Geriatric syndrome (GS) increases risk of disability and mortality in older adults. Sarcopenia is a predominant illness of GS and accelerate its progression. This study aimed to investigate ...associations between mortality, emergency department (ED) re-visits and GS-related illnesses among older adults who visited the ED.
This retrospective observational study enrolled elderly patients who visited the ED in our hospital between January 2018 and October 2020. Patients were evaluated for potential sarcopenia, which was defined by both low handgrip strength and calf circumference. Follow-up was at least 6 months. Data of age, gender, mortality, ED re-visits, and GS-related illnesses were collected and analyzed for associations.
A total of 273 older adults aged 74 years or older were included, of whom 194 were diagnosed with possible sarcopenia. Older adults with possible sarcopenia also had significantly lower body mass index (BMI); a higher proportion needed assistance with daily activities; more had malnutrition, frailty, and history of falls (all
< 0.001) and acute decline in activities of daily living (
= 0.027). Multivariate analysis showed that possible sarcopenia adjusted hazard ratio, aHR): 9.89, 95% confidence interval (CI): 1.17-83.81,
= 0.036, living in residential institutions (aHR: 2.85, 95% CI: 1.08-7.50,
= 0.034), and frailty (aHR: 7.30, 95% CI: 1.20-44.62,
= 0.031) were associated with mortality. Aged over 85 years (adjusted odds ratio: 2.44, 95% CI: 1.25-4.80,
= 0.02) was associated with ED re-visits.
Sarcopenia is associated with mortality among older adults who visit ED. Initial screening for sarcopenia and relevant risk factors among older adults in the ED may help with early intervention for those at high-risk and may improve their prognosis.
Neuropathological hallmarks of Alzheimer's disease are extracellular senile plaques and intracellular neurofibrillary lesions. The neurofibrillary lesions mainly consist of the hyperphosphorylated ...microtubule-associated protein Tau predominantly expressed in the axon of CNS neurons. Hyperphosphorylation of Tau negatively affects its binding to tubulin and decreases the capacity to promote microtubule assembly. Among a number of proline-directed kinases capable of phosphorylating paired helical filament-Tau, glycogen synthase kinase 3β (GSK3β) was first identified as a Tau protein kinase I and has been demonstrated to phosphorylate Tau both in vivo and in vitro. However, the phosphorylation mechanism of Tau by GSK3β remained unclear. In this study, we show that the T231 is the primary phosphorylation site for GSK3β and the Tau227-237 (AVVRTPPKSPS) derived from Tau containing T231P232 motif is identified as the GSK3β binding site with high affinity of a Kd value 0.82 ± 0.16 μmol/L. Our results suggest that direct binding and phosphorylation of T231P232 motif by GSK3β induces conformational change of Tau and consequentially alters the inhibitory activity of its N-terminus that allows the phosphorylation of C-terminus of Tau by GSK3β. Furthermore, hyperphosphorylation reduces Tau's ability to promote tubulin assembly and to form bundles in N18 cells. T231A mutant completely abolishes Tau phosphorylation by GSK3β and retains the ability to promote tubulin polymerization and bundle formation. Taken together, these results suggest that phosphorylation of T231 by GSK3β may play an important role in Tau's hyperphosphorylation and functional regulation.
A new on-chip recovery operation is proposed in the self-aligned nitride (SAN) cell. Merged nitride spacer is sandwiched between high-k metal gate stacks in nano-meter CMOS process. The scaled gate ...length enables the SAN cell be erased by band-to-band hot hole. For multiple-time-programming operation, two effective recovery methods are proposed to recover on/off window after cycling stress. Both ac and dc methods are applied to eliminate deep-trapped charges via electrical self-heating. Experimental data demonstrates dc recovery methods that provide nearly full damage anneal capability and, in turn, effectively extend SAN cell's endurance level.
To emphasize the importance of early recognition and emergent surgery for spontaneous spinal epidural hematoma (SSEH).
A 61-year-old female presented with sudden onset of severe neck and back pain ...after finishing worshiping Buddha followed by quadriparesis, sensory deficits below C4 level and sphincter dysfunction. MR imaging demonstrated acute extensive epidural hematoma of cervico-thoracic spinal segments (C2-T7). Idiopathic SSEH was diagnosed and emergent decompressive laminectomy with hematoma evacuation was performed within 12 hours of symptoms onset. Good functional and neurological outcomes were obtained.
SSEH is a rare but disabling or even fatal entity. Early diagnosis and prompt surgery improve the neurological and functional outcome but still remain a clinical challenge. Relevant physicians should pay attention to the typical symptoms of the rare entity and SSEH should be one of differential diagnoses.
Given the need for tools for early and accurate diagnosis, prediction of disease progression, and monitoring efficacy of therapeutic agents for AD, the study of cerebrospinal fluid (CSF) biomarkers ...has become a rapidly growing field of research. Several studies have reported conflicting data regarding the relationships between CSF biomarkers and dementia severity. In this study, we have focused on the identification of CSF biomarkers and their correlations with the impairment of different cognitive domains measured using the Cognitive Abilities Screening Instrument (CASI). Patients with AD (n=28), non-AD dementia (n=16), other neurological disorders (OND, n=14), and healthy controls (HC, n=21) were enrolled. Our results revealed significantly higher CSF total tau (t-tau) and lower amyloid-beta(42) levels in AD patients compared with those in HC and OND groups. Moreover, our data show that CSF t-tau levels, but not Abeta(42) levels, have an inverse correlation with the score of short-term memory in CASI for patients with AD (Spearman: r=-0.444; p=0.018). This data might indicate that the higher CSF t-tau level is associated with more NFT pathology and more severe impairment of short-term memory in AD patients.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
A new saw-like self-recovery Self-Aligned Nitride (SAN) memory cell is proposed and fabricated in 28nm high-k metal gate (HKMG) CMOS process for high-density logic NVM applications. The cell is ...operated with Source-Side Injection (SSI) for programming and band-to-band hot holes (BBHH) for erasing. Two effective self-heating recovery mechanisms are proposed and performed to maintain a stable On/Off read window after cycling stresses. Besides, the characteristic and reliability comparison of the SAN cell in other technology nodes, 90nm/45nm/32nm, are characterized to further verify the saw-like self-detrapping and self-recovery operation. The new 28nm HKMG SAN memory cell with the self-detrapping recovery results excellent and superior endurance performance and can provide a very promising solution for logic NVM in advanced technologies.
Stroke ranks as the second major cause of death in Taiwan. For better understanding of stroke characteristics in southern Taiwan and to provide further information to other studies of stroke, we ...reviewed the clinical data of our in-patients with acute stroke.
Patients who were admitted to our hospital due to acute stroke between January 1999 and December 1999 were enrolled in our study. We used a stroke registration form to collect clinical data, including laboratory data, stroke subtype, risk factors, neurosonographic result, treatment, related complications, and Rankin Scale. Chi-square test was used to compare clinical parameters among the stroke patients.
A total of 578 patients with acute stroke were enrolled in our study. Among 578 patients, 408 (71%) patients were of ischemic stroke and 170 (29%) patients were of hemorrhagic stroke type. In the ischemic stroke group, the prevalence rate of risk factors were hypertension (71%), intracranial arterial stenosis (41%), diabetes mellitus (37%), current smoking (30%), hyperlipidemia (30%), atrial fibrillation (15%) and extracranial carotid stenosis (15%). Hypertension (79%) and diabetes (17%) were also major risk factors in hemorrhagic stroke patients. The in-hospital case-fatality rate for ischemic stroke (8.8%) was less than that for hemorrhagic stroke (20.6%).
The proportion of hemorrhagic stroke in our acute stroke patients was higher in comparison to western countries. Hypertension, diabetes, smoking and hyperlipidemia were major modifiable risk factors in ischemic stroke. Better control of such risk factors is an important issue in either primary or secondary prevention of stroke. In our study, intracranial arterial stenosis (41%) was more common than extracranial carotid stenosis (15%). The result was different from western stroke registration. The cause is worth further study.
Neuropathological hallmarks of Alzheimer's disease are extracellular senile plaques and intracellular neurofibrillary lesions. The neurofibrillary lesions mainly consist of the hyperphosphorylated ...microtubule-associated protein Tau predominantly expressed in the axon of CNS neurons. Hyperphosphorylation of Tau negatively affects its binding to tubulin and decreases the capacity to promote microtubule assembly. Among a number of proline-directed kinases capable of phosphorylating paired helical filament-Tau, glycogen synthase kinase 3beta (GSK3beta) was first identified as a Tau protein kinase I and has been demonstrated to phosphorylate Tau both in vivo and in vitro. However, the phosphorylation mechanism of Tau by GSK3beta remained unclear. In this study, we show that the T231 is the primary phosphorylation site for GSK3beta and the Tau227-237 (AVVRTPPKSPS) derived from Tau containing T231P232 motif is identified as the GSK3beta binding site with high affinity of a Kd value 0.82 +/- 0.16 mumol/L. Our results suggest that direct binding and phosphorylation of T231P232 motif by GSK3beta induces conformational change of Tau and consequentially alters the inhibitory activity of its N-terminus that allows the phosphorylation of C-terminus of Tau by GSK3beta. Furthermore, hyperphosphorylation reduces Tau's ability to promote tubulin assembly and to form bundles in N18 cells. T231A mutant completely abolishes Tau phosphorylation by GSK3beta and retains the ability to promote tubulin polymerization and bundle formation. Taken together, these results suggest that phosphorylation of T231 by GSK3beta may play an important role in Tau's hyperphosphorylation and functional regulation.
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