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Background Persons with dementia (PwD) are at greater risk for various adverse health outcomes, and the best care model remains to be determined. This study aimed to compare the physical and neurocognitive performance of PwD in the Program of All-inclusive Care for the Elderly (PACE) and residential dementia care units. Methods This was a case-control study comparing outcomes between care recipients of PACE services (PC group) and residential dementia care (RC group). Demographic characteristics, underlying diseases, physical function, cognitive function, mood status, and behavioral and psychotic symptoms of dementia (BPSDs) were assessed every 3-6 months in both groups, while frailty status and Timed Up-and-Go Test (TUGT) performance were assessed every 6 months in the PC group only. Results Overall, 96 participants (PC group: 25, RC group: 71; mean age: 86.4 ± 6.8 years) were enrolled with the median follow-up period of 43.6 weeks. Lower incidence of hospital admissions was noted in the PC group (0.52 ± 1.12 vs 1.38 ± 2.49 admissions/1,000 person-days, p=0.023), even though the PC group had higher multimorbidity and more severe BPSDs. During the study period, the PC group showed a significant improvement in body mass index, less physical dependence, better cognitive performance and reduced depressive mood. In addition, the PC group showed improvement in frailty, leisure hour activities, and TUGT results. However, participants in the PC group were more likely to experience BPSD deterioration (β coeff.: 0.193, 95% CI: 0.121- 0.265). Conclusion The PACE services significantly reduced unexpected hospital admissions of PwD, facilitated the maintenance of physical independence, and improved cognitive performance and mood status. Further randomized controlled studies are needed to determine the most appropriate care model for PwD.

In the smart grid and big data environment, accurate and large amount of power load data for users can be obtained with the wide application of non-intrusive load monitoring technology. In the research process of customers’ information, information security protection of users’ electricity data has become a research hotspot urgently. This article proposes a new type of load decomposition method for electric vehicle load information and compares it with hidden Markov model algorithm to verify its accuracy. On this basis, the elliptic curve encryption algorithm is used to encrypt the users’ electricity data, and the function and effectiveness of the encryption algorithm are verified by comparing the load decomposition of the electric vehicle with the unencrypted data.

Frailty is common among older people and results in adverse health outcomes. We investigated whether exposure to PM2.5 is associated with frailty. This cross-sectional study involved 20,606 community-dwelling participants aged ≥ 65 years, residing in New Taipei City, Taiwan. Analytic data included phenotypic frailty, disease burden by Charlson Comorbidity Index (CCI), urban or rural residence, and household income. PM2.5 exposure was calculated from air quality monitoring records, with low exposure defined as the lowest quartile of the study population. 1,080 frail participants (5.2%) were older, predominantly female, had more comorbidities, lived rurally, and had low PM2.5 exposure (all p 2.5 exposure was higher in prefrail (OR 1.4, 95% CI 1.3–1.5) and frail adults (OR 1.5, 95% CI 1.2–1.9) than in robust individuals, with stronger associations in those who were male (frail: OR 2.1, 95% CI 1.5–3.1; prefrail: OR 2.2, 95% CI 1.9–2.6), ≥ 75 years old (frail: OR 1.8, 95% CI 1.3–2.4; prefrail: OR 1.5, 95% CI 1.3–1.8), non-smokers (frail: OR 1.6, 95% CI 1.3–2.0; prefrail: OR 1.4, 95% CI 1.2–1.5), had CCI ≥ 2 (frail: OR 5.1, 95% CI 2.1–12.6; prefrail: OR 2.1, 95% CI 1.2–3.8), and with low household income (frail: OR 4.0, 95% CI 2.8–5.8; prefrail: OR 2.7, 95% CI 2.2–3.3). This study revealed a significant association between PM2.5 exposure and frailty, with a stronger effect in vulnerable groups.

This systematic review and meta-analysis investigated differences in accuracy, operation time, and radiation exposure time between robot-assisted and freehand techniques for pedicle screw insertion. Two investigators independently searched for articles on randomized controlled trials (RCTs) published from 2012 to 2019. The final meta-analysis included seven RCTs. We compared the accuracy of pedicle screw placement, operation time, and radiation exposure time between robot-assisted and conventional freehand groups. Seven RCTs included 540 patients and placement of 2,476 pedicle screws, of which 1,220 were inserted using the robot-assisted technique and 1,256 were inserted using the conventional freehand technique. The pedicle screw positions were classified using the Gertzbein and Robbins classification (grade A-E). The combined results of Grade A [odds ratio (OR) =1.68; 95% confidence intervals (CI): 0.82-3.44; P=0.16), Grade A+B (OR =1.70; 95% CI: 0.47-6.13; P=0.42), and Grade C+D+E (OR =0.59; 95% CI: 0.16-2.12; P=0.42) for the accuracy rate revealed no significant difference between the two groups. Subgroup analysis results revealed that the TiRobot-assisted technique presented a significantly improved pedicle screw insertion accuracy rate compared with that of the conventional freehand technique, based on Grade A, Grade A+B, and Grade C+D+E classifications. The SpineAssist-assisted technique presented an inferior pedicle screw insertion accuracy rate compared with that of the conventional freehand technique, based on Grade A, Grade A+B, and Grade C+D+E classifications. No difference between the Renaissance-assisted and conventional freehand techniques was noted for pedicle screw insertion accuracy rates, based on both Grade A (OR =1.58; 95% CI: 0.85-2.96; P=0.15), Grade A+B (OR =2.20; 95% CI: 0.39-12.43; P=0.37), and Grade C+D+E (OR =0.45; 95% CI: 0.08-2.56; P=0.37) classifications. Regarding operation time, robot-assisted surgery had significantly longer operation time than conventional freehand surgery. The robot-assisted group had significantly shorter radiation exposure time. Regarding the pedicle screw insertion accuracy rate, the TiRobot-assisted technique was superior, the SpineAssist-assisted technique was inferior, and Renaissance was similar to the conventional freehand technique.

Background Clinical guidelines for specific conditions fragment care provision for elders. The International Consortium for Health Outcomes Measurement (ICHOM) has developed a global standard set of outcome measures for comprehensive assessment of older persons. The goal of this study was to report value-based health metrics in Taiwan using this ICHOM toolset. Methods The cross-sectional study of baseline data excerpted from a prospective longitudinal cohort, which recruited people ≥65 years old with ≥3 chronic medical conditions between July and December 2018. All participants received measurements of physical performance, anthropometric characteristics, health-related behaviors, Charlson Comorbidity Index, and Montreal Cognitive Assessment. The ICHOM toolset comprises three tiers: 1 includes frailty and having chosen a preferred place of death; 2 includes polypharmacy, falls, and participation in decision-making; and 3 includes loneliness, activities of daily living, pain, depression, and walking speed. These items were converted into a 0–10 point value-based healthcare score, with high value-based health status defined as ≥8/10 points. Results Frequencies of individual ICHOM indicators were: frail 11.7%, chose preferred place of death 14.4%, polypharmacy 31.5%, fell 17.1%, participated in decision-making 81.6%, loneliness 26.8%, limited activities of daily living 22.4%, pain 10.4%, depressed mood 13.0%, and slowness 38.5%. People with high disease burden (OR 0.40, 95% CI 0.21–0.76, p = 0.005) or cognitive impairment (OR 0.49, 95%CI 0.27–0.87, p = 0.014) were less likely to have high value-based healthcare status. Conclusions The ICHOM Standard Set Older Person health outcome measures provide an opportunity to shift from a disease-centric medical paradigm to whole person-focused goals. This study identified advanced age, chronic disease burden and cognitive impairment as important barriers to achieving high value-based healthcare status.

How implementing diagnostic-related grouping (DRG) payment affected the use of opioids and psychotropics by hip fracture patients following hospitalization remained unknown. A retrospective, pre-post design, cohort study of data excerpted from Taiwan’s National Health Insurance Research database (NHIRD). Adults aged ≥ 65 years first admitted for hip fracture surgery from 2007 to 2012 were identified and divided into two 1:1 propensity-score matched groups: pre-DRG (2007–2009); DRG (2010–2012). The outcome measures were use of opioid and/or psychotropic drugs within 30 days, 90 days, 180 days, and 365 days after discharge. Data of 16,522 subjects were excerpted, and 8,261 propensity-score matched subjects each classified into the pre-DRG and DRG groups. After adjustment, the DRG group was significantly more likely than the pre-DRG group to have used antipsychotics after discharge from hip fracture surgery (≤30 days, ≤90 days, ≤180 days and ≤365 days). The DRG group also had significantly higher prescription rates of benzodiazepines and antipsychotics during the observation period. Moreover, the DRG group was less likely to use non-steroidal anti-inflammatory drugs (≤30 days, ≤90 days, ≤180 days and ≤365 days) and more likely to use acetaminophen (≤30 days, ≤180 days, and ≤365 days). In conclusion, DRG implementation in Taiwan substantially increased post-acute prescription of antipsychotic and psychotropic agents for hip fracture patients, and changed use of analgesics, which may result in suboptimal quality and safety for these patients. Further research is needed to evaluate the long-term outcomes of DRG implementation, and the potential benefits of appropriate post-acute care bundled with DRG payment.

Lead halide perovskite materials have recently received considerable attention for achieving an economic and tunable laser owing to their solution-processable feature and promising optical properties. However, most reported perovskite-based lasers operate with a large lasing-mode volume, resulting in a high lasing threshold due to the inefficient coupling between the optical gain medium and cavity. Here, we demonstrate a continuous-wave nanolasing from a single lead halide perovskite (CsPbBr3) quantum dot (PQD) in a plasmonic gap-mode nanocavity with an ultralow threshold of 1.9 Wcm-2 under 120 K. The calculated ultrasmall mode volume (∼0.002 λ3) with a z-polarized dipole and the significantly large Purcell enhancement at the corner of the nanocavity inside the gap dramatically enhance the light-matter interaction in the nanocavity, thus facilitating lasing. The demonstration of PQD nanolasing with an ultralow-threshold provides an approach for realizing on-chip electrically driven lasing and integration into on-chip plasmonic circuitry for ultrafast optical communication and quantum information processing.

Background Older people present to the emergency department (ED) with distinct patterns and emergency care needs. This study aimed to use comprehensive geriatric assessment (CGA) surveying the patterns of ED visits among older patients and determine frailty associated with the risk of revisits/readmission. Methods This prospective study screened 2270 patients aged ≥75 years in the ED from August 2018 to February 2019. All patients underwent CGA. A 3-months follow-up was conducted to observe the hospital courses of admission and revisit/readmission. Results A total of 270 older patients were enrolled. The independent predictors of admission at initial ED visit were the risk of nutritional deficit and instrumental activities of daily living (IADL). In the admission group, the independent predictors of revisit/readmission were a fall in the past year and mobility difficulties. In the discharge group, the independent predictors of revisit/readmission were frailty and insomnia. Regardless if older patients were either admitted or discharged at the initial ED visit, the independent predictor of revisit/readmission for older patients was frailty. Conclusion Our study showed that frailty was the only independent predictor for revisit/readmission after ED discharge during the 3-month follow up. For ED physicians, malnutrition and IADL were independent predictors in recognizing whether the older patient should be admitted to the hospital. For discharged older ED patients, frailty was the independent predictor for the integration of community services for older patients to decrease the rate of revisit/readmission in 3 months.

Objectives Physical capacity decline may precede physical disability. We explored age-related physical capacity decline among rural community-dwelling Taiwanese older women to provide reference values and to identify indicators of early-onset decline in physical capacity. Methods Older women aged 65–96 were recruited from rural community centers. Physical capacity was measured by handgrip strength (HS), gait speed (GS), five-times-sit-to-stand (5xSTS), timed up and go (TUG), and the Berg balance scale (BBS). Participants were stratified into four age groups: 65–69, 70–74, 75–79, and ≥80 years. Results Of 137 participants, 61 % exhibited poor 5xSTS, 34–49 % showed low HS, poor TUG and BBS, and 26 % had slow GS. The mean values in GS, HS, 5xSTS, TUG, and BBS were 1.02 m/s, 17.8 kg, 14.5 s, 12.6 s, and 50 points, respectively. Abnormal mean values were first noted at age 70–74 years for 5xSTS, age 75–79 years for HS, TUG, and BBS, and age ≥80 years for GS. Also, more than half the participants exhibited the first poor 5xSTS at age 70–74 years; the first poor HS and TUG at age 75–79 years; and lastly, the first poor BBS and GS at age ≥80 years. At age 65–69 years, 14–41 % of participants reported poor performance in all measures except for GS. Conclusions Low HS and poor 5xSTS and TUG performance were more common and had earlier onset than slow GS. More attention should be directed toward the 5xSTS, TUG, and HS in rural community-dwelling Taiwanese older women.

Frailty is common among older people and results in adverse health outcomes. We investigated whether exposure to PM2.5 is associated with frailty. This cross-sectional study involved 20,606 community-dwelling participants aged ≥ 65 years, residing in New Taipei City, Taiwan. Analytic data included phenotypic frailty, disease burden by Charlson Comorbidity Index (CCI), urban or rural residence, and household income. PM2.5 exposure was calculated from air quality monitoring records, with low exposure defined as the lowest quartile of the study population. 1,080 frail participants (5.2%) were older, predominantly female, had more comorbidities, lived rurally, and had low PM2.5 exposure (all p

OBJECTIVE To explore the features of Traditional Chinese Medicine (TCM) syndromes in male infertility using computer-based analyses. METHODS Latent class analysis was used to analyze the TCM syndrome data from 813 patients with male infertility and establish a latent tree model. RESULTS A latent tree model with a Bayesian information criterion score of – 11 263 was created. This model revealed that the characteristics of basic TCM syndromes in patients with male infertility were kidney Yang deficiency, kidney Qi deficiency, spleen Yang deficiency, liver Qi stagnation, Qi stagnation and blood stasis, and dump-heat; moreover, most patients with male infertility had complex syndromes (spleen-kidney Yang deficiency and liver Qi stagnation) rather than simple single syndromes. CONCLUSION The hidden tree model analysis revealed the objective and quantitative complex relationships between the TCM symptoms of male infertility, and obtained the quantification and objective evidence of TCM syndromes in male infertility.

To evaluate the impact of individual components of unfavorable body composition and their combinations on quality of life (QoL) among middle-aged and older adults.Data from 1779 participants (53.1 % female; mean age 63.9 ± 9.2 years) from the I-Lan Longitudinal Aging Study were analyzed in this study. Demographic characteristics of all participants and data from anthropometric measurements, functional assessments, dual-energy X-ray absorptiometry scans, and surveys of QoL were obtained. Low skeletal muscle mass was defined by the Asian Working Group of Sarcopenia consensus, and obesity was defined by waist circumference (WC), body fat percentage, or body mass index (BMI). QoL was assessed by the 12-Item Short Form Health Survey version 2, which was divided into the physical component summary (PCS) and mental component summary (MCS). The composite score was determined based on the items of unfavorable body composition. Independent associations between unfavorable body composition components and QoL were evaluated by the multivariate linear regression model. Z transformation was performed to facilitate evaluation between different components of body composition and their relationship with QoL.All definitions of obesity were significantly associated with a lower PCS score (WC: β=-1.2, SE = 0.3, p0.001; body fat percentage: β=-1.0, SE = 0.3, p0.001; BMI: β=-0.9, SE = 0.3, p = 0.002 in the fully adjusted model). The PCS score decreased linearly as the composite score of unfavorable body composition increased, especially when obesity was defined by WC (score = 1: β=-0.7, SE = 0.4, p = 0.053, score = 2: β=-1.1, SE = 0.4, p = 0.008; score = 3: β=-2.4, SE = 1.0, p = 0.013). After Z transformation, obesity was significantly negatively associated with the PCS score (β=-0.9∼-0.2, SE = 0.1∼0.2, p values all less than 0.01). In contrast, a one-standard-deviation increase in WC was associated with a significantly higher MCS score (β = 0.3, SE = 0.1, p = 0.019).Community-dwelling middle-aged and older people with obesity had significantly lower PCS scores, and the effect was enhanced when low skeletal muscle mass or osteopenia/osteoporosis was present. Central obesity was the only unfavorable body composition parameter with negative effects on both the physical and the mental domains of QoL. Further longitudinal or intervention studies are needed to evaluate the impact on QoL of changes in body composition that occur with aging.

Objective A prescription cascade is a subsequent event that occurs when an adverse drug event is misinterpreted as a new medical condition, resulting in the prescription of a potentially unnecessary medication to treat this new condition. This study was designed to test the hypothesis of whether prescribing cascades exist and their magnitude among older individuals by using prescription sequence symmetry analysis (PSSA). Design A retrospective population-based cohort study based on data from Taiwan's National Health Insurance Research Database (NHIRD), a nationwide claims-based database that covers 99% of the population in Taiwan. Setting and Participants Patients receiving newly initiated index and marker drugs in the outpatient setting between 2014 and 2016 were included. Those who received index and marker drugs on the same date were excluded. Measures PSSA measures the propensity for a marker drug (eg, thyroxine) to be prescribed after an index drug (eg, amiodarone) has been initiated, where the index drug is suspected of inducing a side effect (eg, hypothyroidism) and the marker drug is used to treat the side effect. We evaluated 14 PSSA sets as potential prescription cascade–related drug pairs (index and marker drug), including 2 confirmatory analyses (eg, amiodarone and thyroxin), to check the validity of the PSSA results and 12 exploratory analyses of cardiovascular medication–related prescribing cascades (eg, statins and antidepressants). The observation periods for sequences of incident marker drug use were 1 year before and 1 year after the use of the incident index drug, and the symmetry of prescriptions filled for the 2 periods was examined. The results of the PSSA were performed as the crude sequence ratio (SR), defined as the ratio of patients initiating the marker drug after the index drug (causal group) to those initiating the marker drug before the index drug (noncausal group), and the adjusted SR (aSR) with 95% confidence intervals (CIs). Results Among 12 potential prescription cascade–related drug pairs in exploratory analysis, 9 of them reached statistical significance, and aSR ranged from 1.02 to 1.46. Dihydropyridine calcium channel blocker–induced edema showed the highest aSR (1.46, 95% CI 1.45–1.48), and statin-induced muscle pain showed the lowest aSR (1.02, 95% CI 1.02–1.03). Conclusions and Implications Our study supported the application of PSSA in detecting prescribing cascades using a nationwide claims database. Nevertheless, most previously reported prescribing cascades among cardiovascular medications were shown to have a low effect size of sequence ratios among older individuals.

Lycium barbarum polysaccharide (LBP), is a major active ingredient Lycium barbarum (LB), which exhibits several beneficial effects through NF-κB, PI3K-Akt-mTOR, p38-MAPK, Wnt-β-catenin, PI3K-Akt-GSK-3β, and MyD88 signal pathway, including anti-oxidation, and anti-aging, hypolipidemic and hypoglycemic, radiation, anti-tumor, and neuroprotection. Today, many researching papers are published on the LBP in physiology and pathology; however, the review of the LBP taking part in the signal transduction pathway in physiology and pathology is rear searched. Therefore, this research topic is a collection of reviews and original research articles that focus on the methods of the LBP extraction and its effects on the signal transduction pathway. The aim of this study is to provide theoretical evidence for in-depth analysis of the mechanisms of LBP in clinical clinical research studies.

In this study, closed bipolar electrochemical etching was introduced to prepare etched tunnels on aluminum foils. The morphological evolution and tunnel etching behaviors of aluminum foils in the traditional electrochemical etching system and closed bipolar electrochemical etching system were thoroughly investigated using scanning electron microscopy and electrochemical measurements. Compared with the tunnels etched on the aluminum foil by traditional electrochemical etching, those by closed bipolar electrochemical etching had a larger diameter and a more uniform distribution of length. These characteristics are beneficial for improving the specific surface area of the etched aluminum foil. Furthermore, aluminum foils do not need direct electricity connection, thus offering a potential advantage in industrial production.

Functional ability and intrinsic capacity are key elements of healthy aging, in which exercise and good nutrition play important roles. This 12-week double-blinded randomized controlled trial enrolled community-dwelling adults aged 50 years and older to examine the effects of Sarcojoint®, a comprehensive formula for the musculoskeletal system, plus resistance exercise on muscle mass. This study intended to enroll 80 participants with a randomly selected subsample of 32 participants (16 from the intervention group and 16 from controls) for magnetic resonance imaging (MRI) to assess the cross-sectional area of the bilateral mid-thighs. The participants were then randomly assigned to the intervention group (Sarcojoint® 1 package twice a day) and control group (vitamin B as placebo) at a 1: 1 ratio. All the participants were required to undergo a regular exercise program (45 min at the gym per week and two sessions of 30-min exercise at home). The data from 66 participants (68.1 ± 7.1 years and 16.7% males; intervention group: 32, control group: 34) were available for analysis. The whole study was pre-registered and data reporting followed Consolidated Standards of Reporting Trials with the primary endpoints of muscle mass, 30-s chair-rise test, and gait speed. Results of MRI were the subgroup analysis to examine muscle mass and intramuscular adiposity. The baseline characteristics of all the participants between groups were similar, as well as those of the MRI subgroups. Within-group comparisons showed that the intervention group, but not the control group, significantly reduced the total body fat percentage (34.3 ± 5.5 vs. 35.0 ± 5.4%, P = 0.021). Serum vitamin D was increased in the intervention group (24.1 ± 6.1 vs. 21.1 ± 7.0 ng/mL; P = 0.025) and was reduced in the control group (18.0 ± 5.2 vs. 20.2 ± 5.8 ng/mL; P = 0.006). The physical performance tests of both groups were significantly improved. The between-group analysis showed no significant differences in 30-s chair stand test, handgrip strength and appendicular muscle mass. The sub-group analysis showed significant improvement in the serum levels of vitamin D (6.70 ± 8.20 vs. -0.50 ± 3.90 ng/mL; P = 0.001) and the mid-thigh cross-sectional area of the nondominant legs (165.4 ± 291.4 vs. -61.1 ± 195.0 mm2; P = 0.034) in the intervention group. In conclusion, Sarcojoint® plus resistance exercise significantly increased muscle mass and serum levels of vitamin D, but not significantly better in muscle strength and physical performance than controls. More investigations are needed to evaluate the long-term effects of Sarcojoint® on middle-aged and older adults.

Objectives To explore how age and sex affect the impacts of self-rated health, self-reported physical activities, physical function, and depressive symptoms on long-term mortality among community-dwelling middle-aged and older adults using a nationally representative population-based cohort study. Methods Data from 1550 study participants from the Social Environment and Biomarkers of Aging Study (SEBAS) were retrieved for analysis, and all participants were divided into four groups based on their age and gender. Middle aged participants were aged 53 to 64 years, and elderly subjects were ≥ 65 years old. Multivariate logistic regression models were applied to investigate the associations between age, sex, and self-reported disabilities of physical activities, physical function (activities of daily living (ADL) and instrumental activities of daily living (IADL) and depression. Results Although the self-reported health status was similar across different age- and sex-stratified subgroups, older women were at the highest risk in self-reported difficulty with physical activities (aOR 2.58 [1.55-4.28]) and difficulty with IADL (aOR 3.32 [2.20-5.03]) compared to men. After adjusting for living arrangement, residence locale, education levels, occupation, socioeconomic status, self-reported health, multimorbidity, impairments in daily activities, and depressive symptoms, older men were found to display the highest risk of mortality (aHR 2.06 [95% CI 1.45-2.93]). Conclusions Although self-reported health was similar across different age and sex stratified subgroups, women (particularly older women) are significantly more likely to have worse physical and functional health than men. After adjusting for all confounding factors, men are at substantially greater risk for mortality despite reporting better health and functional performance.

The reduction kinetics of zinc ferrite in CO was investigated under isothermal conditions at different CO concentration and roasting temperature with the help of the thermogravimetric analysis (TGA). The reduction of zinc ferrite was a step-wise mechanism. As the model fitting results suggest, the first stage was controlled by the rate of first-order (when CO = 4%) or the second-order (when CO = 6%, 8%) reaction, with the Ea in 4%, 6%, and 8% of CO being 91.45 kJ mol−1, 73.08 kJ mol−1, and 73.49 kJ mol−1, correspondingly. Also, the diffusion of reactant proves to constitute the rate-determining step in the second stage, and the reaction model is R2 (contracting cylinder), wherein the Ea in 4%, 6%, and 8% of CO is 80.81 kJ mol−1, 59.11 kJ mol−1, and 59.19 kJ mol−1, correspondingly. The generation of magnetite and zinc oxide is the chemical reaction control, and the generation of ferrous oxide, metal iron was the diffusion control. The increase in the CO concentration from 4% to 6% or 8% could decrease the Ea and increase the reaction order, consequently, the reductive roasting was accelerated.

Millions of tons of iron-bearing manganese residue are produced as a by-product of the electrolytic manganese industry. And the environmental contamination caused by manganese residue has received increasing attention. This paper focuses on the recovery of iron and manganese from high iron-bearing manganese residues. Manganese ferrite in manganese residues is initially decomposed by oxidative roasting, and the intermediates are magnetized in a reductive roasting step. The roasted product is milled and subjected to multi-stage magnetic separation. The optimum conditions are as follows: roasting at 750 °C under air flow for 30 min, roasting in a CO atmosphere at 750 °C for 30 min, and separating under a magnetic intensity of 1000 G for weak magnetic separation and of 12,000 G for strong magnetic separation. The recovery and grade of iron in the iron concentrate were 72.29% and 62.21%, respectively, and those of manganese in the manganese concentrate were 90.75% and 35.21%, respectively. This study demonstrates that the combination of roasting and magnetic separation provides a promising process for the recovery of iron and manganese from high-iron-bearing manganese residues.

Paternal high-fat diet prior to mating programmes impaired glucose tolerance in female offspring. We examined whether the metabolic consequences in offspring could be abolished by folate treatment of either the male rats before mating or the corresponding female rats during pregnancy. Male F0 rats were fed either control diet or high-fat, high-sucrose and high-salt diet (HFSSD), with or without folate, before mating. Male rats were mated with control-diet-fed dams. After mating, the F0 dams were fed control diet with or without folate during pregnancy. Male, but not female offspring of HFSSD-fed founders were heavier than those of control-diet-fed counterparts (p

To investigate the effect of body weight, waist circumference and their changes on all-cause and cardiovascular mortality.A nationwide population-based cohort study.627 community-dwelling older adults.Participants were interviewed for demographic and anthropometric data collected. Blood were drawn for testing biochemistry data. Central obesity was defined as waist circumference is greater than 80 cm for women and 90 cm for men. Obesity, overweight, normal and underweight were defined as BMI ≥27 kg/m2 , ≥24 kg/m2 ,18.5-24 kg/m2 and18.5 kg/m2. Cox proportion hazard model was used to explore the impact of body weight and its change on mortality.The distribution of weight changes and mortality was right skewed, but U-shape of waist change for all-cause mortality was observed. Compared to normal BMI at baseline, the association between underweight (HR: 1.7, 95% CI: 0.7-4.0), overweight (HR:0.7, 95% CI:0.4-1.2) and obesity (HR:1.3,95% CI:0.8-2.3) showed insignificantly associated with all-cause mortality. The HR of those weight loss5% (HR: 1.7, 95% CI: 1.1-2.8) and waist decrease5% (HR: 1.7, 95% CI: 1.0-2.8) were higher than those of stable weight/waist +/- 5% over a 6-year period. Compared to those stable weight/waist, the mortality risk was similar in those of weight gain or waist increase (HR 0.7,95%CI: 0.4-1.5 and HR:0.9, 95%CI:0.4-1.6).Weight loss and waist decrease were significantly associated with long-term mortality risk, a life-course approach for body weight management is needed to pursuit the most optimal health benefits for the middle-aged and older adults.

BACKGROUND Myostatin is a negative regulator of muscle growth but the relationship between serum myostatin levels and muscle mass is unclear. This study investigated the association between serum myostatin levels and skeletal muscle mass among healthy older community residents in Taiwan, to evaluate the potential of serum myostatin as a biomarker for diagnosing sarcopenia and/or evaluating the effect of its treatment. METHODS Study data were excerpted from a random subsample of the I-Lan Longitudinal Aging Study population. Serum myostatin levels were determined and categorized into tertiles (low, medium, high). Relative appendicular skeletal muscle mass (RASM) was calculated as appendicular lean body mass by dual-energy X-ray absorptiometry divided by height squared (kg/m2 ). Low muscle mass was defined as recommended by the Asian Working Group for Sarcopenia. RESULTS The analytic study sample comprised 463 adults (mean age: 69.1 years; 49.5% men). Compared with subjects with normal RASM, those with lower RASM were older and frailer, with significantly higher prevalence of malnutrition, lower serum dehydroepiandrosterone (DHEA) levels, and were more likely to have low serum myostatin status. Multivariable logistic regression analysis showed that male sex (OR 3.60, 95% CI 1.30-9.92), malnutrition (OR 4.39, 95% CI 1.56-12.36), DHEA (OR 0.99, 95% CI 0.99-1.00), and low myostatin (OR 3.23, 95% CI 1.49-7.01) were all independent risk factors for low RASM (all P

Background Myostatin is a negative regulator of muscle growth but the relationship between serum myostatin levels and muscle mass is unclear. This study investigated the association between serum myostatin levels and skeletal muscle mass among healthy older community residents in Taiwan, to evaluate the potential of serum myostatin as a biomarker for diagnosing sarcopenia and/or evaluating the effect of its treatment. Methods Study data were excerpted from a random subsample of the I‐Lan Longitudinal Aging Study population. Serum myostatin levels were determined and categorized into tertiles (low, medium, high). Relative appendicular skeletal muscle mass (RASM) was calculated as appendicular lean body mass by dual‐energy X‐ray absorptiometry divided by height squared (kg/m2). Low muscle mass was defined as recommended by the Asian Working Group for Sarcopenia. Results The analytic study sample comprised 463 adults (mean age: 69.1 years; 49.5% men). Compared with subjects with normal RASM, those with lower RASM were older and frailer, with significantly higher prevalence of malnutrition, lower serum dehydroepiandrosterone (DHEA) levels, and were more likely to have low serum myostatin status. Multivariable logistic regression analysis showed that male sex (OR 3.60, 95% CI 1.30–9.92), malnutrition (OR 4.39, 95% CI 1.56–12.36), DHEA (OR 0.99, 95% CI 0.99–1.00), and low myostatin (OR 3.23, 95% CI 1.49–7.01) were all independent risk factors for low RASM (all P

AIM: To compare the clinical effects of 2.2mm coaxial micro-incision and 3.0mm standard incision in cataract phacoemulsification surgery. METHODS: A total of 67 patients(80 eyes)were randomly divided into two groups. Cataract phacoemulsification and artificial lens implantation surgery was carried out with 2.2mm coaxial micro-incision(Group A, 40 eyes)and 3.0 mm standard incision(Group B, 40 eyes), respectively. The effective phacoemulsification time and average ultrasound energy, corneal endothelial cell count, corneal edema, corneal astigmatism, postoperative visual acuity and postoperative complications were compared between the two groups. RESULTS: Effective phacoemulsification time of Group A and Group B was 8.18±11.22s and 7.82±2.12s, respectively, and the difference had no statistical significance(P>0.05); average ultrasonic energy was(17.25±4.22)% and(17.64±4.27)%, respectively, and the difference was not statistical significance(P>0.05). There was no significant difference in endothelial cells between the two groups of corneal endothelial cells at 1wk after surgery compared with that before operation(P>0.05). On the first day after surgery, corneal edema was observed in some patients. There were 9 eyes in Group A, 6 eyes in Group B, corneal edema relief or subsidence after 3d to 5d. There was significant difference in corneal astigmatism change between the two groups at 1wk(PP>0.05). The changes of corneal astigmatism before and after operation in Group A were insignificant(P>0.05), while the changes of corneal astigmatism before and after operation in Group B were significantly different(PP>0.05). The uncorrected visual acuity(UCVA)differences of the two groups was statistically significant at 1d, 1wk and 1mo after operation(PP>0.05). CONCLUSION: For soft or medium-hard nucleus cataract, compared with the traditional 3.0mm small-incision coaxial phacoemulsification, the 2.2mm micro-incision coaxial phacoemulsification can effectively reduce the surgically induced astigmatism, and the astigmatism state is relatively stable, and conducive to early recovery of visual acuity.

Sulfidation roasting followed by flotation is widely known as a possible generic technology for enriching valuable metals in low-grade Zn-Pb oxide ores. Zn2SiO4 is the primary Zn phase in willemite. Zn4Si2O7(OH)2(H2O), the main Zn phase in hemimorphite, transforms into Zn2SiO4 at temperatures above 600 °C. To enrich the Zn in willemite and hemimorphite, the Zn species should first be converted to ZnS. Therefore, a thorough understanding of the sulfidation reaction of Zn2SiO4 during roasting with pyrite is of vital important. In this study, the sulfidation behavior and reaction mechanisms of a Zn2SiO4-pyrite roasting system were determined using HSC 5.0 software, TG-FTIR spectroscopy, XRD, XPS and SEM-EDS. The results indicate that the sulfidation process can be divided into three steps: the decomposition of pyrite and formation of a sulfur-rich environment, the sulfur-induced migration of O2− and transformation of sulfur vapor, and the sulfidation reaction via oxygen-sulfur exchange. During the sulfidation roasting process, pyrite was converted to loose and porous Fe3O4, whereas Zn2SiO4 was transformed into ZnS and SiO2 in situ. These findings provide theoretical support for controlling the sulfidation roasting process of willemite and hemimorphite.

Aluminum foil with micro/nano structure has been prepared by electrochemical DC etching and a subsequent anodization treatment followed by removal of the alumina film. When the micron-sized tunnels were generated on the etched aluminum foil, the size and distribution of the nano-concave formed on the sidewall of the etched tunnels varied with the anodized time in H2SO4 and C4H6O6 electrolyte. The optimal value of the specific surface area for the aluminum foil with micro/nano structure is approximately four times larger than that of the only etched aluminum foil. It is indicated from the chronoamperometry and BET measurements that the specific capacitance of aluminum foil with micro/nano structure can be significantly improved by suitable anodization in H2SO4 electrolyte, in comparison with a comparatively small increasement in C4H6O6 electrolyte. This can be attributed to the fact that the tardy anodization process will consume a considerable amount of aluminum substrate, resulting in the aggravation of the merged tunnels.

In order to improve the corrosion resistance of aluminum alloy, anodic oxide/perfluorooctyltriethoxysilane/graphene oxide (AAO/POTS/GO) composite film was designed through molecular dynamics simulation and quantum chemical calculation, and the composite film was prepared by anodizing and self-assembly technology. The morphology, composition and structure of the film were characterized by SEM, EDS, Raman, XRD and XPS, and the corrosion resistance was characterized by electrochemical test and salt spray test. The impedance of the AAO/POTS/GO composite film is 4 orders of magnitude higher than that of the AAO film, reaching 5.17 × 109 Ω•cm2. The corrosion current density is 3 orders of magnitude lower than that of AAO film. The corrosion resistance efficiency reaches 99.98%, and the corrosion rate is 5.494 × 10−5 mm/year, and the salt spray test does not appear until the 40th day. Theoretical simulation shows that the chemical bond of Si-O-Al is formed by the interaction between the hydrolyzed Si-O-C2H5 and the metal surface atoms. This result is consistent with the final result of the experiment in this paper.

Older adults with multiple complex care needs tend to receive fragmented care that may jeopardize their quality of life (QoL) and health outcomes. This study evaluated the determinants of improved QoL among integrated outpatient service recipients with multimorbidity.We conducted a retrospective cohort study of integrated geriatric outpatient services (IGOS) at a tertiary medical center in Taiwan. Data from 2018 to 2019 were retrieved. All patients underwent comprehensive geriatric assessment, which included demographic information, serial functional assessments, and assessment for QoL. QoL was reassessed through a telephone survey 6 months after the patients' first visit to IGOS. Factors associated with the interval changes in QoL were identified using multivariate logistic regression.Data from 995 patients receiving IGOS (mean age: 82.21 ± 7.96 years, 54.5% males) were analyzed. An overall mean improvement in QoL was noted (EQ-5D index: +0.055±0.26, p0.001) while 747 recipients reported maintained or improved QoL. The results of the multivariate logistic regression showed that poorer nutritional status (OR = 1.56, 95% CI: 1.07-2.28), depressive symptoms (OR = 1.99, 95% CI: 1.38-2.86), and frailty (OR = 1.66, 95% CI: 1.10-2.52) were independent risk factors for poorer QoL after adjustment for baseline QoL.Integrated outpatient services improved the quality of life of older adults with multimorbidity. Those with poorer nutritional status, depressive symptoms and frailty were less likely to show improvement in their QoL.