Investigation on Satisfaction among Elderly Residents of Senior Homes in China from a Social Marketing Perspective

Background: An aging society is a challenge for China with over 200 million adults aged over 60.  In respond to the growing aging population, senior homes become inevitable care model for frail older adults in China.  However, current senior homes seldom consider elderly special needs in their design, construction and operation stages which induce the low level of satisfaction.  Hence, this paper introduces social marketing concept into the senior homes for improving elderly satisfaction.  By adopting social marketing, operators of senior homes provide product (including built environment, healthcare services, social activities and so on) and set price in order to achieve positive behavior of the elders (i.e., satisfaction).Methods: To achieve this, questionnaire survey was conducted with 248 elderly respondents living in senior homes over than 6 months.  Several statistical methods including descriptive analysis, correlation analysis and multiple regression modeling were used to analyze quantitative data.Results: The results identified nine social marketing variables including charge rate, built environment, daily caring services, catering services, medical treatment, cleanliness, recreation activities, library and seminar.  Current findings indicated that (1) most senior homes in China pay attention to improve living environment and healthcare services, but might ignore the importance of charge rate and social activities; (2) all social marketing variables were significantly positively related to elderly satisfaction on senior homes; and (3) charge rate, built environment, daily caring services, catering services, medical services and cleanliness exert positive impact on overall satisfaction of elderly residents.  Conclusion: Social marketing as a growing applied approach in healthcare industry is innovatively introduced to senior homes in China.  By adopting social marketing, Chinese senior homes should investigate elders’ special needs and requirements and provide appropriate living environment and caring services. Keywords: China; Elders; Satisfaction; Senior Homes; Social Marketin

Prediction of Drug-Target Interactions and Drug Repositioning via Network-Based Inference

Drug-target interaction (DTI) is the basis of drug discovery and design. It is time consuming and costly to determine DTI experimentally. Hence, it is necessary to develop computational methods for the prediction of potential DTI. Based on complex network theory, three supervised inference methods were developed here to predict DTI and used for drug repositioning, namely drug-based similarity inference (DBSI), target-based similarity inference (TBSI) and network-based inference (NBI). Among them, NBI performed best on four benchmark data sets. Then a drug-target network was created with NBI based on 12,483 FDA-approved and experimental drug-target binary links, and some new DTIs were further predicted. In vitro assays confirmed that five old drugs, namely montelukast, diclofenac, simvastatin, ketoconazole, and itraconazole, showed polypharmacological features on estrogen receptors or dipeptidyl peptidase-IV with half maximal inhibitory or effective concentration ranged from 0.2 to 10 µM. Moreover, simvastatin and ketoconazole showed potent antiproliferative activities on human MDA-MB-231 breast cancer cell line in MTT assays. The results indicated that these methods could be powerful tools in prediction of DTIs and drug repositioning

Canagliflozin and Cardiovascular and Renal Outcomes in Type 2 Diabetes Mellitus and Chronic Kidney Disease in Primary and Secondary Cardiovascular Prevention Groups

Background: Canagliflozin reduces the risk of kidney failure in patients with type 2 diabetes mellitus and chronic kidney disease, but effects on specific cardiovascular outcomes are uncertain, as are effects in people without previous cardiovascular disease (primary prevention). Methods: In CREDENCE (Canagliflozin and Renal Events in Diabetes With Established Nephropathy Clinical Evaluation), 4401 participants with type 2 diabetes mellitus and chronic kidney disease were randomly assigned to canagliflozin or placebo on a background of optimized standard of care. Results: Primary prevention participants (n=2181, 49.6%) were younger (61 versus 65 years), were more often female (37% versus 31%), and had shorter duration of diabetes mellitus (15 years versus 16 years) compared with secondary prevention participants (n=2220, 50.4%). Canagliflozin reduced the risk of major cardiovascular events overall (hazard ratio [HR], 0.80 [95% CI, 0.67-0.95]; P=0.01), with consistent reductions in both the primary (HR, 0.68 [95% CI, 0.49-0.94]) and secondary (HR, 0.85 [95% CI, 0.69-1.06]) prevention groups (P for interaction=0.25). Effects were also similar for the components of the composite including cardiovascular death (HR, 0.78 [95% CI, 0.61-1.00]), nonfatal myocardial infarction (HR, 0.81 [95% CI, 0.59-1.10]), and nonfatal stroke (HR, 0.80 [95% CI, 0.56-1.15]). The risk of the primary composite renal outcome and the composite of cardiovascular death or hospitalization for heart failure were also consistently reduced in both the primary and secondary prevention groups (P for interaction >0.5 for each outcome). Conclusions: Canagliflozin significantly reduced major cardiovascular events and kidney failure in patients with type 2 diabetes mellitus and chronic kidney disease, including in participants who did not have previous cardiovascular disease

Canagliflozin and renal outcomes in type 2 diabetes and nephropathy

BACKGROUND Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to <90 ml per minute per 1.73 m2 of body-surface area and albuminuria (ratio of albumin [mg] to creatinine [g], >300 to 5000) and were treated with renin–angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of <15 ml per minute per 1.73 m2), a doubling of the serum creatinine level, or death from renal or cardiovascular causes. Prespecified secondary outcomes were tested hierarchically. RESULTS The trial was stopped early after a planned interim analysis on the recommendation of the data and safety monitoring committee. At that time, 4401 patients had undergone randomization, with a median follow-up of 2.62 years. The relative risk of the primary outcome was 30% lower in the canagliflozin group than in the placebo group, with event rates of 43.2 and 61.2 per 1000 patient-years, respectively (hazard ratio, 0.70; 95% confidence interval [CI], 0.59 to 0.82; P=0.00001). The relative risk of the renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes was lower by 34% (hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P<0.001), and the relative risk of end-stage kidney disease was lower by 32% (hazard ratio, 0.68; 95% CI, 0.54 to 0.86; P=0.002). The canagliflozin group also had a lower risk of cardiovascular death, myocardial infarction, or stroke (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P=0.01) and hospitalization for heart failure (hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P<0.001). There were no significant differences in rates of amputation or fracture. CONCLUSIONS In patients with type 2 diabetes and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years

VB₁ Promoted Green Synthesis of Chalcones and Its Neuroprotection Potency Evaluation

For the first time, thiamine hydrochloride (VB1) has been employed as a catalyst for the synthesis of chalcones by metal-free Claisen–Schmidt condensation. Such an environmentally benign approach has several advantages such as a wide range of functional groups tolerance, a high yield of products, and the recoverability of this catalyst. Moreover, this unprecedented methodology enables the synthesis of the pharmaceutically important molecule 2′,4′-dihydroxy-6′-methoxy-3′,5′-dimethylchalcone (3f) and its derivatives. Moreover, 3f and its derivatives were screened for their preliminary in vitro neuroprotective activity against oxygen-glucose deprivation/reoxygenation (OGD/R)-induced apoptosis in SH-SY5Y cell lines. Most of the compounds exhibited the neuroprotective activity, and one of the prepared chalcones (3s), which incorporates prenyl moiety, showed the most potency by decreasing the expression of cleaved caspase-3, cleaved caspase-9, Bax, and p53 protein