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In developed countries, the relationship between education level, wealth, and healthy aging have been found to be mediated by modifiable risk factors, such as obesity, physical activities, and smoking status. The present study was to investigate the association between education level, monthly per-capita expenditure (PCE), and healthy aging in the older Indonesian population, and to clarify modifiable risk factors that mediate this association. A 7-year prospective longitudinal study (2007-2014) was conducted on 696 older Indonesian individuals (≥ 50 years) living in 13 different provinces in Indonesia during the survey periods. Data on educational level, PCE, and modifiable risk factors were collected in 2007. Information on healthy aging was obtained in both 2007 and 2014. A multivariate-adjusted logistic regression model was used to estimate the odds ratio (ORs) and 95% confidence intervals (CIs) for healthy aging by education level and PCE. The mediating effects were estimated using a four-way effect decomposition. Out of 696 eligible subjects, 206 (29.6%) were judged as healthy aging in 2014. The OR (95% CI) for healthy aging for participants with a higher education level was 1.81 (1.23-2.65) compared with those with a lower education level, and no significant association was observed between PCE and healthy aging. An association was thus observed between education level and healthy aging, but not PCE. Importantly, the association between education level, PCE, and healthy aging does not appear to be mediated by the modifiable risk factors. Priorities in making health policy would be different between developed countries and developing countries. [ABSTRACT FROM AUTHOR]

Background: Weightbearing computed tomography (WBCT) is a useful tool for the assessment of hindfoot alignment (HA). Foot ankle offset (FAO) is a recently introduced parameter, determined from WBCT images using semiautomatic software. The aim of this study was to determine the clinical relevance and reproducibility of FAO for the evaluation of HA. Methods: A prospective comparative study was performed on consecutive patients requiring bilateral WBCT between September 2017 and April 2018. Based on the clinical assessment of HA, patients were divided into 3 groups: (1) normal alignment group (G1), (2) valgus (G2), and (3) varus (G3). FAO and long axial view (HACT) were measured on WBCT images, and the groups were compared. The reproducibility of FAO and HACT was determined through intraclass correlation coefficients (ICCs). Regression analysis was performed to investigate the correlation between the 2 methods. Overall, 249 feet (126 patients) were included (G1 = 115, G2 = 78, and G3 = 56 feet). Results: The mean values for FAO and HACT were 1.2% ± 2.8% and 3.9 ± 3.1, respectively, in G1; 8.1% ± 3.7% and 9.7 ± 4.9 in G2; and -6.6% ± 4.8% and -8.2 ± 6.6 in G3. Intra- and interobserver reliability was 0.987 and 0.988 for FAO and 0.949 and 0.949 for HACT, respectively. There was a good linear correlation between HACT and FAO (R2 = 0.744), with a regression slope of 1.064. Conclusions: WBCT was a useful method for the characterization of HA. FAO was reproducible and correlated well with physical examination. [ABSTRACT FROM AUTHOR]

Tooth loss is a risk factor for pneumonia mortality, but it is unclear whether oral care negates excess mortality due to pneumonia among community-dwelling elderly with tooth loss. The purpose of this study was to examine the influence of oral care on the association between the number of remaining teeth and the risk of pneumonia death. We analyzed for 18,098 individuals (aged ≥ 65 years) participating in a prospective cohort study. In a 2006 baseline survey, the following data were collected: the number of remaining teeth, oral care, history of disease, smoking, alcohol drinking, education level and so forth. We also obtained data on dates and causes of death between 2006 and 2014. The primary outcome was mortality due to pneumonia. Compared with those having ≥ 20 teeth, the risk of pneumonia mortality was increased among participants having 10-19 or 0-9 teeth; the multivariate hazard ratios (HRs) (95% confidence intervals [CI]) were 1.45 (1.03-2.04) and 1.38 (1.01-1.87), respectively. Among those having 0-9 teeth, a significantly increased risk of mortality due to pneumonia was disappeared for those who brushed their teeth ≥ 2 times per day, for those with visiting a dentist, and for those with use of denture, whereas the risk persisted among those who brushed their teeth ≤ 2 times per day, for those without visiting a dentist, and for those without use of denture. Tooth-brushing, visiting a dentist or use of denture may negate the increased risk of pneumonia death among the elderly with tooth loss. [ABSTRACT FROM AUTHOR]

BACKGROUND: Skeletal muscle atrophy is a striking example of the multiple changes in the physiological state of humans and animals induced by microgravity. Previous studies have shown that a blood circulation disorder may be a cause of this atrophy, and traditional Chinese medicine has been regarded as a potential countermeasure to reverse the atrophy in China. This study was carried out to test the effects of Xuefuzhuyu capsules (XFZY) on the skeletal muscle atrophy induced by simulated microgravity. METHODS: The mass and cross-sectional area of the soleus muscle were compared in rats treated with XFZY that were hindlimb unloaded for 30 d (XFZY-TS group), untreated rats that were hindlimb unloaded for 30 d (TS group), and control rats (CON group). The expression and phosphorylation levels of key proteins of the sarcoplasmic reticulum stress system were also measured. RESULTS: Treatment with XFZY attenuated the loss of muscle mass and cross-sectional area induced by hindlimb unloading. Western blot analysis showed that the phosphatidyl-inositol-3-kinase/phospho-Akt (PI3K/p-Akt) pathways were down-regulated after 30 d in theTS group compared with the CON group.This effect was partly reversed by XFZY. Hindlimb unloading increased the expression of glucose-regulated protein 78 (GRP78), cytosine-cytosine-adenosine-adenosine-thymidine/enhancer-binding protein homologous protein (CHOP), C-Jun N-terminal kinase (JNK), and Caspase 12. Treatment with XFZY alleviated this increased protein expression. DISCUSSION: Our results suggest that XFZY could partially reverse the effects of hindlimb unloading on muscle atrophy and perhaps target the sarcoplasmic reticulum stress system, possibly through the GRP78-CHOP-JNK-Caspase 12 pathway. [ABSTRACT FROM AUTHOR]

Production parameters have been established to play a fundamental role in dictating the physical characteristics and sensing properties of knitted sensors. This research studied the influence of elastic yarn type and rib fabric structure variation on the physical, tensile and conductive properties and sensitivity performance of knitted underwear strain sensors to be used for breathing mensuration. Four different structures in 1×1, 1×2, 1×3 and 2×2 mock ribs were knitted using covered elastic (CY) and bare strand elastic yarn (BS) combinations. These two parameters proffered unique physical, conductive and tensile characteristics to the samples. Wear and machine tests were conducted to ascertain the sensor's piezoresistive responses. The machine test showed a higher piezoresistive response, with an average peak value (APV) from 1.70 Ω to 0.24 Ω, while those for the wear test recorded were around 0.0110 Ω to 1.867 Ω for all sample categories. However, sensors knitted with covered elastic yarns produced the best breathing test results (APV of 1.089 Ω - 1.86 Ω) compared to bare strand elastic yarns (APV 0.0027 Ω - 0.0790 Ω) when used in a wearable environment. Fabric structure variation had influences on both conductive and tensile characteristics; however, the effects on the piezoresistive response were negligible. The influences of the unique characteristics provided by these core parameters on sensor resistance values, piezoresistance, aging, ease of deformation and dimensional stability have also been discussed. [ABSTRACT FROM AUTHOR]

Ruminants are often fed a high-concentrate (HC) diet to meet lactating demands, yet long-term concentrate feeding induces subacute ruminal acidosis (SARA) and leads to a decrease in milk fat. Buffering agent could enhance the acid base buffer capacity and has been used to prevent ruminant rumen SARA and improve the content of milk fat. Therefore, we tested whether a buffering agent increases lipid anabolism in the livers of goats and influences of milk fat synthesis. Twelve Saanen-lactating goats were randomly assigned to two groups: one group received a HC diet (Concentrate: Forage=60:40, Control) and the other group received the same diet with a buffering agent added (10 g sodium butyrate, C4H7NaO2; 10 g sodium bicarbonate, NaHCO3; BG) over a 20-week experimental period. Overall, milk fat increase (4.25±0.08 vs. 3.24±0.10; P<0.05), and lipopolysaccharide levels in the jugular (1.82±0.14 vs. 3.76±0.33) and rumen fluid (23,340±134 vs. 42,550±136) decreased in the buffering agent group (P<0.05). Liver consumption and release of nonesterified fatty acid (NEFA) into the bloodstream increased (P<0.05). Phosphatidylinositol 3-kinase (PI3K), protein kinase B (AKT) and ribosomal protein S6 kinase (p70S6K) up-regulated significantly in the livers of the buffering agent group (P<0.05). It also up-regulated expression of the transcription factor sterol regulatory element binding protein-1c (SREBP-1c) and its downstream targets involved in fatty acid synthetic, including fatty acid synthetase (FAS), stearoyl-CoA desaturase (SCD-1) and acetyl-CoA carboxylase 1 (ACC1) (P<0.05). The BG diet increased insulin levels in blood (19.43±0.18 vs. 13.81±0.10, P<0.05), and insulin receptor was likewise elevated in the liver (P<0.05). Cumulatively, the BG diet increased plasma concentrations of NEFA by INS-PI3K/AKTSREBP- 1c signaling pathway promoting their synthesis in the liver. The increased NEFA concentration in the blood during BG feeding may explain the up-regulated in the milk fat of lactating goats. [ABSTRACT FROM AUTHOR]

Oxygen reduction reaction (ORR) not only needs the excellent electrode materials, but also requires quick mass transfer of dissolved oxygen. To strengthen the ORR and O2- oxidation desulfurization, pressurized water electrolysis was carried out in this work. The results showed that the desulfurization ratio increased with increasing pressure, indicating that the pressure has strengthened the O2- generation. As expected, the ORR initial potential shifted from -0.034 V to -0.030 V with increasing pressure from 0.1Mpa to 2Mpa. The peak current, the limit current density and the peak integral area all increased with increasing pressure. On the other hand, the reduction in solution resistance (Rs) and reaction resistance (Rct) further verified that the pressure can strengthen the transfer of dissolved oxygen and the ORR dynamics.More importantly, the pressure has improved O2- generated potential in a large parameter window (the width of the metastable zone, the difference between the initial potential and the peak potential of the ORR). The pressure could enhance the O2- formation, and improve the desulfurization process. [ABSTRACT FROM AUTHOR]

Roles of ultrasound on the hydroxyl radical generation from water electrolysis were examined in this work. Results indicated that the ultrasound could not only strengthen the mass transfer of liquid phase, but also could improve the electron gain and loss for hydroxyl ion, and thus improve the hydroxyl radical generation. Results from ESR signal indicated that, ultrasonic strengthened hydroxyl radical formation from water electrolysis in whatever in alkaline or acidic solution. Ultrasound improved the equilibrium potential and current of OER, indicating that ultrasound inhibited the thermodynamics conditions in OER. Ultrasound inhibited the oxygen gas release, and thus resulting in the increase in the amount of hydroxyl radicals. The Rct of OER increased with ultrasound addition, while the Rs for water electrolysis decreased. Whatever platinum (Pt) or nickel (Ni) electrode, bauxite electrolysis desulfurization all were improved by ultrasound, and the desulfurization of Ni under ultrasound was higher than Pt without ultrasound. That is, electrolysis desulfurization with Ni electrode in presence of ultrasound could replace electrolysis desulfurization with Pt electrode in absence of ultrasound. [ABSTRACT FROM AUTHOR]

Background: Implantable cardioverter defibrillators (ICDs) are lifesaving devices for patients with heart failure (HF) and reduced ejection fraction. However, utilization and determinants of ICD insertion in Asia are poorly defined. We determined the utilization, associations of ICD uptake, patient-perceived barriers to device therapy and, impact of ICDs on mortality in Asian patients with HF.Methods and Results: Using the prospective ASIAN-HF (Asian Sudden Cardiac Death in Heart Failure) registry, 5276 patients with symptomatic HF and reduced ejection fraction (HFrEF) from 11 Asian regions and across 3 income regions (high: Hong Kong, Japan, Korea, Singapore, and Taiwan; middle: China, Malaysia, and Thailand; and low: India, Indonesia, and Philippines) were studied. ICD utilization, clinical characteristics, as well as device perception and knowledge, were assessed at baseline among ICD-eligible patients (EF ≤35% and New York Heart Association Class II-III). Patients were followed for the primary outcome of all-cause mortality. Among 3240 ICD-eligible patients (mean age 58.9±12.9 years, 79.1% men), 389 (12%) were ICD recipients. Utilization varied across Asia (from 1.5% in Indonesia to 52.5% in Japan) with a trend toward greater uptake in regions with government reimbursement for ICDs and lower out-of-pocket healthcare expenditure. ICD (versus non-ICD) recipients were more likely to be older (63±11 versus 58±13 year; P<0.001), have tertiary (versus ≤primary) education (34.9% versus 18.1%; P<0.001) and be residing in a high (versus low) income region (64.5% versus 36.5%; P<0.001). Among 2000 ICD nonrecipients surveyed, 55% were either unaware of the benefits of, or needed more information on, device therapy. ICD implantation reduced risks of all-cause mortality (hazard ratio, 0.71; 95% confidence interval, 0.52-0.97) and sudden cardiac deaths (hazard ratio, 0.33; 95% confidence interval, 0.14-0.79) over a median follow-up of 417 days.Conclusions: ICDs reduce mortality risk, yet utilization in Asia is low; with disparity across geographic regions and socioeconomic status. Better patient education and targeted healthcare reforms in extending ICD reimbursement may improve access.Clinical Trial Registration: URL: https://clinicaltrials.gov/ct2/show/NCT01633398. Unique identifier: NCT01633398. [ABSTRACT FROM AUTHOR]

Mailuo Shutong Pills (MLST) have displayed pharmacological activity against thromboangiitis obliterans (TAO). However, the active ingredients and therapeutic mechanism of MLST against TAO remained to be further clarified. The aim of this study was to explore the active components of MLST and their synergistic mechanism against TAO by integrating pharmacokinetics (PK) and pharmacometabolomics (PM). TAO model rats were established by sodium laurate solution. Firstly, the efficacy of MLST was evaluated by gangrene score, blood flow velocity, and hematoxylin-eosin (H&E) staining. Secondly, PK research was conducted on bioavailable components to characterize their dynamic behaviors under TAO. Thirdly, multiple plasma and urine metabolic biomarkers for sodium laurate-induced TAO rats were found by untargeted metabolomics, and then variations in TAO-altered metabolites following MLST treatment were analyzed utilizing multivariate and bioinformatic analysis. Additionally, metabolic pathway analysis was performed using MetaboAnalyst. Finally, the dynamic link between absorbed MLST-compounds and TAO-associated endogenous metabolites was established by correlation analysis. MLST significantly alleviated gangrene symptoms by improving the infiltration of inflammatory cells and blood supply in TAO rats. Significant differences in metabolic profiles were found in 17 differential metabolites in plasma and 24 in urine between Sham and TAO rats. The 10 bioavailable MLST-compounds, such as chlorogenic acid and paeoniflorin, showed positive or negative correlations with various TAO-altered metabolites related to glutamate metabolism, histidine metabolism, arachidonic acid metabolism and so on. This study originally investigated the dynamic interaction between MLST and the biosystem, providing unique insight for disclosing the active components of MLST and their synergistic mechanisms against TAO, which also shed light on new therapeutic targets for TAO and treatment. [Display omitted] [ABSTRACT FROM AUTHOR]

Objective: Biologic studies have shown that certain components of green tea may have protective effects on neurocognition. However, because of the lack of human epidemiologic studies, the impact of green tea consumption on the incidence of dementia has never been confirmed. The objective of this cohort study was to clarify the association between green tea consumption and incident dementia.Methods: In this 5.7-year prospective cohort study, using a questionnaire, information on daily green tea consumption and other lifestyle factors was collected from elderly Japanese individuals aged 65 years or more. Data on incident dementia were retrieved from the public Long-term Care Insurance Database.Results: Among 13,645 participants, the 5.7-year rate of incident dementia was 8.7%. More frequent green tea consumption was associated with a lower risk of incident dementia (hazard ratio for ≥5 cups/day versus <1 cup/day: 0.73; 95% confidence interval: 0.61-0.87). The lower risk of incident dementia was consistent even after selecting participants who did not have subjective memory complaints at the baseline.Conclusion: Green tea consumption is significantly associated with a lower risk of incident dementia. [ABSTRACT FROM AUTHOR]

The Telecare Medicine Information System (TMIS) has brought us a lot of conveniences. However, it may also reveal patients' privacies and other important information. So the security of TMIS can be paid much attention to, in which identity authentication plays a very important role in protecting TMIS from being illegally used. To improve the situation, TMIS needs a more secure and more efficient authentication scheme. Recently, Yan and Li et al. have proposed a secure authentication scheme for the TMIS based on biometrics, claiming that it can withstand various attacks. In this paper, we present several security problems in their scheme as follows: (a) it cannot really achieve three-factor authentication; (b) it has design flaws at the password change phase; (c) users' biometric may be locked out; (d) it fails to achieve users' anonymous identity. To solve these problems, a new scheme using the theory of Secure Sketch is proposed. The thorough analysis shows that our scheme can provide a stronger security than Yan-Li's protocol, despite the little higher computation cost at client. What's more, the proposed scheme not only can achieve anonymity preserving but also can achieve session key agreement. [ABSTRACT FROM AUTHOR]