de prevención y apoyo.
Burnout syndrome, also known as burnout syndrome or physical and mental exhaustion, is a problem of great social repercussion nowadays. Objective. To identify the dimensions of burnout syndrome in university students of Accounting and Finance. Materials and Method. The study was developed under a cross-sectional observational design. In this sense, a total of 161 students participated in the research. The Maslach Burnout Inventory for Educators was used. Results. The participants when classified in the different dimensions of burnout syndrome showed as regularity significant differences (p<1.056e-06), (p<1.199e-10), (p<1.309e-13) with 74 (46%) and 57 (35%), 85 (53%) and 47 (29%) and 91 (56%) and 39 (24%) for the low and high levels of the dimensions emotional exhaustion, cynicism and professional inefficacy, respectively. No statistical associations were found between the dimensions of the syndrome and the variables age, gender and marital status of the participants. Conclusion. There are significant differences between the values of the dimensions of burnout syndrome in Accounting and Finance students; most participants are classified in the low and high levels of the three dimensions. On the other hand, no statistical associations were observed when classifying participants according to age, gender and marital status. These findings provide relevant information on the prevalence of the dimensions of burnout syndrome in students, which may be useful for the development of prevention and support strategies.
A síndrome de burnout, também conhecida como síndrome de esgotamento ou exaustão física e mental, é um problema com grandes repercussões sociais nos dias de hoje. Objetivos. Identificar as dimensões da Síndrome de Burnout em estudantes universitários de Contabilidade e Finanças. Material e Método. O estudo foi realizado através de um desenho observacional transversal. Participaram da pesquisa 161 estudantes. Foi utilizado o Maslach Burnout Inventory for Educators. Resultados. Os participantes quando classificados nas diferentes dimensões da síndrome de burnout apresentaram regularmente diferenças significativas (p<1,056e-06), (p<1,199e-10), (p<1,309e-13) com 74 (46%) e 57 (35%), 85 (53%) e 47 (29%) e 91 (56%) e 39 (24%) para os níveis baixo e alto das dimensões exaustão emocional, cinismo e ineficácia profissional, respetivamente. Não foram encontradas associações estatísticas entre as dimensões da síndrome e as variáveis idade, género e estado civil dos participantes. Conclusões. Existem diferenças significativas entre os valores das dimensões da síndrome de burnout em estudantes de Contabilidade e Finanças; a maioria dos participantes está classificada nos níveis baixo e alto das três dimensões. Por outro lado, não foram observadas associações estatísticas ao classificar os participantes de acordo com a idade, o género e o estado civil. Estes resultados fornecem informações relevantes sobre a prevalência das dimensões da síndrome de burnout em estudantes, o que pode ser útil para o desenvolvimento de estratégias de prevenção e apoio.
Subject(s)
Humans , Burnout, PsychologicalABSTRACT
OBJECTIVE: To examine the association between hearing function, assessed with pure-tone average (PTA) of air conduction thresholds, and 24-hour ambulatory blood pressure (BP) in older adults. STUDY DESIGN: Cross-sectional study. SETTING: A total of 1404 community-dwelling individuals aged ≥65 years from the Seniors-ENRICA cohort were examined. METHODS: Hearing loss was defined as PTA > 40-AudCal hearing loss decibels (dB-aHL) in the better ear for standard frequency (0.5, 1, and 2 kHz), speech frequency (0.5, 1, 2, and 4 kHz), and high frequency (3, 4, and 8 kHz). Circadian BP patterns were calculated as the percentage decline in systolic BP during the night, and participants were classified as dipper, nondipper, and riser. Ambulatory hypertension was defined as BP ≥ 130/80 mm Hg (24 hour), ≥135/85 (daytime), and ≥120/70 (nighttime) or on antihypertensive treatment. Analyses were performed with linear- and logistic-regression models adjusted for the main confounders. RESULTS: In multivariable analyses, the PTA was associated with higher nighttime systolic BP [ß coefficient per 20 dB-aHL increment standard frequency (95% confidence interval, CI): 2.41 mm Hg (0.87, 3.95); ß (95% CI) per 20 dB-aHL increment speech frequency 2.17 mm Hg (0.70, 3.64)]. Among hypertensive patients, hearing loss at standard and high-frequency PTA was associated with the riser BP pattern [odds ratio: 2.01 (95% CI, 1.03-3.93) and 1.45 (1.00-2.09), respectively]; also, hearing loss at standard PTA was linked to uncontrolled nighttime BP [1.81 (1.01-3.24)]. CONCLUSION: PTA was associated with higher nighttime BP, and hearing loss with a riser BP pattern and uncontrolled BP in older hypertensives.