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0%), and five are moderately riskier (the unhealthy percentage is 5.0%-10.0%). Age is the most important determinant, followed by locomotor function, cognitive function, homebound, gender and residential location, in that order, which all show heterogeneous associations with the risk patterns. Conclusions The Exhaustive CHAID is suitable to derive scientifically-sound insights into an early screening of risk factors for pre-frail groups and tailor-made preventive LTC interventions for frail groups in a flexible and objective way. check details Geriatr Gerontol Int 2020; •• ••-••.Astrocytes are fundamental for maintaining brain homeostasis and are commonly involved in the progression of neurodegenerative diseases including Alzheimer's disease (AD). In response to injury or toxic material, astrocytes undergo activation that results in hypertrophy and process ramification. Although numerous studies have shown that reactive astrocytes are intimately related to the pathogenesis of AD, their characteristic features including morphological and molecular alterations that occur during different stages of AD progression remain to be elucidated. Here, we crossed astrocyte-specific reporter mice hGFAP-CreERT2;Rosa-tdTomato with APP/PS1 mice, and then used genetic tracing to characterize the morphological profiles and expression of molecular biomarkers associated with progressive β-amyloid deposits in the cortical region of AD mice. Expression of glutamine synthetase (GS) was lower in cortical reactive astrocytes, in contrast to the higher expression of glial fibrillary acidic protein, of APP/PS1 mice and AD patients relative to that in cortical astrocytes of wild-type mice and age-matched controls, respectively. GS activity was also decreased obviously in the cortex of APP/PS1 mice at 6 and 12 months of age relative to that in the wild-type mice of the same ages. Furthermore, cortical reactive astrocytes in APP/PS1 mice and AD patients did not undergo proliferation. Finally, based on RNA-sequencing analysis, we identified differentially expressed transcripts of signal transduction molecules involved in early induction of reactive astrocytes in the cortex of APP/PS1 mice. These findings provide a morphological and molecular basis with which to understand the function and mechanism of reactive astrocytes in the progression of AD.Prior to the first international consensus classification published in 1993, the clinical distinction between erythema multiforme (EM), Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) had been subject to uncertainty and controversy for more than a century. Based on this classification, the three conditions are defined by the morphology of the individual lesions and their pattern of distribution. Etiopathogenetically, the majority of EM cases is caused by infections (primarily herpes simplex virus and Mycoplasma pneumoniae), whereas SJS/TEN are predominantly triggered by drugs. The SCORTEN (score of toxic epidermal necrolysis) can and should be used to assess disease prognosis in patients with SJS/TEN. While supportive treatment is generally considered sufficient for EM, there is still uncertainty as to the type of systemic therapy required for SJS/TEN. Given the lack of high-quality therapeutic trials and (in some cases) conflicting results, it is currently impossible to issue definitive recommendations for any given immunomodulatory therapy. While there is always a trade-off between rapid onset of treatment-induced immunosuppression and an uptick in infection risk, there has been increasing evidence that cyclosporine in particular may be able to halt disease progression (i.e. skin detachment) and lower mortality rates. Assistance in diagnosis and management of the aforementioned conditions may be obtained from the Center for the Documentation of Severe Skin Reactions (dZh) at the Department of Dermatology, University Medical Center, Freiburg, Germany.Background Bone health is underdiagnosed and undermanaged in men. Bone loss occurs in men with hypogonadism and in aging men. Thus, patients with a diagnosis of late-onset hypogonadism (LOH) are at risk of osteoporosis and osteoporotic fractures. Objectives To provide an update on research data and clinical implications regarding bone health in men with LOH by reviewing literature articles on this issue. Materials and methods A thorough search of listed publications in PubMed on bone health in older men with hypogonadism was performed, and other articles derived from these publications were further identified. Results Late-onset Hypogonadism may be associated with reduced bone mineral density (BMD). In a pathophysiological perspective, the detrimental effects of testosterone (T) deficiency on BMD are partly ascribed to relative estrogen deficiency and both serum T and serum estradiol (E2) need to be above 200 ng/dL and 20 pg/mL to prevent bone loss. The effects of exogenous T on BMD are controversial, but most of the studies confirm that testosterone replacement therapy (TRT) increases BMD and prevents further bone loss in men with hypogonadism. No data are available on TRT and the prevention of fractures. Discussion and conclusion In men with documented LOH, a specific clinical workup should be addressed to the diagnosis of osteoporosis in order to program subsequent follow-up and consider specific bone active therapy. TRT should be started according to guidelines of male hypogonadism while keeping in mind that it may also have positive effects also on bone health in men with LOH.Background In recent years, there has been a significant increase in scabies infestations throughout German-speaking countries. Given the high frequency of treatment failures, the question arises as to whether topical permethrin treatment is always performed correctly. Patients and methods Our department uses a fluorescent test cream to teach patients on how to correctly apply topical permethrin. In the context of a prospective observational study of 21 patients, we systematically assessed and analyzed potential application errors. Results None of the participants succeeded in adequately applying the cream to the entire skin as previously instructed. The median number of regions left untreated was six (minimum 2; maximum 18), which included a median body surface area of 6 % (minimum 2 %; maximum 30 %). With regard to predilection sites of scabies, the ankles were left untreated in 62 % of cases, followed by the interdigital spaces (toes) (33 %) and the sacral region (24 %). All patients considered the pretreatment training to be very useful. Conclusions The present findings clearly demonstrate potential shortcomings when it comes to the application of topical antiscabies treatment. This may provide a (potentially underestimated) explanation for the large number of reports on treatment failures in this regard, which falsely suggest potential treatment resistance.Background This study reports the outcomes of a single institutional experience treating non-small cell lung cancer (NSCLC) involving the pulmonary hilum with low-dose stereotactic body radiation therapy (SBRT). The authors also present a series of repeat hilar SBRT. Methods Inclusion criteria required treatment with SBRT for NSCLC involving regional lymph nodes of the (i) hilum, (ii) mediastinum, (iii) aortopulmonary window (station 5), or (iv) mainstem bronchus. At least one clinical follow-up with imaging was required, unless the patient had a prior documented death from cancer. Results A total of 32 patients with 44 treatments were included, and 37 treatments targeted the hilum directly, with seven concerning the mediastinum, AP window, or mainstem bronchus. Median dose was 28 Gy in four fractions with once-weekly fractionation. At a median clinical follow-up of 23 months, local control was 64%. Median overall survival was 24 months, and median progression-free survival was 15 months. A total of 48% of trnd feasible Toxicity was minimal with low-dose SBRT Once-weekly fractionation may have contributed to low rate of side effects.Context No studies evaluated the prospective association between hyperglycemia assessed by laboratory measurements and the risk of mortality among patients with coronavirus disease 2019 (COVID-19). Objective We aimed to evaluate the association between different degrees of hyperglycemia and the risk of all-cause mortality among hospitalized patients with COVID-19. Design A retrospective study. Setting Union Hospital in Wuhan, China. Participants 453 patients were admitted to the hospital with laboratory-confirmed SARS-Cov-2 infection from January 22, 2020 to March 17, 2020. Main outcomes and measures Patients were classified into four categories normal glucose, hyperglycemia (fasting glucose 5.6-6.9 mmol/L and/or HbA1c 5.7-6.4%), newly diagnosed diabetes (fasting glucose ≥7 mmol/L and/or HbA1c ≥6.5%), and known diabetes. The major outcomes included in-hospital mortality, intensive care unit (ICU) admission, and invasive mechanical ventilation (IMV). Results Patients with newly diagnosed diabetes had the highest percentage to be admitted to the ICU (11.7%) and require IMV (11.7%), followed by patients with known diabetes (4.1%; 9.2%) and patients with hyperglycemia (6.2%; 4.7%), compared with patients with normal glucose (1.5%; 2.3%), respectively. The multivariable-adjusted hazard ratios of mortality among COVID-19 patients with normal glucose, hyperglycemia, newly diagnosed diabetes, and known diabetes were 1.00, 3.29 (95% confidence interval [CI] 0.65-16.6), 9.42 (95% CI 2.18-40.7), and 4.63 (95% CI 1.02-21.0), respectively. Conclusion We firstly showed that COVID-19 patients with newly diagnosed diabetes had the highest risk of all-cause mortality compared with COVID-19 patients with known diabetes, hyperglycemia and normal glucose. Patients with COVID-19 need to be under surveillance for blood glucose screening. This article is protected by copyright. All rights reserved.Background The objective of this study was to explore the association between fresh fruit consumption and long-term risk of upper gastrointestinal cancer (UGI) in the Linxian Dysplasia Nutrition Intervention Trial (NIT) cohort. Methods A cohort of 3318 subjects with esophageal squamous dysplasia participated in the Linxian Dysplasia NIT in May 1985 and were followed up until 30 September 2015. Demographic characteristics, lifestyle, and history of diseases were collected at the baseline. The primary endpoint was death from esophageal squamous cell carcinoma (ESCC), gastric cardia carcinoma (GCC), and gastric noncardia carcinoma (GNCC). Hazard ratios (HRs) and 95% confidence intervals (95% CIs) were estimated using the Cox proportional hazard model. Results In the 30-year follow-up, a total of 541 ESCC, 284 GCC, and 77 GNCC deaths occurred. Relative to those who never or rarely consumed fresh fruit, the risk of ESCC mortality in participants who consumed fresh fruit more than 12 times/year were significantly decreased by 37.3% (HR = 0.63, 95% CI 0.49-0.81). In the subgroup analyses, significantly protective effects on ESCC mortality were observed especially in females (HR = 0.59, 95% CI 0.40-0.89), non-smokers (HR = 0.67, 95% CI 0.48-0.94), and nondrinkers (HR = 0.69, 95% CI 0.51-0.93). Conclusions Consuming fresh fruit more than 12 times/year may reduce the long-term risk of ESCC mortality in this dysplasia population, particularly in females, non-smokers, and nondrinkers. Future studies are needed to confirm these findings.