Associations between nutritional status, physical performance, and disability among older Americans

Impaired functional status with aging is a major concern of the older population, limiting their daily activities, predisposing them to falls and increasing their mortality and morbidity risk. This condition also increases the admissions to nursing homes and caregiver burden. The purpose of this dissertation is to provide a better understanding of the relationship between nutritional risk factors, physical performance and disability among older Americans. This dissertation consists of three studies which used data from the National Health and Nutrition Examination Surveys (NHANES). The first study examined the association between overall diet quality, as measured by the United States Department of Agriculture’s (USDA) Healthy Eating Index-2005 (HEI-2005), and physical performance, as measured by gait speed and knee extensor power, among adults ≥ 50 y. Older adults with higher HEI-2005 scores had a faster gait speed compared to those with the lowest HEI-2005 score (1.03 and 1.04 m/s in quartiles three and four, respectively, vs. 1.00 m/s in quartile one; both p < 0.05). For knee extensor power, those with the highest HEI-2005 scores had greater knee extensor power compared to those with the lowest HEI-2005 scores (1.60 W/kg in quartile four vs. 1.50 W/kg in quartile one; p = 0.03). The second study examined the association between overall diet quality, measured by HEI-2005, and self-reported disability among adults aged 60 and older. Self-reported measures of disability included activities of daily living (ADLs), instrumental activities of daily living (IADLs), leisure and social activities (LSAs), lower extremity mobility (LEM), and general physical activities (GPAs). Older adults with higher HEI-2005 scores were less likely to experience LEM disability (p for trend < 0.001) and GPAs disability (p for trend < 0.001). Compared to older adults whose HEI-2005 scores were in the lowest quartile, the likelihood of both LEM and GPA disability were significantly lower in individuals whose scores were in quartiles two, three, and four. Compared to those who had HEI-2005 scores in the lowest quartile, the odds of IADLs disability were significantly lower in older adults whose scores were in quartile two and three. The third study examined the association between food insecurity and physical performance including gait speed and knee extensor power, among adults aged 50 and older. Responses to the US Household Food Security Survey Module (HFSSM) were used to assign participants to study food security categories. The association between food insecurity and gait speed varied by smoking status (p = 0.005). For non-smokers, those who were marginally food secure (0.91 m/s, p = 0.016) and food insecure (0.94 m/s, p = 0.004) had significantly slower gait speeds than food secure participants (1.04 m/s). No statistically significant associations were observed for both current and former smokers. Similar findings were observed for knee extensor power. These results suggest the ensuing proper nutritional status and being nonsmokers are vital to maintain the functional status among older adults. More studies are needed to understand the complex factors that influence the nutritional and functional status of older adults to reduce healthcare costs and enhance quality of life

Dynamic safety assessment of a nonlinear pumped-storage generating system in a transient process

This paper focuses on a pumped-storage generating system with a reversible Francis turbine and presents an innovative framework for safety assessment in an attempt to overcome their limitations. Thus the aim is to analyze the dynamic safety process and risk probability of the above nonlinear generating system. This study is carried out based on an existing pumped-storage power station. In this paper we show the dynamic safety evaluation process and risk probability of the nonlinear generating system using Fisher discriminant method. A comparison analysis for the safety assessment is performed between two different closing laws, namely the separate mode only to include a guide vane and the linkage mode that includes a guide vane and a ball valve. We find that the most unfavorable condition of the generating system occurs in the final stage of the load rejection transient process. It is also demonstrated that there is no risk to the generating system with the linkage mode but the risk probability of the separate mode is 6 percent. The results obtained are in good agreement with the actual operation of hydropower stations. The developed framework may not only be adopted for the applications of the pumped-storage generating system with a reversible Francis turbine but serves as the basis for the safety assessment of various engineering applications.National Natural Science Foundation of ChinaFundamental Research Funds for the Central UniversitiesScientific research funds of Northwest A&F UniversityScience Fund for Excellent Young Scholars from Northwest A&F University and Shaanxi Nova progra

Efficient Point based Global Illumination on Intel MIC Architecture

International audiencePoint-Based Global Illumination (PBGI) is a popular rendering method in special effects and motion picture productions. The tree-cut computation is in general the most time consuming part of this algorithm, but it can be formulated for efficient parallel execution, in particular regarding wide-SIMD hardware. In this context, we propose several vectorization schemes, namely single, packet and hybrid, to maximize the utilization of modern CPU architectures. While for the single scheme, 16 nodes from the hierarchy are processed for a single receiver in parallel, the packet scheme handles one node for 16 receivers. These two schemes work well for scenes having smooth geometry and diffuse material. When the scene contains high frequency bumps maps and glossy reflections, we use a hybrid vectorization method. We conduct experiments on an Intel Many Integrated Corearchitecture and report preliminary results on several scenes, showing that up to a 3x speedup can be achieved when compared with non-vectorized execution

Nandao-Questions as a Special Kind of Rhetorical Questions

This paper addresses the syntax and semantics of a special kind of Rhetorical Questions (RQs) in Mandarin, i.e. questions with nandao (nandao-Q). Nandao-Qs necessarily have rhetorical question readings. To derive this, I propose that nandao is a WH-word which takes a question denoting a single proposition and turns it into a set with the complement proposition. This analysis differs significantly from earlier proposals for deriving RQ meanings as asserting the negation of the proposition denoted by its IP (cf. Sadock 1979, Han 2002, a.o.). The degenerate question nature of nandao-Q can explain why nandao-Q unlike Ordinary Questions (OQs) cannot be embedded under [+wh] selecting words like wen and zhidao

Estrogens promote misfolded proinsulin degradation to protect insulin production and delay diabetes

Summary: Conjugated estrogens (CE) delay the onset of type 2 diabetes (T2D) in postmenopausal women, but the mechanism is unclear. In T2D, the endoplasmic reticulum (ER) fails to promote proinsulin folding and, in failing to do so, promotes ER stress and β cell dysfunction. We show that CE prevent insulin-deficient diabetes in male and in female Akita mice using a model of misfolded proinsulin. CE stabilize the ER-associated protein degradation (ERAD) system and promote misfolded proinsulin proteasomal degradation. This involves activation of nuclear and membrane estrogen receptor-α (ERα), promoting transcriptional repression and proteasomal degradation of the ubiquitin-conjugating enzyme and ERAD degrader, UBC6e. The selective ERα modulator bazedoxifene mimics CE protection of β cells in females but not in males. : Estrogens prevent diabetes in women, but the mechanism is poorly understood. Xu et al. report that estrogens activate the endoplasmic-reticulum-associated protein degradation pathway, which promotes misfolded proinsulin degradation, suppresses endoplasmic reticulum stress, and protects insulin secretion in mice and in human pancreatic β cells. Keywords: estrogens, beta cell, islet, endoplasmic reticulum stress, proinsulin misfolding, diabetes, bazedoxifene, sex dimorphism, ERAD, SER

Dynamic evolution of a hydraulic-mechanical-electric system with randomly fluctuating speed based on Chebyshev polynomial approximation method

The research proposed in this paper focuses on the dynamic evolution of a hydraulic-mechanical-electric system under the effect of randomly fluctuating speed. The rapid growth of installed wind power capacity may potentially affect the stability of power grids, causing larger fluctuations of the generator speed to hydropower stations. In this work, a probabilistic component is associated to the generator speed of a deterministic hydraulic-mechanical-electric system providing a novel random model. This latter is analyzed to investigate the dynamic evolution of the system adopting the Chebyshev polynomial approximation method. A careful comparison of the numerical application results obtained by the deterministic and the probabilistic approaches is carried out. In addition, the influence of the fluctuation intensity (D) on the differential gain (kd) of the PID is investigated, proposing a law for kd as function of D. Finally, the operating ranges of the grid water hammer and of the elastic water hammer models are compared in order to validate the consistence of the law. The results of the study provide robust bases for the stable and safe operation of hydropower stations.National Natural Science Foundation of ChinaFundamental Research Funds for the Central UniversitiesNorthwest A&F Universit

The Relationship between Serum Osteocalcin Concentration and Glucose Metabolism in Patients with Type 2 Diabetes Mellitus

To study the correlations between serum osteocalcin and glucose metabolism in patients with type 2 diabetes, 66 cases were collected to determine total osteocalcin, undercarboxylated osteocalcin, fasting blood glucose, fasting insulin, and HbA1c. Osteocalcin concentrations were compared between groups of different levels of HbA1c, and parameters of glucose metabolism were compared between groups of different levels of total osteocalcin and undercarboxylated osteocalcin. The relationship between osteocalcin and parameters of glucose metabolism was also analyzed. We found that the total osteocalcin concentration of high-HbA1c group was significantly lower than that of low-HbA1c group. The fasting blood glucose of low-total-osteocalcin group was significantly higher than that of high-total-osteocalcin group in male participants, while the fasting blood glucose of low-undercarboxylated-osteocalcin group was significantly higher than that of high-undercarboxylated-osteocalcin group in all participants and in male participants. Total osteocalcin was inversely correlated with HbA1c, and undercarboxylated osteocalcin was inversely correlated with fasting blood glucose. However, no significant correlation was found between osteocalcin and HOMA-IR. Total osteocalcin was an independent related factor of HbA1c level. In summary, decreased serum total osteocalcin and undercarboxylated osteocalcin are closely related to the exacerbation of glucose metabolism disorder but have no relations with insulin resistance

Extending access to essential services against constraints: the three-tier health service delivery system in rural China (1949-1980).

BACKGROUND: China has made remarkable progress in scaling up essential services during the last six decades, making health care increasingly available in rural areas. This was partly achieved through the building of a three-tier health system in the 1950s, established as a linked network with health service facilities at county, township and village level, to extend services to the whole population. METHODS: We developed a Theory of Change to chart the policy context, contents and mechanisms that may have facilitated the establishment of the three-tier health service delivery system in rural China. We systematically synthesized the best available evidence on how China achieved universal access to essential services in resource-scarce rural settings, with a particular emphasis on the experiences learned before the 1980s, when the country suffered a particularly acute lack of resources. RESULTS: The search identified only three peered-reviewed articles that fit our criteria for scientific rigor. We therefore drew extensively on government policy documents, and triangulated them with other publications and key informant interviews. We found that China's three-tier health service delivery system was established in response to acute health challenges, including high fertility and mortality rates. Health system resources were extremely low in view of the needs and insufficient to extend access to even basic care. With strong political commitment to rural health and a "health-for-all" policy vision underlying implementation, a three-tier health service delivery model connecting villages, townships and counties was quickly established. We identified several factors that contributed to the success of the three-tier system in China: a realistic health human resource development strategy, use of mass campaigns as a vehicle to increase demand, an innovative financing mechanisms, public-private partnership models in the early stages of scale up, and an integrated approach to service delivery. An implementation process involving gradual adaptation and incorporation of the lessons learnt was also essential. CONCLUSIONS: China's 60 year experience in establishing a de-professionalized, community-based, health service delivery model that is economically feasible, institutionally and culturally appropriate mechanism can be useful to other low- and middle-income countries (LMICs) seeking to extend essential services. Lessons can be drawn from both reform content and from its implementation pathway, identifying the political, institutional and contextual factors shaping the three-tier delivery model over time

Real-Time Purchase Prediction Using Retail Video Analytics

The proliferation of video data in retail marketing brings opportunities for researchers to study customer behavior using rich video information. Our study demonstrates how to understand customer behavior of multiple dimensions using video analytics on a scalable basis. We obtained a unique video footage data collected from in-store cameras, resulting in approximately 20,000 customers involved and over 6,000 payments recorded. We extracted features on the demographics, appearance, emotion, and contextual dimensions of customer behavior from the video with state-of-the-art computer vision techniques and proposed a novel framework using machine learning and deep learning models to predict consumer purchase decision. Results showed that our framework makes accurate predictions which indicate the importance of incorporating emotional response into prediction. Our findings reveal multi-dimensional drivers of purchase decision and provide an implementable video analytics tool for marketers. It shows possibility of involving personalized recommendations that would potentially integrate our framework into omnichannel landscape

Photoluminescence from Bi5(GaCl4)3 molecular crystal

Bi5(GaCl4)3 sample has been synthesized through the oxidation of Bi metal by gallium chloride (GaCl3) salt. Powder X-ray diffraction as well as micro-Raman scattering results revealed that, in addition to crystalline Bi5(GaCl4)3 in the product, amorphous phase containing [GaCl4]- and [Ga2Cl7]- units also exist. The thorough comparison of steady-state and time-resolved photoluminescent behaviors between Bi5(GaCl4)3 product and Bi5(AlCl4)3 crystal leads us to conclude that Bi53+ is the dominant emitter in the product, which gives rise to the ultrabroad emission ranging from 1 to 2.7 micrometer. Detailed quantum chemistry calculation helps us assign the observed excitations to some electronic transitions of Bi53+ polycation, especially at shorter wavelengths. It is believed that our work shown here not only is helpful to solve the confusions on the luminescent origin of bismuth in other material systems, but also serves to develop novel broadband tunable laser materials