Butlerhwang9284

Multimorbidity, polypharmacy, and potentially inappropriate medication (PIM) pose challenges for the care of people with cognitive impairment. The aim of the present study is to explore whether multimorbidity, polypharmacy, and PIM predict falls and hospital admissions in a sample of people with cognitive impairment in day-care centers in Germany.

We used data from the German day-care study (multicenter longitudinal study, n = 433). Multimorbidity was defined as ≥ 2 chronic diseases. Polypharmacy was defined as prescriptions to ≥ 5 drugs. Potentially inappropriate medication was defined as scoring on the PRISCUS list. Binary logistic regression analyses were computed to determine whether multimorbidity, polypharmacy, and potentially inappropriate medication at t0 predicted falls and hospital admissions as outcomes at t1 (six months later).

The rate of multimorbidity and polypharmacy was 87.8% and 60.3%, respectively. 15.9% of the people with cognitive impairment received PIM / PRISCUS-listed drugs, 43.6% ACB-listed drugs, and 52.7% CNS depressant drugs. Falls and hospital admissions during follow-up were prevalent in 19.4% and 24.7% of the people with cognitive impairment. Both were significantly predicted by the total number of drugs (falls OR = 1.152, p = 0.001, overall model p < 0.001; hospital admissions OR = 1.103, p = 0.020, overall model p = 0.001), even if regression analyses were controlled for the number of comorbidities.

Polypharmacy and potentially inappropriate medication are highly prevalent in people with cognitive impairment in German day-care centers. The number of drugs and appropriateness of medication seem to be crucial for the risk of falls and hospital admissions. Polypharmacy and PIM should be critically reviewed by healthcare providers and avoided as much as and whenever possible.

ISRCTN16412551, 30 July 2014, registered partly retrospectively.

ISRCTN16412551, 30 July 2014, registered partly retrospectively.

G-protein coupled receptors (GPCRs) sense and transmit extracellular signals into the intracellular machinery by regulating G proteins. GPCR malfunctions are associated with a variety of signaling-related diseases, including cancer and diabetes; at least a third of the marketed drugs target GPCRs. Thus, characterization of their signaling and regulatory mechanisms is crucial for the development of effective drugs.

In this study, we developed a machine learning model to identify GPCR agonists and antagonists. We designed two-step prediction models the first model identified the ligands binding to GPCRs and the second model classified the ligands as agonists or antagonists. Using 990 selected subset features from 5270 molecular descriptors calculated from 4590 ligands deposited in two drug databases, our model classified non-ligands, agonists, and antagonists of GPCRs, and achieved an area under the ROC curve (AUC) of 0.795, sensitivity of 0.716, specificity of 0.744, and accuracy of 0.733. www.selleckchem.com/TGF-beta.html In addition, we verified that 70% (44 out of 63) of FDA-approved GPCR-targeting drugs were correctly classified into their respective groups.

Studies of ligand-GPCR interaction recognition are important for the characterization of drug action mechanisms. Our GPCR-ligand interaction prediction model can be employed in the pharmaceutical sciences for the efficient virtual screening of putative GPCR-binding agonists and antagonists.

Studies of ligand-GPCR interaction recognition are important for the characterization of drug action mechanisms. Our GPCR-ligand interaction prediction model can be employed in the pharmaceutical sciences for the efficient virtual screening of putative GPCR-binding agonists and antagonists.

Different methods have been used to improve the imaging diagnosis of focal liver lesions (FLL). Among them, magnetic resonance imaging (MRI) has received more attention since it provides significant amount of information without radiation exposure. However, atypical imaging characteristics of FLL on MRI may complicate the differential diagnosis between benign and malignant FLL. This study aimed to compare the diagnostic value ofT1 mapping and diffusion-weighted imaging (DWI) fordifferentiating of benign and malignant FLLs.

This retrospective study enrolled 294 FLLs, including 150 benign and 144 malignant lesions. Whole liver T1 mapping sequences were obtained before and 2min after the administration of Gd-DTPA to acquire native T1 and enhanced T1 and ΔT1%. Additionally, DWI sequence was conducted to generate apparent diffusion coefficient (ADC) maps. These quantitative parameters were compared using one-way analysis of variance, and the diagnostic accuracy of T1 mapping and ADC for FLLs was calculated by I in evaluating FLLs. Native T1 shows better performance than DWI in distinguishing benign liver lesions, specifically, cysts, and haemangioma.

The 3D Variable flip angle T1 mapping technique with Gd-DTPA has a high clinical potential for identifying benign and malignant FLLs. The enhanced T1 and ΔT1% values have similar diagnostic accuracy compared with DWI in evaluating FLLs. Native T1 shows better performance than DWI in distinguishing benign liver lesions, specifically, cysts, and haemangioma.

The current study aimed to examine the association between drinking water quality and cognitive function and to identify the direct and indirect effects of drinking water quality and dyslipidemia on cognitive function among older adults in China.

Primary data for the study were selected from China Health and Retirement Longitudinal Study (CHARLS, 2015) and 4,951 respondents aged 60 and above were included. Data on drinking water quality were selected from the 2015 prefectural water quality data from the Institute of Public and Environment Affairs in China and measured by theBlue City Water Quality Index. Dyslipidemia was measured by self-reported dyslipidemia diagnosis and lipid panel. Three composite measures of cognitive function included mental status, episodic memory, and global cognition. Mixed effects models were conducted to assess the associations between drinking water quality or dyslipidemia and cognitive function. The mediation effects of dyslipidemia were examined by path analyses.

Exposure water quality could be a potential public health effort to delay the onset of cognitive impairment and prevent the dementia pandemic in older people.

Drinking water quality was associated with cognitive function in older Chinese and the relationship was independent of natural or socioeconomic variations in neighborhood environments. Improving drinking water quality could be a potential public health effort to delay the onset of cognitive impairment and prevent the dementia pandemic in older people.

Restriction of sodium intake is routinely recommended for patients with chronic kidney disease (CKD). Whether or not sodium intake is associated with the progression of CKD and mortality remains uncertain. We evaluated the association between urinary sodium excretion (as a surrogate for sodium intake) with the occurrence of renal failure and mortality in patients with non-dialytic CKD.

We conducted a retrospective study of patients followed at a CKD clinic care hospital from October 2006 to March 2017. Adult patients with non-dialytic CKD were included. Using a time-to-event analysis, we examined the association of urinary sodium excretion as a categorical variable (categorized as quintiles 1st quintile 0.54-2.51g; 2nd quintile 2.52-3.11g, 3rd quintile 3.12-3.97g, 4th quintile 3.98-5.24g and 5th quintile 5.26-13.80g) and the outcomes of interest. The primary outcome was defined as progression to end-stage renal disease requiring any type of renal replacement therapy. The secondary outcome was mortality.

Two hundred five patients were included in the study (mean follow up of 2.6years) with a mean eGFR of 26 (19-41) ml/min/1.73m2. 37 patients (18%) required renal replacement therapy and 52 (25,3%) died. There was association between urinary sodium excretion and need for renal replacement therapy (adjusted HR 0.245; 95%CI 0.660-0.912). There was no association between urinary sodium excretion and mortality in adjusted models.

Moderate sodium intake was associated with a lower risk of renal failure.

Moderate sodium intake was associated with a lower risk of renal failure.

The variation of right main stem bronchus leads to the orifice of the right upper lobe bronchus may be obstructed or increase the incidence of malposition intraoperatively when the right sided double-lumen tube is used. Therefore, the aim of this study was to compare the accuracy of three methods measured the length of the right main stem bronchus via chest computed tomography as a guide to the use of right sided double-lumen tube.

In this study, 168 adult patients undergoing left sided thoracic surgery were included. All these patients were allocated to carina-proximal (C-P) group, carina-distal (C-D) group and carina-carina (C-C) group. The position of endobronchial cuff observed via Fiberoptic bronchoscopy after successful initial placement and after turning the patients to the lateral decubitus position, as well as the incidence of malposition of right sided double-lumen tube intraoperative were recorded to assess the accuracy of three methods in predicting the position of right sided double-lumen tube.

The distance between the carina to the proximal margin of the right upper lobe orifice, carina to the distal margin of the right upper lobe orifice and carina to the first right interlobar carina of the right upper lobe orifice were 17.2 ± 2.3 mm, 25.4 ± 3.7 mm and 28.5 ± 3.1 mm (P < 0.05). In the C-D group, the number of endobronchial cuffs seen to be herniating out of the carina, the number of bronchoscopies during initial placement and on the lateral position, the number of total malposition intraoperative and the number of reposition manoeuvres intraoperative were significantly less than the C-P group or the C-C group (P < 0.05).

The length of the right main stem bronchus measured by the carina to distal margin of right upper lobe orifice method was more accurate than the other two methods in guiding the use of right sided double-lumen tube.

Clinical Trials. gov. no. NCT04127903. Registered at https//register.

gov on 16/10/2019.

gov on 16/10/2019.In 2022, researchers from around the world entered the BMC Ecology and Evolution photography competition. The contest produced a spectacular collection of photographs that capture the wonder of the natural world and the growing need to protect it as the human impact on the planet intensifies. This editorial celebrates the winning images selected by the Editor of BMC Ecology and Evolution and senior members of the journal's editorial board.

Glycated albumin (GA) is known to reflect the current inflammatory burden in non-diabetes mellitus (DM) patients. In this study, we investigated whether GA at diagnosis could reflect the cross-sectional activity and predict poor outcomes during follow-up in non-DM patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV).

The medical records of 118 immunosuppressive drug-naïve AAV patients were retrospectively reviewed, and 76 patients who had both GA and glycated haemoglobin (HbA1c) results but not DM were included in this study. Demographic, clinical, and laboratory data at diagnosis were assessed.

The median age of AAV patients was 61years, and 31 patients were male. GA was positively correlated with five-factor score (r = 0.282), Birmingham vasculitis activity score (BVAS) assigned to renal manifestation (r = 0.315), and blood urea nitrogen (r = 0.382), whereas negatively correlated with haemoglobin (r = -0.345). AAV patients with end-stage renal disease (ESRD) exhibited significantly higher GA than those without ESRD (15.