Frailty is defined as a reduced physiologic reserve vulnerable to external stressors. For older individuals, frailty plays a decisive role in increasing adverse health outcomes in most clinical ...situations. Many tools or criteria have been introduced to define frailty in recent years, and the definition of frailty has gradually converged into several consensuses. Frail older adults often have multi-domain risk factors in terms of physical, psychological, and social health. Comprehensive geriatric assessment (CGA) is the process of identifying and quantifying frailty by examining various risky domains and body functions, which is the basis for geriatric medicine and research. CGA provides physicians with information on the reversible area of frailty and the leading cause of deterioration in frail older adults. Therefore frailty assessment based on understanding CGA and its relationship with frailty, can help establish treatment strategies and intervention in frail older adults. This review article summarizes the recent consensus and evidence of frailty and CGA.
We study why firms voluntarily create and use finance committees and whether firms realize benefits. Firms are more likely to have a finance committee when they have defined benefit pension plans, ...debt equity issuance and active dividend payout. Capital expenditures, restructuring, material weaknesses in internal controls and restatements are drivers of creating a finance committee. While we find a weak association between finance committee use and financial performance on average, we find that finance committees that are highly independent have better‐performing investments. Finance committees contribute to lowering the cost of debt for firms with small audit committees.
Parkinson's disease (PD) is a progressive neurodegenerative disease characterized by the loss of dopaminergic neurons in the substantia nigra (SN) and the reduction of dopamine levels in the ...striatum. Although details of the molecular mechanisms underlying dopaminergic neuronal death in PD remain unclear, neuroinflammation is also considered a potent mediator in the pathogenesis and progression of PD. In the present study, we present evidences that microglial NLRP3 inflammasome activation is critical for dopaminergic neuronal loss and the subsequent motor deficits in the 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) mouse model of PD. Specifically, NLRP3 deficiency significantly reduces motor dysfunctions and dopaminergic neurodegeneration of MPTP-treated mice. Furthermore, NLRP3 deficiency abolishes MPTP-induced microglial recruitment, interleukin-1β production and caspase-1 activation in the SN of mouse brain. In primary microglia and mixed glial cell cultures, MPTP/ATP treatment promotes the robust assembly and activation of the NLRP3 inflammasome via producing mitochondrial reactive oxygen species. Consistently, 1-methyl-4-phenyl-pyridinium (MPP
) induces NLRP3 inflammasome activation in the presence of ATP or nigericin treatment in mouse bone-marrow-derived macrophages. These findings reveal a novel priming role of neurotoxin MPTP or MPP
for NLRP3 activation. Subsequently, NLRP3 inflammasome-active microglia induces profound neuronal death in a microglia-neuron co-culture model. Furthermore, Cx3Cr1
-based microglia-specific expression of an active NLRP3 mutant greatly exacerbates motor deficits and dopaminergic neuronal loss of MPTP-treated mice. Taken together, our results indicate that microglial NLRP3 inflammasome activation plays a pivotal role in the MPTP-induced neurodegeneration in PD.
This letter reports a performance analysis of a dual-hop relay system composed of asymmetric radio-frequency and free-space optics (RF/FSO) links. This approach is based on the fact that FSO links ...can provide even wider bandwidths as compared to RF ones. In particular, an exact closed-form expression for the end-to-end outage probability of the RF/FSO relay links is derived. Overall, the RF/FSO links show a slightly worse performance than the RF/RF links, but the performance gap is gradually reduced as the signal-to-noise ratio (SNR) increases. Our mathematical analysis results were verified by exactly matching Monte Carlo simulation results.
Iterative reconstruction degrades image quality. Thus, further advances in image reconstruction are necessary to overcome some limitations of this technique in low-dose computed tomography (LDCT) ...scan of the chest. Deep-learning image reconstruction (DLIR) is a new method used to reduce dose while maintaining image quality. The purposes of this study was to evaluate image quality and noise of LDCT scan images reconstructed with DLIR and compare with those of images reconstructed with the adaptive statistical iterative reconstruction-Veo at a level of 30% (ASiR-V 30%).
This retrospective study included 58 patients who underwent LDCT scan for lung cancer screening. Datasets were reconstructed with ASiR-V 30% and DLIR at medium and high levels (DLIR-M and DLIR-H, respectively). The objective image signal and noise, which represented mean attenuation value and standard deviation in Hounsfield units for the lungs, mediastinum, liver, and background air, and subjective image contrast, image noise, and conspicuity of structures were evaluated. The differences between CT scan images subjected to ASiR-V 30%, DLIR-M, and DLIR-H were evaluated.
Based on the objective analysis, the image signals did not significantly differ among ASiR-V 30%, DLIR-M, and DLIR-H (
= 0.949, 0.737, 0.366, and 0.358 in the lungs, mediastinum, liver, and background air, respectively). However, the noise was significantly lower in DLIR-M and DLIR-H than in ASiR-V 30% (all
< 0.001). DLIR had higher signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) than ASiR-V 30% (
= 0.027, < 0.001, and < 0.001 in the SNR of the lungs, mediastinum, and liver, respectively; all
< 0.001 in the CNR). According to the subjective analysis, DLIR had higher image contrast and lower image noise than ASiR-V 30% (all
< 0.001). DLIR was superior to ASiR-V 30% in identifying the pulmonary arteries and veins, trachea and bronchi, lymph nodes, and pleura and pericardium (all
< 0.001).
DLIR significantly reduced the image noise in chest LDCT scan images compared with ASiR-V 30% while maintaining superior image quality.
The present study investigated whether self-estimation bias in maths competence was associated with motivational costs or benefits, concurrently and prospectively, and whether these associations ...depended on students' achievement levels. Participants were 2,807 seventh grade students who were reassessed after 2 years to examine the longitudinal effects on motivation and achievement attributable to overestimation of their own competence. It was found that high-achieving students experienced short-term as well as long-term benefits with overestimation, although motivational benefits flattened out and no further benefit was observed after an optimal level of overestimation. However, low-achieving students experienced short-term motivational benefits even with extreme overestimation, but these short-term benefits resulting from extreme overestimation turned out to be a 'poisoned chalice' without the skills and knowledge to bolster the inflated self-confidence.
Phosphatidylethanolamine (PE), a major component of the cellular membrane across all domains of life, is synthesized exclusively by membrane-anchored phosphatidylserine decarboxylase (PSD) in most ...bacteria. The enzyme undergoes auto-cleavage for activation and utilizes the pyruvoyl moiety to form a Schiff base intermediate with PS to facilitate decarboxylation. However, the structural basis for self-maturation, PS binding, and decarboxylation processes directed by PSD remain unclear. Here, we present X-ray crystal structures of PSD from Escherichia coli, representing an apo form and a PE-bound complex, in which the phospholipid is chemically conjugated to the essential pyruvoyl residue, mimicking the Schiff base intermediate. The high-resolution structures of PE-complexed PSD clearly illustrate extensive hydrophobic interactions with the fatty acyl chains of the phospholipid, providing insights into the broad specificity of the enzyme over a wide range of cellular PS. Furthermore, these structures strongly advocate the unique topology of the enzyme in a lipid bilayer environment, where the enzyme associates with cell membranes in a monotopic fashion via the N-terminal domain composed of three amphipathic helices. Lastly, mutagenesis analyses reveal that E. coli PSD primarily employs D90/D142-H144-S254 to achieve auto-cleavage for the proenzyme maturation, where D90 and D142 act in complementary to each other.
The significant rise in cardiac arrest cases within hospitals, coupled with a low survival rate, poses a critical health issue. And in most situations, nurses are the first responders. To develop ...nursing students' competencies in advanced cardiopulmonary resuscitation, systematic and repetitive learner-centered self-directed education that can promote the integration of knowledge and practice is necessary.
To develop an advanced cardiopulmonary resuscitation training program using a web-based serious game for nursing students and verifying its efficacy.
The program was developed based on the stages of analysis, design, development, implementation, and evaluation, and the Input Process Outcome Model of Serious Game Design formed the theoretical basis.
The research design employed a before-and-after non-equivalent control group, and data collection took place among 2nd and 3rd year nursing students at K University in D City, Korea, from March 2, 2023, to March 24, 2023.
The program consisted of a 120-min video lecture, 30 min of a web-based serious game, 30-min of written self-reported debriefing, and individual feedback using a video conference system. The effectiveness of the program was measured for both groups using an 89-item structured questionnaire regarding knowledge, confidence in performance, problem-solving ability, and learning transfer expectations.
The program was effective in improving nursing students' advanced cardiopulmonary knowledge, confidence in performance, problem-solving ability, and learning transfer expectation immediately after intervention.
This program underscores the necessity of a new direction in nursing education, emphasizing learner-centered approaches, rather than the traditional focus on the mere transmission of basic knowledge and skills, to cultivate nurses with advanced cardiopulmonary resuscitation capabilities.
Objectives
This study aimed to investigate the levels of fatigue, social support, spiritual well‐being, and distress of female cancer survivors at the workplace, and identify factors associated with ...distress.
Methods
One hundred and eighty‐two working female cancer survivors participated from the outpatient ward in two medical institutions in South Korea and they completed questionnaires assessing their general characteristics, fatigue, social support (colleagues and superiors), and spiritual well‐being distress (existential and religious well‐being). The data were analyzed using descriptive statistics, T‐test, one‐way ANOVA, correlation, and multiple linear regression with SPSS /WIN18 version.
Results
Most of the participants were breast and thyroid cancer (78.5%), married (46.2%), working periods below 10 years (62.7%) and the average age was 49.7 years. Distress positively correlated with fatigue and significant predictors of distress were “type of work” and “main source of household income” among general characteristics, fatigue, religious well‐being, and existential well‐being.
Conclusions
Our findings suggest that integrated program including educational and practical factors to reduce fatigue and increase spiritual well‐being (i.e., peace, faith, meaning, et al.) can decrease distress. Whereas, the “ambivalence” of God accompanied by high religious well‐being (i.e., punishment, abandon, blame, and so on) can rather increase distress. The development of an integrated management system of distress at work can be applied as a practical factor to improve job satisfaction, organizational performance, and quality of life.
Tissue-resident macrophages play an important role in maintaining tissue homeostasis and innate immune defense against invading microbial pathogens. Brain-resident macrophages can be classified into ...microglia in the brain parenchyma and non-parenchymal brain macrophages, also known as central nervous system-associated or border-associated macrophages, in the brain-circulation interface. Microglia and non-parenchymal brain macrophages, including meningeal, perivascular, and choroid plexus macrophages, are mostly produced during embryonic development, and maintained their population by self-renewal. Microglia have gained much attention for their dual roles in the maintenance of brain homeostasis and the induction of neuroinflammation. In particular, diverse phenotypes of microglia have been increasingly identified under pathological conditions. Single-cell phenotypic analysis revealed that microglia are highly heterogenous and plastic, thus it is difficult to define the status of microglia as M1/M2 or resting/activated state due to complex nature of microglia. Meanwhile, physiological function of non-parenchymal brain macrophages remain to be fully demonstrated. In this review, we have summarized the origin and signatures of brain-resident macrophages and discussed the unique features of microglia, particularly, their phenotypic polarization, diversity of subtypes, and inflammasome responses related to neurodegenerative diseases.
PDF
