Geriatric syndrome awareness and its determinants in China: a cross-sectional study.

BACKGROUND: This study aims to investigate the awareness rate of six common geriatric syndromes and related influencing factors among the older adults aged 65 and above in China. METHODS: This is a multicenter cross-sectional study involving 6,653 participants aged 65 and older from four regions who completed a questionnaire on geriatric syndrome awareness. The questionnaire covered demographic data, health information, medication usage, and an assessment scale for knowledge of six geriatric syndromes (GS Awareness Scale). RESULTS: A total of 6,653 respondents were surveyed, with 5,318 valid questionnaires collected (79.93%), including 1,311 from Zhejiang (24.7%), 1,356 from Beijing (25.5%), 1,373 from Sichuan (25.8%), and 1,278 from Fujian (24.0%). The highest awareness was for falls, with 3,295 individuals (62.0%), followed by dementia with 2,929 individuals (55.1%), malnutrition with 2,907 individuals (54.7%), frailty with 2,156 individuals (40.5%), urinary incontinence with 2,006 individuals (37.7%), and sarcopenia with 1,914 individuals (36.0%). Univariate analysis showed that factors such as region, age, marital status, living situation, educational level, source of respondents, income status, and smoking had statistically significant differences in awareness rates (P < 0.05). Multivariate logistic regression results indicated that the source of respondents significantly affected the awareness rates (P < 0.05), with the older adults from rural areas having an increased risk of lower awareness compared to urban areas; age also significantly influenced the awareness rates (P < 0.05), with older age groups (76-85, 86-95 years) having a higher risk of reduced awareness compared to those aged 65-75 years. CONCLUSIONS: The awareness of common geriatric syndromes among the older adults population aged 65 years and older in China is notably low. Consequently, there exists a critical need to enhance the formulation of policies regarding geriatric syndromes across various regions, aiming to elevate health literacy among this demographic.

Are effect sizes in self-efficacy field changing over time? A meta-meta analysis.

Theories relating to self-efficacy have developed rapidly since Bandura first proposed the concept in 1977. In the past two decades, psychologists have carried out numerous studies to research the cultural and psychological changes in social development. The research topic of this study is whether self-efficacy changes over time. This study uses a meta-meta analysis and includes 13 meta-analyses, including 536 effect sizes, with a total sample size of 421,880. We find that individual self-efficacy increases over time, which may be related to social development trends. However, the effects of interventions on self-efficacy remain similar (Qmodel  = 1.807, df = 1, p > .05), and a possible explanation is that time effects of self-efficacy confuse the effects of intervention, because both in the intervention group and control group, the average of self-efficacy increases over time. And we find that a general decline in the predictive effects of self-efficacy (Qmodel  = 5.117, df = 1, p = .024), especially the ability to predict relatively objective variables (e.g. job performance, teaching effectiveness, and transfer of training). A possible explanation is that as social development people tend to overestimate their self-efficacy. Another possible explanation is that the effect sizes in the original studies being overrated, may due to intentional selective reporting or unintentional statistical errors.

The origin and composition of cucurbit "phloem" exudate.

Cucurbits exude profusely when stems or petioles are cut. We conducted studies on pumpkin (Cucurbita maxima) and cucumber (Cucumis sativus) to determine the origin and composition of the exudate. Morphometric analysis indicated that the exudate is too voluminous to derive exclusively from the phloem. Cold, which inhibits phloem transport, did not interfere with exudation. However, ice water applied to the roots, which reduces root pressure, rapidly diminished exudation rate. Sap was seen by microscopic examination to flow primarily from the fascicular phloem in cucumber, and several other cucurbit species, but primarily from the extrafascicular phloem in pumpkin. Following exposure of leaves to 14CO2, radiolabeled stachyose and other sugars were detected in the exudate in proportions expected of authentic phloem sap. Most of this radiolabel was released during the first 20 s. Sugars in exudate were dilute. The sugar composition of exudate from extrafascicular phloem near the edge of the stem differed from that of other sources in that it was high in hexose and low in stachyose. We conclude that sap is released from cucurbit phloem upon wounding but contributes negligibly to total exudate volume. The sap is diluted by water from cut cells, the apoplast, and the xylem. Small amounts of dilute, mobile sap from sieve elements can be obtained, although there is evidence that it is contaminated by the contents of other cell types. The function of P-proteins may be to prevent water loss from the xylem as well as nutrient loss from the phloem.

Antisense repression of sucrose phosphate synthase in transgenic muskmelon alters plant growth and fruit development.

To unravel the roles of sucrose phosphate synthase (SPS) in muskmelon (Cucumis melo L.), we reduced its activity in transgenic muskmelon plants by an antisense approach. For this purpose, an 830 bp cDNA fragment of muskmelon sucrose phosphate synthase was expressed in antisense orientation behind the 35S promoter of the cauliflower mosaic virus. The phenotype of the antisense plants clearly differed from that of control plants. The transgenic plant leaves were markedly smaller, and the plant height and stem diameter were obviously shorter and thinner. Transmission electron microscope observation revealed that the membrane degradation of chloroplast happened in transgenic leaves and the numbers of grana and grana lamella in the chloroplast were significantly less, suggesting that the slow growth and weaker phenotype of transgenic plants may be due to the damage of the chloroplast ultrastructure, which in turn results in the decrease of the net photosynthetic rate. The sucrose concentration and levels of sucrose phosphate synthase decreased in transgenic mature fruit, and the fruit size was smaller than the control fruit. Together, our results suggest that sucrose phosphate synthase may play an important role in regulating the muskmelon plant growth and fruit development.

Cloning and characterization of a sucrose synthase-encoding gene from muskmelon.

A full-length cDNA clone encoding sucrose synthase (SS; EC 2.4.1.13) was isolated from muskmelon (Cucumis melo L.) by RT-PCR and RACE. The clone, designated as CmSS1, contains 2,585 nucleotides with an open reading frame of 2,412 nucleotides. The deduced 804 amino acid sequence showed high identities with other plant sucrose synthase. Real time PCR analysis indicated that CmSS1 expression differed among root, stem, leaf, flower and fruit tissues. The analysis during fruit development indicated that CmSS1 mRNA showed its maximum level at 5 days after pollination (DAP) and decreased gradually during fruit development until its minimum level in mature fruit. The sucrose content was very low in fruit before 20 DAP but increased dramatically between 20 and 30 DAP during fruit development. However, SS activities in both direction of sucrose synthesis and sucrose cleavage were very low and changed little during fruit development, suggesting that SS may play little role in determining sucrose accumulation during muskmelon fruit.

Antisense suppression of an acid invertase gene (MAI1) in muskmelon alters plant growth and fruit development.

To unravel the roles of soluble acid invertase in muskmelon (Cucumis melo L.), its activity in transgenic muskmelon plants was reduced by an antisense approach. For this purpose, a 1038 bp cDNA fragment of muskmelon soluble acid invertase was expressed in antisense orientation behind the 35S promoter of the cauliflower mosaic virus. The phenotype of the antisense plants clearly differed from that of control plants. The transgenic plant leaves were markedly smaller, and the stems were obviously thinner. Transmission electron microscopy revealed that degradation of the chloroplast membrane occurred in transgenic leaves and the number of grana in the chloroplast was significantly reduced, suggesting that the slow growth and weaker phenotype of the transgenic plants may be due to damage to the chloroplast ultrastructure, which in turn resulted in a decrease in net photosynthetic rate. The sucrose concentration increased and levels of acid invertase decreased in transgenic fruit, and the fruit size was 60% smaller than that of the control. In addition, transgenic fruit reached full-slip at 25 d after pollination (DAP), approximately 5 d before the control fruit (full-slip at 30 DAP), and this accelerated maturity correlated with a dramatic elevation of ethylene production at the later stages of fruit development. Together, these results suggest that soluble acid invertase not only plays an important role during muskmelon plant and fruit development but also controls the sucrose content in muskmelon fruit.

Risk factors of lymph node metastasis in patients with non-small cell lung cancer ≤ 2 cm in size: A monocentric population-based analysis.

AIM: This study was designed to determine the risk factors of lymph node metastasis in non-small cell lung cancer (NSCLC) patients with tumors ≤ 2 cm, using the Shanghai Chest Hospital Lung Cancer Database. METHODS: Five hundred and eighteen patients with NSCLC ≤ 2 cm were included in this study, and were classified into lymph node-positive and lymph node-negative groups. Univariate and multivariate logistic regression analyses were performed to select the independent risk factors for lymph node metastasis in NSCLC patients. RESULTS: No evidence of metastasis was found in tumors ≤ 1 cm, all positive results were in tumors sized 1-2 cm. Imaging characteristics, including solid and part-solid nodules, were strongly associated with lymph node metastasis (odds ratio [OR] 24.959, 95% confidence interval [CI] 5.999-103.835, P < 0.001; OR 12.559, 95% CI 3.564-44.259, P < 0.001) and subgroup logistic analysis (OR 21.384, 95% CI 5.058-90.407, P < 0.001; OR 11.632, 95% CI 3.290-41.126, P < 0.001). Greater lymph node metastasis was observed in non-adeno non-squamous carcinoma. The presence of pleural invasion and carcinoembryonic antigen levels indicated lymph node dissection. Similar results were revealed in subgroup analysis in tumors ≤ 2 to > 1 cm. CONCLUSION: Size had a great impact on lymph node metastasis, especially tumors of 1-2 cm. Preoperative imaging, non-adeno non-squamous carcinoma, pleural invasion, and carcinoembryonic antigen all indicated lymph node dissection. There was no discrepancy between N1 and N2 positive lymph nodes.

Combination of In Silico Analysis and In Vitro Assay to Investigate Drug Response to Human Epidermal Growth Factor Receptor 2 Mutations in Lung Cancer.

The epidermal growth factor receptor 2 (HER2) has been established as an important target of HER2-positive lung cancer, but somatic mutations in HER2 kinase domain are frequently observed that may cause drug resistance and sensitivity for tyrosine kinase inhibitors (TKIs). In this study, the response profile of 14 small-molecule TKIs upon 11 clinical HER2 mutations was investigated systematically using a synthetic strategy that integrated in silico analysis and in vitro assay to explore the structural basis, energetic property and biological implication underlying the intermolecular interactions of TKIs with wild-type and variant HER2. It is found that most clinical mutations are far away from HER2 active site and thus can only address modest or moderate effect on inhibitor binding. However, few single-point substations such as D769H and D769Y as well as the gatekeeper mutation T798 M were predicted to cause strong resistance for an array of TKIs by reshaping the geometric feature and physiochemical property of the active site. Furthermore, inhibitor response to the most common insertion mutation in HER2 exion 20 (HER2(YVMA) ) was examined in detail; the response can be grouped into three classes: sensitization, resistance and insusceptibility. The Bcr-Abl inhibitor bosutinib and EGFR inhibitor gefitinib were selected as the representatives of, respectively, sensitization and insusceptibility to perform kinase assay against the GST-tagged, recombinant kinase domains of wild-type HER2(WT) and HER2(YVMA) variant. As expected, the biological activity of bosutinib was improved by ∼160-fold due to the insertion, while gefitinib exhibited low inhibitory potency on both HER2(WT) and HER2(YVMA) (IC50 >100 µM). Structural analysis revealed an intensive network of hydrogen bonds and hydrophobic interactions in HER2(YVMA) bosutinib complex, whereas only few nonspecific van der Waals contacts were observed at the complex interface of HER2(YVMA) with gefitinib.

Isolation and characterization of a muskmelon cDNA encoding Lycopene Beta-cyclase.

Lycopene Beta-cyclase (LCY-B) is thought to play a critical role in Beta-carotene synthesis in fruit. A full-length cDNA clone encoding Lycopene Beta-cyclase was isolated from muskmelon (Cucumis melo L.) by RT-PCR and RACE. The clone, designated CmLcyb1, contains 1871 nucleotides, with an open reading frame of 1512 nucleotides. The deduced 504-amino-acid sequence showed high identities with other plant Lycopene Beta-cyclases. Real time quantitative RT-PCR analysis indicated that CmLcyb1 was expressed in all tissues and organs of muskmelon inbred M01-3 with white mesocarp and, 'Homoka', an orange mesocarp cultivar. The expression levels of CmLcyb1 in roots, stems, leaves and flowers in the two genotypes differed little. The expression level was highest in mature fruit of 'Homoka' and was much higher than that in mature fruit of M01-3. Moreover, the mRNA level of CmLcyb1 was very low in fruits before fruit-size fixation and increased dramatically in the size-fixed fruits of these two genotypes. The mRNA levels of CmLcyb1 during fruit development of 'Homoka' were all higher than those of M01-3. Interestingly, Beta-carotene content showed almost the same change trend as mRNA levels during fruit development in these two genotypes, suggesting that Beta-carotene accumulation may be linked to the CmLcyb1 transcript level in muskmelon fruit.

Cloning and characterization of a soluble acid invertase-encoding gene from muskmelon.

Soluble acid invertase (S-AIV; EC 3.2.1.26) is thought to play a critical role in sucrose hydrolysis in muskmelon (Cucumis melo L.) fruit. A full-length cDNA clone encoding S-AIV was isolated from muskmelon by RT-PCR and RACE. The clone, designated as CmS-AIV1, contains 2178 nucleotides with an open reading frame of 1908 nucleotides. The deduced 636 amino acid sequence showed high identities with other plant soluble acid invertases. Northern blot analysis indicated that CmS-AIV1 was expressed in flowers and fruit, but was not detected in roots, stems or leaves. Moreover, the mRNA accumulation of CmS-AIV1 showed its maximum level at 10 days after pollination (DAP) and decreased gradually during fruit development until its minimum level at mature fruit. Interestingly, the sucrose content was very low in fruit before 20 DAP but increased dramatically between 20 and 30 DAP during fruit development. In contrast to sucrose content, the activities of S-AIV was very high in fruit before 20 DAP and decreased apparently between 20 and 30 DAP, suggesting that sucrose metabolism may be linked to the CmS-AIV1 transcript level in muskmelon fruit.