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  • 1
    In: Journal of the American Geriatrics Society, Wiley, Vol. 62, No. 4 ( 2014-04), p. 754-761
    Abstract: The National Institute for Health and Clinical Excellence ( NICE ) in the United Kingdom developed guidelines for the diagnosis, prevention, and management of delirium in July 2010 that included 10 recommendations for delirium prevention. The Hospital Elder Life Program ( HELP ) is a targeted multicomponent strategy that has proven effective and cost‐effective at preventing functional and cognitive decline in hospitalized older persons. HELP provided much of the basis for seven of the NICE recommendations. Given interest by new HELP sites to meet NICE guidelines, three new protocols addressing hypoxia, infection, and pain that were not previously included in the HELP program were developed. In addition, the NICE dehydration guideline included constipation, which was not specifically addressed in the HELP protocols. This project describes the systematic development of three new protocols (hypoxia, infection, pain) and the expansion of an existing HELP protocol (constipation and dehydration) to achieve alignment between the HELP protocols and NICE guidelines. Following the Institute of Medicine recommendations for developing trustworthy guidelines, an interdisciplinary group of experts conducted a systematic review of current literature, rated the quality of the evidence, developed intervention protocols based on the highest‐quality evidence, and submitted the protocols first to internal review and then to external review by an interdisciplinary panel of experts. The protocols were revised based on the review process and incorporated into the HELP materials. Inclusion of these protocols enhances the scope of the HELP program and allows fulfillment of NICE guideline recommendations for delirium prevention. The rigorous process applied may provide a useful example for updating existing guidelines or protocols that may be applicable to a broad range of clinical applications.
    Type of Medium: Online Resource
    ISSN: 0002-8614 , 1532-5415
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2014
    detail.hit.zdb_id: 2040494-3
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  • 2
    In: Medicine, Ovid Technologies (Wolters Kluwer Health), Vol. 97, No. 4 ( 2018-01), p. e9747-
    Type of Medium: Online Resource
    ISSN: 0025-7974
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2018
    detail.hit.zdb_id: 2049818-4
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  • 3
    Online Resource
    Online Resource
    Wiley ; 2017
    In:  Cochrane Database of Systematic Reviews
    In: Cochrane Database of Systematic Reviews, Wiley
    Type of Medium: Online Resource
    ISSN: 1465-1858
    Language: English
    Publisher: Wiley
    Publication Date: 2017
    detail.hit.zdb_id: 2038950-4
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  • 4
    Online Resource
    Online Resource
    Wiley ; 2015
    In:  Cochrane Database of Systematic Reviews
    In: Cochrane Database of Systematic Reviews, Wiley
    Type of Medium: Online Resource
    ISSN: 1465-1858
    Language: English
    Publisher: Wiley
    Publication Date: 2015
    detail.hit.zdb_id: 2038950-4
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  • 5
    Online Resource
    Online Resource
    Oxford University Press (OUP) ; 2020
    In:  Innovation in Aging Vol. 4, No. Supplement_1 ( 2020-12-16), p. 177-177
    In: Innovation in Aging, Oxford University Press (OUP), Vol. 4, No. Supplement_1 ( 2020-12-16), p. 177-177
    Abstract: Background: Phase angle (PhA) has been suggested as an indicator of cellular death and nutritional status. We aimed to evaluate the performance of phase angle as a sarcopenia marker among 50 years older and determine the optimal cut-off values. Materials and Methods: A cross section of 4500 with ≥50 years were assessed in terms of sarcopenia with bioelectrical indices. Phase angle can be determined through bioelectrical impedance analysis (In Body 770). Muscle strength and physical function were measured using hand grip and 4 m walking speed. Significant determinants of sarcopenia were further analyzed with multivariate logistic regression analysis. Results: 869 patients (19.31%) were diagnosed with sarcopenia. The average PhA was 5.03 ± 0.64° (Male: 5.31 ± 0.66°; Female: 4.87 ± 0.57°). After adjusting age, gender, race, occupation, BMI, marital status, smoking, drinking, exercise, chronic disease and ADL, phase angle was still independent associated factors with sarcopenia: phase angle (OR=0.25, 95% CI: 0.203-0.308, P & lt; 0.001). Receiver operating characteristic analysis revealed that the optimal phase angle cutoff value to detect sarcopenia was ≤4.9º (AUC=0.768). Conclusions: Bioelectrical phase angle can be an useful bioelectrical marker to identify sarcopenia.
    Type of Medium: Online Resource
    ISSN: 2399-5300
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2020
    detail.hit.zdb_id: 2905697-4
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  • 6
    In: Advanced Functional Materials, Wiley
    Abstract: Ferromagnetic materials with a strong spin‐orbit coupling (SOC) have attracted much attention in recent years because of their exotic properties and potential applications in energy‐efficient spintronics. However, such materials are scarce in nature. Here, a proximity‐induced paramagnetic to ferromagnetic transition for the heavy transition metal oxide CaRuO 3 in (001)‐(LaMnO 3 /CaRuO 3 ) superlattices is reported. Anomalous Hall effect is observed in the temperature range up to 180 K. Maximal anomalous Hall conductivity and anomalous Hall angle are as large as ∼15 Ω −1 cm −1 and ∼0.93%, respectively, by one to two orders of magnitude larger than those of the typical 3d ferromagnetic oxides such as La 0.67 Sr 0.33 MnO 3 . Density functional theory calculations indicate the existence of avoid band crossings in the electronic band structure of the ferromagnetic CRO layer, which enhances Berry curvature thus strong anomalous Hall effects. Further evidences from polarized neutron reflectometry show that the CaRuO 3 layers are in a fully ferromagnetic state (∼0.8 μ B /Ru), in sharp contrast to the proximity‐induced canted antiferromagnetic state in 5d oxides SrIrO 3 and CaIrO 3 (∼0.1 μ B /Ir). More than that, the magnetic anisotropy of the (001)‐(LaMnO 3 /CaRuO 3 ) superlattices is eightfold symmetric, showing potential applications in the technology of multistate data storage.
    Type of Medium: Online Resource
    ISSN: 1616-301X , 1616-3028
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 2029061-5
    detail.hit.zdb_id: 2039420-2
    SSG: 11
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  • 7
    In: BMC Medicine, Springer Science and Business Media LLC, Vol. 18, No. 1 ( 2020-12)
    Abstract: The coronavirus disease 2019 (COVID-19) has been a pandemic worldwide. Old age and underlying illnesses are associated with poor prognosis among COVID-19 patients. However, whether frailty, a common geriatric syndrome of reduced reserve to stressors, is associated with poor prognosis among older COVID-19 patients is unknown. The aim of our study is to investigate the association between frailty and severe disease among COVID-19 patients aged ≥ 60 years. Methods A prospective cohort study of 114 hospitalized older patients (≥ 60 years) with confirmed COVID-19 pneumonia was conducted between 7 February 2020 and 6 April 2020. Epidemiological, demographic, clinical, laboratory, and outcome data on admission were extracted from electronic medical records. All patients were assessed for frailty on admission using the FRAIL scale, in which five components are included: fatigue, resistance, ambulation, illnesses, and loss of weight. The outcome was the development of the severe disease within 60 days. We used the Cox proportional hazards models to identify the unadjusted and adjusted associations between frailty and severe illness. The significant variables in univariable analysis were included in the adjusted model. Results Of 114 patients, (median age, 67 years; interquartile range = 64–75 years; 57 [50%] men), 39 (34.2%), 39 (34.2%), and 36 (31.6%) were non-frail, pre-frail, and frail, respectively. During the 60 days of follow-up, 43 severe diseases occurred including eight deaths. Four of 39 (10.3%) non-frail patients, 15 of 39 (38.5%) pre-frail patients, and 24 of 36 (66.7%) frail patients progressed to severe disease. After adjustment of age, sex, body mass index, haemoglobin, white blood count, lymphocyte count, albumin, CD8+ count, D-dimer, and C-reactive protein, frailty (HR = 7.47, 95% CI 1.73–32.34, P  = 0.007) and pre-frailty (HR = 5.01, 95% CI 1.16–21.61, P  = 0.03) were associated with a higher hazard of severe disease than the non-frail. Conclusions Frailty, assessed by the FRAIL scale, was associated with a higher risk of developing severe disease among older COVID-19 patients. Our findings suggested that the use of a clinician friendly assessment of frailty could help in early warning of older patients at high-risk with severe COVID-19 pneumonia.
    Type of Medium: Online Resource
    ISSN: 1741-7015
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2020
    detail.hit.zdb_id: 2131669-7
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  • 8
    Online Resource
    Online Resource
    Springer Science and Business Media LLC ; 2022
    In:  BMC Geriatrics Vol. 22, No. 1 ( 2022-12)
    In: BMC Geriatrics, Springer Science and Business Media LLC, Vol. 22, No. 1 ( 2022-12)
    Abstract: It remains unclear whether stress hyperglycemia is associated with delirium. We performed this cohort study to determine the association between stress hyperglycemia and delirium. Methods We consecutively enrolled patients aged ≥70 years who were admitted to the Geriatric Department of West China Hospital between March 2016 and July 2017. Stress hyperglycemia ratio (SHR) was calculated as fasting blood glucose divided by estimated average glucose derived from glycosylated hemoglobin (HbA1c) and was classified into three tertiles. Delirium was screened within 24 h of admission and three times daily thereafter, using the confusion assessment method. The Cox proportional hazards models were used to assess the association of SHR with delirium. Results Among 487 included patients (mean age 83.0 years, 72.0% male), 50 (10.3%) patients experienced delirium during hospitalization. Compared to the second tertile, both the lowest and the highest SHR tertiles were independently associated with delirium (hazard ratio [HR] 3.71, 95% confidence interval [CI] 1.45-9.51; and HR 2.97, 95% CI 1.29-6.81, respectively). Similar results were found after further adjusting for statin comedication. Multiple-adjusted restricted cubic splines revealed a nonlinear relationship between SHR and delirium ( P nonlinearity =0.04). Adding SHR to conventional risk factors improved the risk prediction of delirium (net reclassification index 0.39, P =0.01; integrated discrimination improvement 0.07, P =0.03). Subgroup analyses indicated that the relationship between SHR and delirium was more apparent in patients with HbA1c 〈 6.5%, with significantly higher HR in the first (3.65, 95% CI 1.11-11.97) and third (3.13, 95% CI 1.13-8.72) SHR tertiles compared to the second tertile, while there was no significant association between SHR and delirium in those with HbA1c ≥6.5%. Conclusions Both lower and higher SHR were associated with increased risk of delirium but only in patients with HbA1c 〈 6.5%. Admission SHR may serve as a promising predictor of delirium, and incorporating this biomarker into prediction algorithms might have potential clinical utility in aiding delirium risk stratification, especially in those with HbA1c 〈 6.5%.
    Type of Medium: Online Resource
    ISSN: 1471-2318
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 2059865-8
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  • 9
    In: Science, American Association for the Advancement of Science (AAAS), Vol. 377, No. 6604 ( 2022-07-22)
    Abstract: Rapid population growth, rising meat consumption, and the expanding use of crops for nonfood and nonfeed purposes increase the pressure on global food production. At the same time, the excessive use of nitrogen fertilizer to enhance agricultural production poses serious threats to both human health and the environment. To achieve the required yield increases and make agriculture more sustainable, intensified breeding and genetic engineering efforts are needed to obtain new crop varieties with higher photosynthetic capacity and improved nitrogen use efficiency (NUE). However, progress has been slow, largely due to the limited knowledge about regulator genes that potentially can coordinately optimize carbon assimilation and nitrogen utilization. RATIONALE Transcription factors control diverse biological processes by binding to the promoters (or intragenic regions) of target genes, and a number of transcription factors have been identified that control carbon fixation and nitrogen assimilation. A previous comparative analysis of maize and rice leaf transcriptomes and metabolomes revealed a set of 118 candidate transcription factors that may act as regulators of C 4 photosynthesis. We screened these transcription factors for their responsiveness to light and nitrogen supply in rice, and found that the gene Dehydration-Responsive Element-Binding Protein 1C ( OsDREB1C ), a member of the APETALA2/ethylene-responsive element binding factor (AP2/ERF) family, exhibits properties expected of a regulator that can simultaneously modulate photosynthesis and nitrogen utilization. RESULTS OsDREB1C expression is induced in rice by both light and low-nitrogen status. We generated overexpression lines ( OsDREB1C -OE) and knockout mutants ( OsDREB1C -KO) in rice, and conducted field trials in northern, southeastern, and southern China from 2018 to 2021. OsDREB1C -OE plants exhibited 41.3 to 68.3% higher yield than wild-type (WT) plants due to increased grain number per panicle, elevated grain weight, and enhanced harvest index. We observed that light-induced growth promotion of OsDREB1C -OE plants was accompanied by enhanced photosynthetic capacity and concomitant increases in photosynthetic assimilates. In addition, 15 N feeding experiments and field studies with different nitrogen fertilization regimes revealed that NUE was improved in OsDREB1C- OE plants due to elevated nitrogen uptake and transport activity. Moreover, OsDREB1C overexpression led to more efficient carbon and nitrogen allocation from source to sink, thus boosting grain yield, particularly under low-nitrogen conditions. Additionally, the OsDREB1C -OE plants flowered 13 to 19 days earlier and accumulated higher biomass at the heading stage than WT plants under long-day conditions. OsDREB1C is localized in the nucleus and the cytosol and functions as a transcriptional activator that directly binds to cis elements in the DNA, including dehydration-responsive element (DRE)/C repeat (CRT), GCC, and G boxes. Chromatin immunoprecipitation sequencing (ChIP-seq) and transcriptomic analyses identified a total of 9735 putative OsDREB1C-binding sites at the genome-wide level. We discovered that five genes targeted by OsDREB1C [ ribulose-l,5-bisphosphate carboxylase/oxygenase small subunit 3 ( OsRBCS3 ), nitrate reductase 2 ( OsNR2 ), nitrate transporter 2.4 ( OsNRT2.4 ), nitrate transporter 1.1B ( OsNRT1.1B ), and flowering locus T-like 1 ( OsFTL1 )] are closely associated with photosynthesis, nitrogen utilization, and flowering, the key traits altered by OsDREB1C overexpression. ChIP-quantitative polymerase chain reaction (ChIP-qPCR) and DNA affinity purification sequencing (DAP-seq) assays confirmed that OsDREB1C activates the transcription of these genes by binding to the promoter of OsRBCS3 and to exons of OsNR2 , OsNRT2.4 , OsNRT1.1B , and OsFTL1 . By showing that biomass and yield increases can also be achieved by OsDREB1C overexpression in wheat and Arabidopsis , we have demonstrated that the mode of action and the biological function of the transcription factor are evolutionarily conserved. CONCLUSION Overexpression of OsDREB1C not only boosts grain yields but also confers higher NUE and early flowering. Our work demonstrates that by genetically modulating the expression of a single transcriptional regulator gene, substantial yield increases can be achieved while the growth duration of the crop is shortened. The existing natural allelic variation in OsDREB1C , the highly conserved function of the transcription factor in seed plants, and the ease with which its expression can be altered by genetic engineering suggest that this gene could be the target of future crop improvement strategies toward more efficient and more sustainable food production. OsDREB1C coordinates yield and growth duration. OsDREB1C was identified by its responsiveness to light and low nitrogen in a screen of 118 transcription factors related to C 4 photosynthesis. Transcriptional activation of multiple downstream target genes by OsDREB1C confers enhanced photosynthesis, improved nitrogen utilization, and early flowering. Together, the activated genes cause substantial yield increases in rice and wheat.
    Type of Medium: Online Resource
    ISSN: 0036-8075 , 1095-9203
    RVK:
    RVK:
    Language: English
    Publisher: American Association for the Advancement of Science (AAAS)
    Publication Date: 2022
    detail.hit.zdb_id: 128410-1
    detail.hit.zdb_id: 2066996-3
    detail.hit.zdb_id: 2060783-0
    SSG: 11
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  • 10
    Online Resource
    Online Resource
    Elsevier BV ; 2015
    In:  Journal of the American Medical Directors Association Vol. 16, No. 5 ( 2015-05), p. 438.e1-438.e6
    In: Journal of the American Medical Directors Association, Elsevier BV, Vol. 16, No. 5 ( 2015-05), p. 438.e1-438.e6
    Type of Medium: Online Resource
    ISSN: 1525-8610
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2015
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