Hospitalization-Associated Change in Gait Speed and Risk of Functional Limitations for Older Adults

BACKGROUND: Hospitalization-associated functional decline is a common problem for older adults, but it is unclear how hospitalizations affect physical performance measures such as gait speed. We sought to determine hospitalization-associated change in gait speed and likelihood of new limitations in mobility and activities of daily living (ADLs). METHODS: We used longitudinal data over 5 years from the Health, Aging and Body Composition Study, a prospective cohort of black and white community-dwelling men and women, aged 70-79 years, who had no limitations in mobility (difficulty walking 1/4 mile or climbing 10 steps) or ADLs (transferring, bathing, dressing, and eating) at baseline. Gait speed, and new self-reported limitations in mobility and ADLs were assessed annually. Selected participants (n = 2,963) had no limitations at the beginning of each 1-year interval. Hospitalizations were self-reported every 6 months and verified with medical record data. Generalized estimating equations were used to examine hospitalization-associated change in gait speed and odds of new limitations over each 1-year interval. Fully adjusted models included demographics, hospitalization within the past year, health conditions, symptoms, body mass index, and health-related behaviors. RESULTS: In fully adjusted models, any hospitalization was associated with decrease in gait speed (-0.04 m/s; 95% confidence interval [CI]: -0.05 to -0.03) and higher odds of new limitations in mobility or ADLs (odds ratio = 1.97, 95% CI: 1.70-2.28), and separately with increased odds of new mobility limitation (odds ratio = 2.22, 95% CI: 1.90-2.60) and new ADL limitations (odds ratio = 1.84, 95% CI: 1.53-2.21). Multiple hospitalizations within a year were associated with gait speed decline (-0.06 m/s; 95% CI: -0.08 to -0.04) and greater odds of new limitations in mobility or ADLs (odds ratio = 2.96, 95% CI: 2.23-3.95). CONCLUSIONS: Functionally independent older adults experienced hospitalization-associated declines in gait speed and new limitations in mobility and ADLs

Aquatic emergency preparedness and response system in Viet Nam

Viet Nam is one of the top worldwide producers of aquaculture products which accounts for about 22 percent of total agricultural GDP of Viet Nam. Recently, diseases have become the biggest challenge for global aquaculture development therefore the Vietnamese government has paid close attention to develop an effective aquatic emergency preparedness and response system to timely deal with disease introduction and outbreaks. The Department of Animal Health (DAH), under the Ministry of Agriculture and Rural Development (MARD), which is the competent authority of aquatic animal health management. To monitor transboundary diseases (especially the OIE-listed diseases), the current Vietnamese regulations only allow import of aquatic animals and its products which are certified as disease-free by competent authority of exporting country, and export aquatic animals and its products complying with importing conditions of importing country. Regional Animal Health Offices (belong to DAH) shall carry out sampling for testing pathogens and isolation for imported aquatic animals and its products as regulated in Circular 26/2016/TT-BNNPTNT dated 30 June 2016 before granting permit to import or export. For domestic transportation of aquatic animals, provincial sub DAH is responsible for monitoring infectious pathogens to certify disease-free status of aquatic animals before issuing health certificate for movement. In addition, a reporting and response system to aquatic animal diseases was established in the country from farm level to central level (DAH). Early detection and warning of diseases is critical for disease prevention and control, thus since 2014, the DAH has implemented national surveillance programs focusing on dangerous diseases in the key farming species (brackish-water shrimps, pangasius catfish) according to Circular 04/2016/TT-BNNPTNT dated 10 May 2016 of MARD and support exportation of aquatic animals and its products complying with international regulations and importing countries based on OIE recommendations and Circular 14/2016/TT-BNNPTNT dated 2 June 2016

Extraction of anthocyanins from Butterfly pea (Clitoria ternatea L. Flowers) in Southern Vietnam: Response surface modeling for optimization of the operation conditions

In this paper, the Response Surface Methodology (RSM), in conjunction with Central Composite Design (CCD), was used to optimize the extraction of anthocyanins from Butterfly pea (Clitoria ternatea L.Flowers) cultivated in Southern Vietnam. The effect of extraction temperatures of solvent ethanol (50-70 °C), duration of extraction (40-50 min) and solid-liquid ratios (20:1-30:1) was measured as independent variables on the total extraction anthocyanins in the response function. The highest anthocyanin content of 132.756 mg/L of butterfly pea anthocyanin was collected at the solid liquid ratio of 23:1, extraction time of 46 min, and temperature 60.6°C. Butterfly pea anthocyanins yield detailed significant correlation with high F values, low P values (<0.0001), and desirable determination coefficient (R2 = 0.9994)

Associations of Underlying Health Conditions With Anxiety and Depression Among Outpatients: Modification Effects of Suspected COVID-19 Symptoms, Health-Related and Preventive Behaviors

Objectives: We explored the association of underlying health conditions (UHC) with depression and anxiety, and examined the modification effects of suspected COVID-19 symptoms (S-COVID-19-S), health-related behaviors (HB), and preventive behaviors (PB).Methods: A cross-sectional study was conducted on 8,291 outpatients aged 18–85 years, in 18 hospitals and health centers across Vietnam from 14th February to May 31, 2020. We collected the data regarding participant's characteristics, UHC, HB, PB, depression, and anxiety.Results: People with UHC had higher odds of depression (OR = 2.11; p &lt; 0.001) and anxiety (OR = 2.86; p &lt; 0.001) than those without UHC. The odds of depression and anxiety were significantly higher for those with UHC and S-COVID-19-S (p &lt; 0.001); and were significantly lower for those had UHC and interacted with “unchanged/more” physical activity (p &lt; 0.001), or “unchanged/more” drinking (p &lt; 0.001 for only anxiety), or “unchanged/healthier” eating (p &lt; 0.001), and high PB score (p &lt; 0.001), as compared to those without UHC and without S-COVID-19-S, “never/stopped/less” physical activity, drinking, “less healthy” eating, and low PB score, respectively.Conclusion: S-COVID-19-S worsen psychological health in patients with UHC. Physical activity, drinking, healthier eating, and high PB score were protective factors

Albiglutide and cardiovascular outcomes in patients with type 2 diabetes and cardiovascular disease (Harmony Outcomes): a double-blind, randomised placebo-controlled trial

Background: Glucagon-like peptide 1 receptor agonists differ in chemical structure, duration of action, and in their effects on clinical outcomes. The cardiovascular effects of once-weekly albiglutide in type 2 diabetes are unknown. We aimed to determine the safety and efficacy of albiglutide in preventing cardiovascular death, myocardial infarction, or stroke. Methods: We did a double-blind, randomised, placebo-controlled trial in 610 sites across 28 countries. We randomly assigned patients aged 40 years and older with type 2 diabetes and cardiovascular disease (at a 1:1 ratio) to groups that either received a subcutaneous injection of albiglutide (30–50 mg, based on glycaemic response and tolerability) or of a matched volume of placebo once a week, in addition to their standard care. Investigators used an interactive voice or web response system to obtain treatment assignment, and patients and all study investigators were masked to their treatment allocation. We hypothesised that albiglutide would be non-inferior to placebo for the primary outcome of the first occurrence of cardiovascular death, myocardial infarction, or stroke, which was assessed in the intention-to-treat population. If non-inferiority was confirmed by an upper limit of the 95% CI for a hazard ratio of less than 1·30, closed testing for superiority was prespecified. This study is registered with ClinicalTrials.gov, number NCT02465515. Findings: Patients were screened between July 1, 2015, and Nov 24, 2016. 10 793 patients were screened and 9463 participants were enrolled and randomly assigned to groups: 4731 patients were assigned to receive albiglutide and 4732 patients to receive placebo. On Nov 8, 2017, it was determined that 611 primary endpoints and a median follow-up of at least 1·5 years had accrued, and participants returned for a final visit and discontinuation from study treatment; the last patient visit was on March 12, 2018. These 9463 patients, the intention-to-treat population, were evaluated for a median duration of 1·6 years and were assessed for the primary outcome. The primary composite outcome occurred in 338 (7%) of 4731 patients at an incidence rate of 4·6 events per 100 person-years in the albiglutide group and in 428 (9%) of 4732 patients at an incidence rate of 5·9 events per 100 person-years in the placebo group (hazard ratio 0·78, 95% CI 0·68–0·90), which indicated that albiglutide was superior to placebo (p&lt;0·0001 for non-inferiority; p=0·0006 for superiority). The incidence of acute pancreatitis (ten patients in the albiglutide group and seven patients in the placebo group), pancreatic cancer (six patients in the albiglutide group and five patients in the placebo group), medullary thyroid carcinoma (zero patients in both groups), and other serious adverse events did not differ between the two groups. There were three (&lt;1%) deaths in the placebo group that were assessed by investigators, who were masked to study drug assignment, to be treatment-related and two (&lt;1%) deaths in the albiglutide group. Interpretation: In patients with type 2 diabetes and cardiovascular disease, albiglutide was superior to placebo with respect to major adverse cardiovascular events. Evidence-based glucagon-like peptide 1 receptor agonists should therefore be considered as part of a comprehensive strategy to reduce the risk of cardiovascular events in patients with type 2 diabetes. Funding: GlaxoSmithKline

Association of mast cell-derived VEGF and proteases in dengue shock syndrome

Background: Recent in-vitro studies have suggested that mast cells are involved in Dengue virus infection. To clarify the role of mast cells in the development of clinical Dengue fever, we compared the plasma levels of several mast cell-derived mediators (vascular endothelial cell growth factor [VEGF], soluble VEGF receptors [sVEGFRs], tryptase, and chymase) and -related cytokines (IL-4, -9, and -17) between patients with differing severity of Dengue fever and healthy controls. Methodology/Principal Findings: The study was performed at Children\u27s Hospital No. 2, Ho Chi Minh City, and Vinh Long Province Hospital, Vietnam from 2002 to 2005. Study patients included 103 with Dengue fever (DF), Dengue hemorrhagic fever (DHF), and Dengue shock syndrome (DSS), as diagnosed by the World Health Organization criteria. There were 189 healthy subjects, and 19 febrile illness patients of the same Kinh ethnicity. The levels of mast cell-derived mediators and -related cytokines in plasma were measured by ELISA. VEGF and sVEGFR-1 levels were significantly increased in DHF and DSS compared with those of DF and controls, whereas sVEGFR-2 levels were significantly decreased in DHF and DSS. Significant increases in tryptase and chymase levels, which were accompanied by high IL-9 and -17 concentrations, were detected in DHF and DSS patients. By day 4 of admission, VEGF, sVEGFRs, and proteases levels had returned to similar levels as DF and controls. In-vitro VEGF production by mast cells was examined in KU812 and HMC-1 cells, and was found to be highest when the cells were inoculated with Dengue virus and human Dengue virus-immune serum in the presence of IL-9. Conclusions: As mast cells are an important source of VEGF, tryptase, and chymase, our findings suggest that mast cell activation and mast cell-derived mediators participate in the development of DHF. The two proteases, particularly chymase, might serve as good predictive markers of Dengue disease severity

Effect of various factors on extraction efficiency of total anthocyanins from Butterfly pea (Clitoria ternatea L. Flowers) in Southern Vietnam

Nowadays, anthocyanins have become an interesting topic of much scientific research and act as potential sources of eco-friendly natural food dyes and their helpful effects on human health.. The purpose of the present article was to apply conventional extraction methods of pigments from Butterfly pea (Clitoria ternatea L.Flowers) in Southern Vietnam were tested to extract anthocyanins. The effects of various factors, including the solvent concentration, extraction time, temperature, and solvent/material ratio on the extraction total anthocyanins from Butterfly pea were investigated. In this study, the concentration of monomeric anthocyanins was completed by the spectrophotometry pH differential method.The highest recovered anthocyanin level was achieved with 50 % ethanol (143.49 mg/L), while the lowest one was obtained with water (90.9 mg/L). The extraction yield was significantly affected by temperature and the excellent condition was 60°C. The extraction yield raised with increasing of solvent/material ratio until equilibrium has arrived at the optimal ratio of 25:1 (mL/g). The extraction yield increased first and then decreased with an extension in time values

Testing the Ortec's Isotopic and Eberlines Snap software for Uranium waste measurements

Uranium enrichment plants normally generate lots of wastes. The wastes are in various matrices such as clothing, glass, concrete, aluminum, and steel, etc. They are in the quantity of a few grams to many kilograms and generally stored in 55-gallon drums. For accountability, it is important to determine the amount of uranium in the waste drums to a certain level of accuracy. There are several commercially available systems that can accurately determine the uranium mass in the waste drums, such as Tomographic-Gamma-Scanner1 (TGS) or Segmented Gamma-Ray Scanner2 (SGS). However, those systems are too cumbersome and expensive. Cheap and simple single detector systems are also available commercially from several companies. The workhorse of these systems is the software, which would work with any germanium detector system. We mocked up waste drums containing several hundred grams to several kilograms of uranium with different isotopic compositions in various matrices. We acquired data using a coaxial germanium detector. We tested two different software codes from two companies, the Ortec's Isotopic software and the Eberline's Snap software. The results with the germanium detector were very encouraging, which led us to test with the NaI detectors. The NaI detectors have much worse resolution than the germanium detectors. However, they are very cheap, can be very large in detector size and, thus, efficient for a given counting time, and are simpler because of not requiring liquid nitrogen for cooling. The results, advantages, and disadvantages of the two software codes and the two detector systems will be discussed