bluuebunny/crossref_metadata_2025 huggingface dataset:
Aberration-free large-area stitch-free 3D nano-printing based on binary holography
Authors: Ren Mindan , Lu Wanping , Shao Qi , Han Fei , Ouyang Wenqi , Zhang Tianyu , Wang Charlie C. L. , Chen Shih-Chi
Published: December 2021

Direct laser writing (DLW) has been widely used in a variety of engineering and research applications. However, the fabrication of complex and robust three-dimensional (3D) structures at submicron-level resolution by DLW is still largely limited by the laser focus quality, i.e., point spread function (PSF), laser dose, precision of mechanical scanners, and printing trajectory. In this work, we present a two-photon polymerization (TPP)-based DLW system based on a digital micromirror device (DMD) and binary holography to realize aberration-free large-area stitch-free 3D printing as well as 3D random-access scanning. First, the binary holograms, which control the amplitude, phase, and position of the laser focus, are optimized by the sensorless adaptive optics algorithm to correct the distorted wavefront in the DMD work field. Next, the DMD is synchronized to a continuously moving sample stage to eliminate stitching errors, i.e., the sample positioner simultaneously moves with the scanning focus until the structure is completed. We have fabricated large-area complex 3D structures, e.g., metamaterial structures, and micro-lenses, and 2D gray level diffractive optical elements (DOEs) with better than 100 nm resolution and optimal scanning trajectories. Notably, the variation of the scanning trajectory, laser power (dose), and voxel sizes can be realized without affecting the scanning speed, i.e., 22.7 kHz, which is equivalent to the DMD pattern rate.
Simultaneous film thickness and refractive index measurement using a constrained fitting method in a white light spectral interferometer
Authors: Yuan Lin , Guo Tong , Tang Dawei , Liu Haitao , Guo Xinyuan
Published: December 2021

Film is widely used in optoelectronic and semiconductor industries. The accurate measurement of the film thickness and refractive index, as well as the surface topography of the top and bottom surfaces are necessary to ensure its processing quality. Multiple measurement methods were developed; however, they are limited by the requirements of a known dispersion model and initial values of thickness and refractive index. Further, their systems are rarely compatible with surface topography measurement methods. We propose a constrained nonlinear fitting method to simultaneously measure the thickness and refractive index of film in a simple white-light spectral interferometer. The nonlinear phase extracted by the spectral phase-shifting is fitted with the theoretical nonlinear phase obtained by multiple reflection model. The constraints of nonlinear fitting are obtained by the interferometric signal of vertical scanning, reconstructed by the integration of the white-light spectral signal to avoid local minima. The proposed method does not require a priori knowledge of the dispersion model and initial values of thickness and refractive index, and its system is compatible with the vertical scanning interferometry (VSI) method to reconstruct the surface topography of the top and bottom surfaces of film. Three SiO2 films with different thicknesses are measured, and the results show that the measured refractive index is within the theoretical value range of wavelength bandwidth and the measured thicknesses are closely aligned with the values provided by the commercial instrument. The measurement repeatability of refractive index reaches 10−3. Measurements on a polymer film demonstrate that this method is feasible for measuring the film without a priori information.
The evolution of happiness pre and peri-COVID-19: A Markov Switching Dynamic Regression Model
Authors: Rossouw Stephanie , Greyling Talita , Adhikari Tamanna
Published: December 2021

Happiness levels often fluctuate from one day to the next, and an exogenous shock such as a pandemic can likely disrupt pre-existing happiness dynamics. This paper fits a Marko Switching Dynamic Regression Model (MSDR) to better understand the dynamic patterns of happiness levels before and during a pandemic. The estimated parameters from the MSDR model include each state’s mean and duration, volatility and transition probabilities. Once these parameters have been estimated, we use the one-step method to predict the unobserved states’ evolution over time. This gives us unique insights into the evolution of happiness. Furthermore, as maximising happiness is a policy priority, we determine the factors that can contribute to the probability of increasing happiness levels. We empirically test these models using New Zealand’s daily happiness data for May 2019 –November 2020. The results show that New Zealand seems to have two regimes, an unhappy and happy regime. In 2019 the happy regime dominated; thus, the probability of being unhappy in the next time period (day) occurred less frequently, whereas the opposite is true for 2020. The higher frequency of time periods with a probability of being unhappy in 2020 mostly correspond to pandemic events. Lastly, we find the factors positively and significantly related to the probability of being happy after lockdown to be jobseeker support payments and international travel. On the other hand, lack of mobility is significantly and negatively related to the probability of being happy.
Towards women-inclusive ecology: Representation, behavior, and perception of women at an international conference
Authors: Lupon Anna , Rodríguez-Lozano Pablo , Bartrons Mireia , Anadon-Rosell Alba , Batalla Meritxell , Bernal Susana , Bravo Andrea G. , Capdevila Pol , Cañedo-Argüelles Miguel , Catalán Núria , Genua-Olmedo Ana , Gutiérrez-Cánovas Cayetano , Feio Maria João , Lucati Federica , Onandia Gabriela , Poblador Sílvia , Rotchés-Ribalta Roser , Sala-Bubaré Anna , Sánchez-Montoya María Mar , Sebastián Marta , Zufiaurre Aitziber , Pastor Ada
Published: December 2021

Conferences are ideal platforms for studying gender gaps in science because they are important cultural events that reflect barriers to women in academia. Here, we explored women’s participation in ecology conferences by analyzing female representation, behavior, and personal experience at the 1st Meeting of the Iberian Society of Ecology (SIBECOL). The conference had 722 attendees, 576 contributions, and 27 scientific sessions. The gender of attendees and presenters was balanced (48/52% women/men), yet only 29% of the contributions had a woman as last author. Moreover, men presented most of the keynote talks (67%) and convened most of the sessions. Our results also showed that only 32% of the questions were asked by women, yet the number of questions raised by women increased when the speaker or the convener was a woman. Finally, the post-conference survey revealed that attendees had a good experience and did not perceive the event as a threatening context for women. Yet, differences in the responses between genders suggest that women tended to have a worse experience than their male counterparts. Although our results showed clear gender biases, most of the participants of the conference failed to detect it. Overall, we highlight the challenge of increasing women’s scientific leadership, visibility and interaction in scientific conferences and we suggest several recommendations for creating inclusive meetings, thereby promoting equal opportunities for all participants.
Midwives’ perspectives on person-centred maternity care in public hospitals in South-east Nigeria: A mixed-method study
Authors: Ogbuabor Daniel Chukwuemeka , Okoronkwo Ijeoma Lewechi
Published: December 2021

Background

Person-centred maternity care (PCMC) is acknowledged as essential for achieving improved quality of care during labour and childbirth. Yet, evidence of healthcare providers’ perspectives of person-centred maternity care is scarce in Nigeria. This study, therefore, examined the perceptions of midwives on person-centred maternity care (PCMC) in Enugu State, South-east Nigeria.

Materials and methods

This study was conducted in seven public hospitals in Enugu metropolis, Enugu State, South-east Nigeria. A mixed-methods design, involving a cross-sectional survey and focus group discussions (FGDs) was used. All midwives (n = 201) working in the maternity sections of the selected hospitals were sampled. Data were collected from February to May 2019 using a self-administered, validated PCMC questionnaire. A sub-set of midwives (n = 56), purposively selected using maximum variation sampling, participated in the FGDs (n = 7). Quantitative data were entered, cleaned, and analysed with SPSS version 20 using descriptive and bivariate statistics and multivariate regression. Statistical significance was set at alpha 0.05 level. Qualitative data were analysed thematically.

Results

The mean age of midwives was 41.8 years ±9.6 years. About 53% of midwives have worked for ≥10 years, while 60% are junior midwives. Overall, the prevalence of low, medium, and high PCMC among midwives were 26%, 49% and 25%. The mean PCMC score was 54.06 (10.99). High perception of PCMC subscales ranged from 6.5% (dignity and respect) to 19% (supportive care). Midwives’ perceived PCMC was not significantly related to any socio-demographic characteristics. Respectful care, empathetic caregiving, prompt initiation of care, paying attention to women, psychosocial support, trust, and altruism enhanced PCMC. In contrast, verbal and physical abuses were common but normalised. Midwives’ weakest components of autonomy and communication were low involvement of women in decision about their care and choice of birthing position. Supportive care was constrained by restrictive policy on birth companion, poor working conditions, and cost of childbirth care.

Conclusion

PCMC is inadequate in public hospitals as seen from midwives’ perspectives. Demographic characteristics of midwives do not seem to play a significant role in midwives’ delivery of PCMC. The study identified areas where midwives must build competencies to deliver PCMC.
Sociodemographic, lifestyle, behavioral, and parental factors associated with sugar-sweetened beverage consumption in children in China
Authors: Guo Haijun , Phung Dung , Chu Cordia
Published: December 2021

Objective

Evidence shows sugar-sweetened beverage (SSB) consumption is a risk factor for obesity and non-communicable diseases (NCDs) in children. Investigating the influential profiles, which have been examined insufficiently, will help to inform the reduction of SSB consumption. The present research examines the current trend in SSB consumption and associated factors among children in China, in order to inform policy development.

Methods

Secondary data was extracted from China’s Health and Nutrition Survey (CHNS; 2004, 2006, 2009, and 2011), a repeated cross-sectional research, and a Chi-squared test was applied to compare SSB consumption in the last year, queried by social demographical, `environmental, behavioral, and parental factors. Multilevel mixed-effects logistic regression was employed to examine the trend and effects of the multiple factors.

Results

A total of 6015 Chinese children aged 6–17 years were investigated. From 2004 to 2011, the percentage of SSB consumption in children increased from 72.6% to 90.3%. The prevalence in urban areas was higher than the prevalence in rural areas, higher in high schools than primary and middle schools, higher in east coast affluent provinces than other provinces, and higher in high-income households than low-income households. Other associated factors include children’s fast food and salty snacks preference, level of physical activity, sedentariness, and parental education. The strongest association with SSB consumption in children was the mother’s SSB consumption (adjusted odds ratio: 5.54, 95% CI: 3.17–9.67).

Conclusion

Children’s SSB consumption has increased significantly in China, and is associated with socio-economic, demographic, level of physical activity, food preference, and parental factors. Future strategies aimed at reducing SSB consumption among children need to consider these factors.
Molecular survey of cattle ticks in Burundi: First report on the presence of the invasive Rhipicephalus microplus tick
Authors: Nyabongo Lionel , Odongo David O. , Milton Gad , Machuka Eunice , Vudriko Patrick , Pelle Roger , Kanduma Esther G.
Published: December 2021

A recent research study on prevalence of tick-borne pathogens in Burundi reported high prevalence and endemicity of Theileria parva, Anaplasma marginale and Babesia bigemina infections in cattle. Detailed information about tick species infesting animals, their distribution and genetic diversity in Burundi is outdated and limited. This study therefore assessed the prevalence and genetic diversity of tick species infesting cattle across agroecological zones (AEZs) in Burundi. A cross-sectional study on the occurrence of tick species was conducted in 24 districts of Burundi between October and December 2017. Differential identification and characterization of ticks collected was conducted using tick morphological keys and molecular tools (cox1 and 12S rRNA gene). Chi-square test was used to test for association between agroecological zones and the prevalence of tick species. Phylogenetic relationships were inferred using bayesian and maximum likelihood algorithms. A total of 483 ticks were collected from the five AEZs sampled. Six tick species comprising of Rhipicephalus appendiculatus, R. sanguineus, R. evertsi evertsi, R. microplus, R. decoloratus and Amblyomma variegatum were observed. Rhipicephalus appendiculatus were the most prevalent ticks (~45%). A total of 138 specimens (28%) were found to be Rhipicephalus microplus, suggesting an emerging threat for cattle farmers. Twelve R. appendiculatus cox1 haplotypes were obtained from 106 specimens that were sequenced. Two cox1 haplotypes of R. microplus which clustered into previously reported Clade A were observed. Rhipicephalus sanguineus and R. evertsi evertsi ticks, the vectors of numerous zoonotic pathogens, were collected from cattle, which constitute a high risk for public health. These findings reveal an overlapping distribution of tick vectors in Burundi. The design of ticks and tick-borne diseases control strategies should consider the distribution of different vectors across the AEZs particularly the presence of the highly invasive R. microplus tick in Burundi and the potential risk of introducing the pathogenic Babesia bovis.
Fatigue during the COVID-19 pandemic: Evidence of social distancing adherence from a panel study of young adults in Switzerland
Authors: Franzen Axel , Wöhner Fabienne
Published: December 2021

In this paper we analyze panel data (N = 400) to investigate the change in attitudes towards the Covid-19 measures and the change in compliance behavior between the first and second lockdowns in a sample of young adults from the University of Bern, Switzerland. We find considerable fatigue. While respondents expressed high acceptance of and compliance with the Covid-19 measures during the first lockdown, both acceptance and compliance behavior decreased substantially during the second lockdown. Moreover, we show via a structural equation model that respondents’ compliance behavior is largely driven by the perception of how others behave and by the acceptance of the Covid-19 measures. All other effects scrutinized e.g., individual and social risk perception, trust in politics, and pro-social orientations affect compliance behavior via the acceptance of Covid-19 measures. We also conduct two tests of causality of the estimated relation between attitudes towards the measures and social distancing behavior. The first test incorporates the effect of compliance behavior reported during the first lockdown on attitudes during the second lockdown. The second test involves estimating a first difference panel regression model of attitudes on compliance behavior. The results of both tests suggest that the effect of Covid-19 attitudes on social distancing behavior can be interpreted causally.
Sleep quality and associated factors among adult patients with epilepsy attending follow-up care at referral hospitals in Amhara region, Ethiopia
Authors: Simie Tsega Sintayehu , Yazew Birhaneselassie Gebeyehu , Mekonnen Kennean
Published: December 2021

Background

Globally, epilepsy is the commonest neurological disorder in adults. It has significant health and economic consequences to the affected individuals and the family. There is ample evidence that epileptic patients are at increased risk of poor sleep quality than the general population. However, there is limited evidence on sleep quality among epileptic patients and associated factors in Ethiopia. Therefore, this study investigated the prevalence of poor sleep quality and associated factors among adult patients with epilepsy.

Method

Institutional based cross-sectional study was conducted among adult epileptic patients attending follow-up care at referral hospitals in the Amhara region. A total of 575 epileptic patients were recruited using a stratified systematic random sampling technique. An interviewer-administered semi-structured questionnaire and record review were used for data collection. To assess sleep quality the pretested Pittsburgh Sleep Quality Index (PSQI) tool was used. A binary logistic regression model was used to assess factors associated with poor sleep quality. Variables with a p-value less than 0.2 in the bivariable binary logistic regression analysis were considered for the multivariable binary logistic regression analysis. In the multivariable binary logistic regression analysis, the Adjusted Odds Ratio (AOR) with the 95% Confidence Interval (CI) were reported to declare the statistical significance and strength of association. Model fitness was assessed using the Hosmer-Lemeshow test and was adequate (p>0.05). Multicollinearity of the independent variables was assessed using the Variance Inflation Factor (VIF) and the mean VIF was less than 10.

Results

A total of 565 participants were enrolled in the study with a response rate of 98.3%. The prevalence of poor sleep quality among adult epileptic patients was 68.8% [95% CI: 64.8%, 72.5%]. In the multivariable binary logistic regression, being unable to read and write [AOR = 3.16, 95%CI: 1.53, 6.51], taking polytherapy treatment [AOR = 2.10, 95% CI: 1.37, 3.21], poor medication adherence [AOR = 2.53, 95%CI: 1.02, 6.23] and having poor support [AOR = 2.72, 95%CI: 1.53, 4.82] and moderate social support [AOR = 1.89, 95%CI: 1.05, 3.41] were significantly associated with higher odds of poor sleep quality.

Conclusion and recommendation

Poor sleep quality is a major public health concern in Ethiopia. The patient’s level of education, number of medication use, medication adherence, and social support were found significant predictors of poor sleep quality. These findings highlight improving medication adherence and social support are effective strategies to improve the sleep quality of epileptic patients. Besides, it is better to give special emphasis to those epileptic patients with a low level of education and taking polytherapy to enhance sleep quality.
Erika MARTÍNEZ (ed.). Materia frágil. Poéticas para el siglo XXI en América Latina y España. Madrid/Frankfurt: Iberoamericana/Vervuert, 2020.
Authors: Soro Cuesta Esther
Published: December 2021

Reseña de Esther Soro sobre Materia frágil. Poéticas para el siglo XXI en América Latina y España.  (Iberoamericana, 2020) de Erika Martínez. 343 p. ISBN: 978-84-9192-127-1.
KNOWLEDGE OF ALZHEIMER’S DISEASE AND TRAINING NEEDS IN FINAL YEAR MEDICAL AND PHARMACY STUDENTS
Authors: Scerri C.
Published: December 2021

Although a significant number of medical and pharmacy professionals come into contact with an increasing number of individuals with Alzheimer’s disease and other dementias, there is concern on the lack of knowledge and skills received during their undergraduate training programmes with the consequence of not providing the required hospital and community care for these individuals following programme completion. The aim of this report is to describe the results of a small scale study investigating the level of knowledge of Alzheimer’s disease and training needs in medical and pharmacy students at the end of their final year of undergraduate training. The findings indicated a lack of in-depth knowledge for both categories of students, in particular on risk factors and pharmacotherapeutic management highlighting an urgent need of refining existent training programmes that equip future medical and pharmacy professionals with the necessary skills in providing adequate care and management for individuals with the disease.
EFFECT OF INCREASED DAILY INTAKE OF PROTEIN, COMBINED WITH A PROGRAM OF RESISTANCE EXERCISES, ON THE MUSCLE MASS AND PHYSICAL FUNCTION OF COMMUNITY-DWELLING ELDERLY WOMEN
Authors: Mori H. , Tokuda Y.
Published: December 2021

Background: In elderly women, significant loss of muscle mass due to declining levels of estrogen secretion is a health concern. Increasing the recommended dietary allowance of protein intake has been included as a general health guideline to prevent age-related sarcopenia. Objectives: To investigate effects of light-to-moderate resistance training combined with increased protein intake on the muscle mass, strength, and physical function of community-dwelling elderly women. Design: The 12-week training program combined weight-bearing and resistance band exercises, performed 3 times per week. Setting: Hyogo Prefecture, in either City K or Town H. Practical Intervention: Women were randomly allocated to three groups: exercise with protein intake adjusted to the recommended daily allowance (RDA) of 1.0–1.1 g/kg body weight/day (MP+EX group); exercise with protein intake adjusted above the RDA level at 1.2–1.3 g/kg body weight/day (HP+EX group); and a control group receiving classroom-based session on nutrition management, with protein intake adjusted to the RDA level (MP group). Measurements: Body weight and physical composition were measured by multi-frequency bioelectrical impedance analysis. Results: Exercise prevented decreases in muscle mass and strength and in performance of physical function tasks (p<0.05). Increasing dietary intake of protein above RDA level increased muscle mass (p<0.01), walking speed (p<0.01) and knee extensor strength (p<0.05). Conclusion: Adjusting protein intake to 1.2–1.3 g/kg body weight/day, in combination with light-to-moderate resistance training, can improve body composition and physical function in elderly women. The result of this study could be effective in lowering the incidence of age-related sarcopenia.
ACUTE DIETARY NITRATE SUPPLEMENTATION FAILS TO IMPROVE EXERCISE ECONOMY IN ELDERLY
Authors: Driller M. , Thompson L. , McQuillan J. , Masters R.
Published: December 2021

Objective: Improvements in exercise economy following dietary nitrate (NO3-) supplementation in young, athletic populations has been well documented, but little research has focused on whether these same benefits translate to elderly populations. Design: Participants completed two experimental trials in a double-blind, randomized, crossover design. Setting: University laboratory. Participants: Twenty-one elderly participants >65 yr (10 male/11 female, mean ± SD; age: 72 ± 6 yr). Intervention: Each trial consisted of participants ingesting a 70ml dose of either NO3- rich (NIT; 5.0mmol.L-1) or NO3- depleted (PLA; 0.003mmol.L-1) beetroot juice two hours prior to reporting to the laboratory. Measurements: On arrival at the laboratory, blood pressure was assessed followed by a five minute walking economy test on a treadmill (3km.h-1 and 1% gradient). VO2, heart rate and RPE were monitored during the walking test. Results: There were no significant differences (p > 0.05) between NIT and PLA trials for any of the measured variables during the walking test. Furthermore, no differences were found for blood pressure between trials. All results were associated with trivial or unclear effect sizes. Conclusion: Despite recent reports of improved exercise economy in young, athletic populations following NO3- supplementation, the current study did not find any benefit to sub-maximal VO2, heart rate, perceived exertion or blood pressure in elderly participants when performing a 5-minute walk following NO3- supplementation.
TREATMENT SATISFACTION: A NEGLECTED BUT IMPORTANT OUTCOME MEASURE IN OLDER PEOPLE WITH TYPE 2 DIABETES
Authors: Langerman H. , Gadsby R.
Published: December 2021

Objective: To investigate the effect of comprehensive geriatric care (CGC) in elderly referred to a rehabilitation unit. This article describes the considerations behind the study. Design: Participants were randomized to either CGC or standard care. Setting: Participants were recruited from two community care rehabilitation units in Aarhus Municipality, Denmark, in the period between 2012 and 2015. Participants: Inclusion: Elderly patients aged 65 and older admitted from home or hospital. Exclusion: Persons receiving palliative care or assessed by a geriatrician during the past month. Intervention: Medical history, physical examination, blood tests, medication adjustment and follow-up by a geriatrician. The control group received standard care with the general practitioners (GPs) as back-up. Outcomes: Primary outcome: Hospital contacts drawn from national registers. Secondary outcomes: GPs contacts, institutionalization, medication status and mortality collected from national registers and Activities of daily living (ADL), physical and cognitive function and quality of life measures collected by a blinded occupational therapist. All outcomes were assessed at day 10, 30 and 90 after arrival at the rehabilitation unit. Conclusion: A new model of care for elderly referred to community rehabilitation was developed and implemented. The potential benefits of this model were compared with usual care in a community rehabilitation unit in a pragmatic randomized clinical trial. We hypothesized that the geriatrician-performed CGC in elderly referred to a rehabilitation unit will reduce the hospital contacts by 25 % without increase in mortality and in contacts to GPs and home care services. We expect that this model will prevent deterioration in ADL, and physical and cognitive functioning, and reduce the risk of institutionalization. If the results are positive, community rehabilitation services should be encouraged to change their routines for treatment of this population accordingly.
DIOGENES SYNDROME: A PROSPECTIVE OBSERVATIONAL STUDY
Authors: Monfort J.-C. , Devouche E. , Wong C. , Pean I. , Hugonot-Diener L.
Published: December 2021

Objectives: This prospective study was designed to look for the most appropriate appellation, clinical symptoms, and underlying associated diseases, and to investigate a possible central etiology. Design and Participants: This prospective observational study involved 50 subjects aged 50-93 years, living in their home in Paris, and consecutively notified to the community authorities due to risks (fire) or nuisances (stench, parasites, hoarding). Clinical symptoms, associated diagnoses, cognitive capacity and life events during childhood were assessed. Results: Hoarding is both the most frequent and the least alerting symptom. Six clinical types cover both medical and social situations that lead to notifications of risk and nuisances to the authorities. Almost half of the situations remained social as no diseases were found to be associated with the Diogenes syndrome. A traumatic life event during childhood could be a risk factor for all Diogenes syndromes although it is most often present among subjects without an associated disease. Conclusions: Our results are in favor of maintaining the appellation “Diogenes syndrome”, which embraces the entirety of the diverse situations reported to the authorities, social services and medical networks. These situations require time and a coordinated investigation by a medico-social team, as subjects with Diogenes syndrome do not always have an associated disease.
HUGE EQUATION ACCURACY FOR SCREENING CHRONIC KIDNEY DISEASE: A PROSPECTIVE STUDY
Authors: Musso C.G. , Maytin S. , Conti P. , Terrasa S. , Primerano A. , Reynaga A. , Vilas M. , Jauregui J.
Published: December 2021

Objectives: Chronically reduced glomerular filtration rate (GFR) in old people does not always mean that they suffer from chronic kidney disease (CKD) since their GFR can just be induced by ageing. The HUGE equation has been recently described and validated in Spain for screening CKD without taking into account the patient´s GFR value This study evaluated HUGE performance in Argentine patiens. Material & Method: This was a prospective study to assess the operational characteristics of the HUGE equation for diagnosing CKD (diagnostic accuracy) in an ambulatory adult (age ≥ 18 years old) population (n: 205) assisted at the ambulatory clinical consult of Hospital Italiano de San Justo, Buenos Aires, Argentina in 2016. Results: It was documented that HUGE equation had a sensitivity of 56.7% (IC: 37.4% - 74.5%), and a specificity of 95.9% (IC: 88.6% - 99.1%) for screening CKD in elderly individuals who have an estimated GFR < 45 ml/min/1.73 m². Additionally, it was found that the screening strategy of combining HUGE with estimated GFR and urinalyses, showed a very good performance for detecting CKD, not only in elderly people but also in young people. Both triple combined CKD screening strategies showed a sensitivity around 86%, and 98% in young and elderly people, respectively. Conclusion: This study documented that the HUGE equation had and acceptable performance for screening moderate-severe CKD (stages III b-V) in elderly people, and an excellent performance for screening CKD in general population in combination with estimated GFR and urinalyses.
COMPARISON OF CURRENT SARCOPENIA CLASSIFICATION CRITERIA IN OLDER NEW ENGLAND WOMEN
Authors: Slezak S.G. , Mahoney K.B , Renna E.N. , Lofgren I.E. , Xu F. , Hatfield D.L. , Delmonico M.J.
Published: December 2021

Objectives: To evaluate the prevalence of sarcopenia in a sample of older, sedentary women using criteria from the European Working Group on Sarcopenia in Older People (EWGSOP), the International Working Group (IWG), and the Foundation for the National Institutes of Health Sarcopenia Project (FNIHSP). Design: Cross-sectional analysis. Setting and Participants: Community-dwelling women (n = 61) aged 71.9 ± 4.6 years (mean±SD) with a BMI 27.3 ± 6.0 kg/m2 who by self-report were healthy and did not exercise were recruited and evaluated for sarcopenia. Measurements: Height, weight, grip strength, gait speed, and appendicular lean mass (via segmental multi-frequency bioelectrical impedance analysis: SMF-BIA) were measured. Prevalence was reported using descriptive statistics and a Fisher’s exact test was used to analyze the distribution frequency of sarcopenia classification by different criteria. Results: In this sample 14.8% met EWGSOP criteria, 6.6% met FNIHSP criteria, and 3.3% met IWG criteria. There was a borderline significant difference in distribution frequency between EWGSOP and IWG classification criteria (p=0.053). Conclusion: The variation in sarcopenia prevalence depending on the diagnostic criteria used is consistent with previous research and there are borderline significant differences between classification criteria in this population. These data suggest the need for additional examination to determine current cut points for ALM measured by SMF-BIA, as well as which established definition of sarcopenia is appropriate for this population.
mTOR REGULATES THE PROLIFERATION AND DIFFERENTIATION OF TENDON STEM CELLS: AN IN VITRO STUDY
Authors: Gao S. , Tang H. , Zhou B.H. , Tang K.L.
Published: December 2021

Objectives: The mechanistic target of rapamycin (mTOR) controls cell growth and proliferation via translation regulation in eukaryotes. The present study investigated the effects of mTOR on the proliferation and differentiation of tendon stem cells (TSCs). Methods: The proliferation and differentiation ability of TSCs was tested in response to antagonist (MHY1485), and a depressor of mTOR (Rapamycin and KU0063794). CCK test was performed to test cell proliferation; quantitative real-time PCR (RT-PCR) and Western blot test were performed to evaluate the differentiation of TSCs. Results: Blocking of mTOR1 inhibited the proliferation of TSCs and blocking of mTOR2 enhanced the proliferation of TSCs; however, the effects of mTOR1 surpassed the effects of mTOR2. Blocking of mTOR1 or activation of mTOR2 induced the expression of TNC, and blocking of mTOR2 inhibited the expression of TNC. Blocking of mTOR1 by rapamycin decreased the expression of ap2. Both blocking of mTOR1 or mTOR2 had little effects on the expression of Runx2 and Sox9; however, activation of mTOR2 induced the expression of Runx2 and Sox9. Moreover, the Western blot test showed that blocking of mTOR1 by Rapamycin or the blocking of both mTOR1 and mTOR2 by KU-0062794 enhanced the expression of TNC; in addition, blocking of mTOR1 by Rapamycin enhanced the expression of c-EBPα and Sox9. However, activation of mTOR1 and mTOR2 by MHY1485 increased the expression of Runx2. Conclusions: mTOR played important roles in the proliferation and differentiation of TSCs. Furthermore, mTOR1 and mTOR2 played different roles on the proliferation and differentiation of TSCs. Blocking mTOR1 inhibited the proliferation of TSCs and played a dominant function.Blocking of mTOR1 enhanced the expression of tenocyte related genes; however, blocking of mTOR2 inhibited the expression of TNC. Blocking of mTOR1 by rapamycin decreased the expression of ap2 and activation of mTOR2 induced the expression of Runx2.
RELEVANCE OF 18F-FLUORODEOXYGLUCOSE-POSITRON EMISSION TOMOGRAPHY/COMPUTED TOMOGRAPHY IN THE DIAGNOSIS OF ATYPICAL TEMPORAL ARTERITIS
Authors: Leclercq M. , Goodrich L. , Le Guillou C. , Gbaguidi X.
Published: December 2021

Atypical form of Giant cell arteritis (GCA), involving the absence of American College of Rheumatology (ACR) criteria, should be suspected before fever or inflammatory syndrome of unknown origin in the elderly. In that case, the diagnosis may be complex insofar as there are many possible infectious, inflammatory or tumorous etiologies. Completion of multiple and / or invasive clinical investigations can be questionable in a frail elderly population. 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) is a non-invasive examination of high sensitivity and specificity in the diagnosis of GCA which may reveal abnormal fixation of the wall of the aorta and its branches. Its negative predictive value close to 90 % is also a strength to exclude the diagnosis. FDG-PET/CT is also effective in the search for differential diagnoses. On the other hand, FDG-PET/CT should not be prescribed in front of typical form of GCA in which ACR criteria are met. This clinical case illustrate the place of FDG-PET/CT in the diagnostic strategy of an inflammatory syndrome in an elderly patient for whom GCA is suspected.
EARLY IDENTIFICATION OF MALNUTRITION RISK AMONG FREE-LIVING ELDERLY PERSONS IN ATHENS, GREECE
Authors: Vassilakou T. , Triantafillou G. , Evrenoglou L.
Published: December 2021

Background: Malnutrition is a serious problem, which cannot be easily detected among free-living elderly people, and may lead to various health and social problems and deteriorate their quality of life. Objectives: To determine the prevalence of malnutrition and malnutrition risk among free-living elderly in the community of an urban municipality of Attica and to identify socio-economic, health and dietary factors that may increase malnutrition risk. Design: Cross-sectional. Setting: Elderly people attending the Open Care Community Centers at N. Philadelphia (an urban municipality of Attica). Participants: 151 free-living people aged over 65 years (78 women and 73 men). Measurements: Mini Nutritional Assessment (MNA) questionnaire was completed, as well as socio-demographic, medical history, physical activity and alcohol consumption data was collected through a personal interview with the participants. Results: None of the individuals was found to be malnourished, but 25,8% of the sample was at risk of malnutrition. After performing backward regression analysis recent appetite (p<0,009) and weight loss (p<0,003), latest development of psychological stress or acute disease (p<0,0001), number of full-course meals (p<0,0001), protein intake index (p<0,002), minimum daily consumption of 2 portions of fruits or vegetables (p<0,0001), daily consumption of liquids (p<0,004), individual's self-evaluation of health (p<0,0001) and nutritional status (p<0,0001) all correlated significantly with MNA Screening Score. Conclusions: A significant number of free-living elderly persons were found at risk of malnutrition. Several dietary variables were found to correlate significantly with malnutrition risk. Early identification of nutritional risk of malnutrition in the community could ameliorate the nutritional status of seniors and consequently their health and quality of life.
EFFECT OF LEUCINE-RICH WHEY PROTEIN AS COMPARED TO SOY PROTEIN ON MUSCLE FUNCTION IN ELDERLY INDIVIDUALS WITH OSTEOPENIA. A FOUR MONTH RANDOMIZED STUDY
Authors: Mehlsen J.L. , Pedersen S.B. , Nørgaard K.I. , Langdahl B.L. , Møller N. , Richelsen B.
Published: December 2021

Objective: This investigation was conducted to determine whether dietary supplementation with a specific leucine-rich whey protein compound improves physical function and muscle strength in osteopenic elderly people compared to soy protein and placebo. Design, participants and setting: The study was a 16-week randomized single blinded placebo controlled intervention, including 47 women and 10 men from 60-85 years of age with osteopenia (T-score < -1.0 by dual energy X-ray absorptiometry scan). The subjects were assigned to three groups in 2:2:1 relations, daily receiving 1) whey (45.8 g protein including 6.14 g leucine (n=24)), 2) soy (45.9 g protein with 3.1 g leucine (n=23)), and 3) isocaloric placebo with maltodextrin (n=10). A home based resistance training protocol (3 x 45 min / week) was followed by all groups concurrently. The primary focus of the study was on the differences between the two protein groups. Measurements: Physical function was determined by six-minute walk (6MW) and four-meter gait speed (4MGS) tests as primary endpoints, and strength (maximum voluntary contraction) by hand grip, leg extension and -flexion as secondary endpoints. Results: 6MW increased significantly in the whey group compared to the soy group (4% as compared to 1% increment, P < 0.05) but no changes were found in 4MGS. There were no differences between any groups in other variables such as in the strength and balance tests. However, p-urate was significantly lower after whey protein as compared to soy (P < 0.01). Conclusions: Four months of leucine-rich whey protein supplementation and concurrent resistance training significantly increased the six-minute walk test in elderly individuals as compared to soy protein. However, whether this minor increment in the walk test is of clinical importance is unknown. There was no effect on the four-meter gait speed or any other secondary muscle function-related endpoints.
DIVERSIFIED ANALYSIS OF NUTRITIONAL STATUS IN COMMUNITY-DWELLING OLDER ADULTS IN JAPAN
Authors: Kawashima M. , Kubota M. , Saito H. , Shinozuka S.
Published: December 2021

Objectives: This study aimed to comprehensively analyze the nutritional status of community-dwelling older adults in Japan. Design and Participant: Participants included 48 outpatients (13 males and 35 females) aged ≧65 years who visited a private clinic in an urban city. Body height, body weight, and blood variables, including albumin, lymphocyte counts and total cholesterol, and pre-albumin, were obtained from the patient charts. The MNA-SF and nutritional intakes, using an established semiquantitative questionnaire, were conducted by an interview with a dietitian. Results: Nutritional risk assessment by MNA-SF revealed that 13 patients (27.1%) were at a risk of malnutrition and 4 patients (8.3%) demonstrated thinness, i.e., BMI <18.5 kg/m2. No statistical difference in terms of sex was found in the MNA-SF or BMI analyses. The caloric, protein, and lipid intake, adjusted by body weight, were significantly higher in females than in males. The daily caloric intake of 15 patients (31.3%) was below the estimated energy requirements defined by Dietary Reference Intakes for Japanese (2015), and the frequency of low estimated energy requirements was significantly higher in males than in females. Multiple regression analysis demonstrated that both BMI and MNA-SF were associated with albumin levels. Conclusions: Our findings suggest that malnutrition is not prevalent among community-dwelling older adults in Japan. Albumin may work as indicators for predicting malnutrition. Considering the lower caloric, protein, and lipid intake of males compared with females, caregivers should note that older adult males may be at a higher risk of malnutrition.
RELATIVE VALIDITY OF SHORT QUESTIONNAIRES TO ASSESS MEDITERRANEAN DIET OR LOW-FAT DIET ADHERENCE
Authors: Miura K. , Entwistle T.R. , Fildes J.E. , Green A.C.
Published: December 2021

Background: Short diet questionnaires can quickly identify dietary habits with minimal burden for users but they require validation for use in specific populations. Objective: To assess relative validity against a food frequency questionnaire (FFQ) of two short questionnaires to assess a Mediterranean diet and a low-fat diet, respectively, among organ transplant recipients as a part of a pilot study. Design: Cross-sectional validation study. Setting: Heart or lung transplant recipients completed two short dietary questionnaires and a full semi-quantitative FFQ as the reference methods, on 3 separate days. Participants: Sixteen heart (n=8) or lung (n=8) transplant recipients aged 16 years or more, at least 6-months post-transplant and clinically stable patients in Manchester, UK. Measurements: Two short dietary questionnaires to assess their Mediterranean diet and low-fat diet and a semi-quantitative FFQ. Relative validity was assessed by comparing the scores derived from each short questionnaire with that of the FFQ. Agreement was assessed using the limits of agreement (LOA), and the agreement was expressed as a ratio of the score from the short dietary to the FFQ score with a ratio of 1.00 indicating perfect agreement. The agreement was formally tested by the two one-sided t-test procedure. Results: The mean agreement was 0.99 (95% LOA 0.60–1.38) for the Mediterranean and 1.04 (95% LOA 0.42–1.64) for the low-fat diet. The two one-sided t-test procedure showed the short questionnaires and the reference method were equivalent (Mediterranean diet overall p=0.004; low-fat diet overall p<0.001). Conclusions: Dietary habits to measure Mediterranean diet and a low-fat diet by short dietary questionnaires and full FFQ were comparable among organ transplant recipients.
HEALTH-FUNCTION INDICATORS FOR THE PREDICTION OF ELDERLY FRAILTY
Authors: Lee I-C. , Chiu Y.-H. , Lee I-N. , Lee C.-Y.
Published: December 2021

Objectives: It is crucially worth noticing of how to assess elderly frailty in recent years. This study explores 16 common indicators of health function to investigate the relationship between these indicators and frailty. It ranks the indicators as reference for frailty assessments. Design: Cross-sectional study. Setting: Regional frailty study. Participants : The sample comprised 597 elderly people who residence in the community. Measurements: This study commenced in 2012. By June 2014, 597 people aged over 65 years participated in this study. With the permission of the subjects, the trained interviewer conducted a face-to-face survey and measured the subjects’ walking speed and the strength of their grip. The statistical methods were t-test, Chi-square, logistic regression analysis and the decision tree. Results: In this study, there is 31.7% of elderly demonstrating the symptoms of frailty. Of the health-function indicators, the relationship between decreased appetite and frailty is the strongest, followed by IADL disability, declining cognitive function, malnutrition and pain. Poor eyesight and falling do not show a significant relationship to frailty. Conclusion: Among 16 health-function indicators, the association between nutritional problems and frailty in elderly people is the most significant. Future assessments of frailty should consider the importance of health-function indicators in order to enhance the scope. Screening at-risk elderly people for potential frailty will enable proper health-care planning to achieve the goal of healthy ageing.
CHANGES IN FUNCTIONAL CAPACITY IN POSTMENOPAUSAL WOMEN ADHERING TO A MEDITERRANEAN DIET
Authors: Ardolino E. , Garrett Ramos A. , Hutchins-Wiese H. , Kerstetter J. , Bihuniak J. , Kleppinger A. , Kenny A.M.
Published: December 2021

Objectives: To evaluate whether Mediterranean style diet (MedSD) is associated with better physical performance. There is evidence from large epidemiological studies that MedSD associates with lower risk of chronic disease and mortality. Poor functional capacity, partially affected by poor physical performance, also predicts higher morbidity and mortality resulting in higher healthcare costs. Design: One group, longitudinal pilot clinical intervention trial of 24 weeks total; 12 weeks observation followed by 12 weeks intervention in 16 postmenopausal women (age>65 y) evaluating effects on physical performance. Setting: Outpatient clinical research center. Participants: 16 postmenopausal women (age>65 y) selected for typical American diet. Intervention: Women consumed their typical diet for 12 weeks followed by a 12-week MedSD intervention. A registered dietitian counseled the subjects to make 4 dietary changes: 1) incorporate 3 tablespoons Extra Virgin Olive Oil (EVOO) daily; 2) include 3-5 servings/week of high omega-3 fish (salmon or tuna); 3) incorporate 1.5 ounces of walnuts daily; 4) incorporate increased amounts of fruits, vegetables and whole grains. Measurement: Food frequency questionnaire scores, 3-day diet record, serum total fatty acids, anthropometry, physical activity, functional capacity (chair rise time, single leg time, hand grip strength were measured. Pre-post analysis compared the 2 weeks typical diet period with the 2 weeks MedSD intervention period. Correlations were used to relate dietary change to physical performance change. Results: Diet analysis revealed adherence to the MedSD (p = < 0.001). No significant differences were observed in hand grip strength or the Short Physical Performance Battery. Significant correlations were found between change in chair rise time and changes in intake of carbohydrates (r= 0.587) and trans and saturated fat (r= 0.818). Inability to identify other significant correlations in primary outcomes was likely affected by small sample size and physically robust participant group. Conclusions: Alterations in consumption patterns to adhere to a MedSD, including reductions in saturated fat and carbohydrate consumption, correlate with improvement in chair rise time. This study design can be used for future studies with a larger group of frailer, older adults to assess the effect of MedSD on physical performance.