This study introduces the concentration index (CI) to assess socioeconomic inequality in the distribution of obesity among American adults aged 18–60 years old. The CI provides a summary measure of ...socioeconomic inequality, and enabled comparisons across gender, age, and ethnicity. Data from the National Health and Nutrition Examination Survey III, 1988–1994 (NHANES III) were used. The degree of socioeconomic inequality in obesity varied considerably across gender, age, and ethnic groups. Among women, we found a stronger, inverse association between socioeconomic status (SES) and obesity compared with men, as well as greater socioeconomic inequality among middle-aged adults (41–49) compared to other age groups. Consistent with previous studies, we found remarkable ethnic differences in the relationship between SES and obesity. Although the extant literature documented a higher prevalence of obesity among minorities than in whites, our results presented a lower socioeconomic inequality in obesity within minority groups. Our analyses suggested that gender, age, and ethnicity could be important factors on socioeconomic inequality in obesity.
Background: Few studies have used the same references across countries to examine the trends of over- and underweight in older children and adolescents. Objective: Using international references, we ...examined the trends of overweight and underweight in young persons aged 6-18 y from 4 countries. Design: Nationally representative data from Brazil (1975 and 1997), Russia (1992 and 1998), and the United States (1971-1974 and 1988-1994) and nationwide survey data from China (1991 and 1997) were used. To define overweight, we used the sex- and age-specific body mass index cutoffs recommended by the International Obesity Task Force. The sex- and age-specific body mass index fifth percentile from the first US National Health and Nutrition Examination Survey was used to define underweight. Results: The prevalence of overweight increased during the study periods in Brazil (from 4.1 to 13.9), China (from 6.4 to 7.7), and the United States (from 15.4 to 25.6); underweight decreased in Brazil (from 14.8 to 8.6), China (from 14.5 to 13.1), and the United States (from 5.1 to 3.3). In Russia, overweight decreased (from 15.6 to 9.0) and underweight increased (from 6.9 to 8.1). The annual rates of increase in the prevalence of overweight were 0.5% (Brazil), 0.2% (China), −1.1% (Russia), and 0.6% (United States). Conclusions: The burden of nutritional problems is shifting from energy imbalance deficiency to excess among older children and adolescents in Brazil and China. The variations across countries may relate to changes and differences in key environmental factors.
As one of the most promising first wall/blanket structure materials in fusion reactors, oxide dispersion strengthened (ODS) ferritic steel has been extensively studied in past decades. The grain size ...of ODS steels is often between 200 and 1000 nm, called ultrafine-grained (UFG). Refining their grain size, if possible, should further enhance their radiation tolerance. In the present work, we report on a novel zirconium-doped nanocrystalline (NC) 14YWTZ ODS steel composed of a ferritic matrix with an average grain size of 50 nm and high-density oxide nanoprecipitates with an average diameter of 3.3 nm. Both NC and UFG 14YWT ODS steels were irradiated with helium ions at 450 °C. Abnormal lattice shrinking and narrowing of X-ray diffraction peaks are found in irradiated NC ODS steel. The NC ODS steel has an extremely high sink strength of ∼ 3 × 1016 m−2, which is mainly contributed by grain boundaries and effectively inhibits the aggregation of He atoms and the growth of He bubbles. The bubble size, void swelling, and irradiation hardening in NC ODS steel irradiated at a high dose, when compared to those in UFG ODS steel, are significantly smaller. The underlying mechanisms for the high irradiation tolerance in the NC ODS steel are discussed. This work provides an approach to further enhancing the radiation resistance of conventional UFG ODS steels by refining their grain size to nanoscale dimensions.
Multidrug resistance (MDR) against chemotherapeutic agents has become one of the major obstacles to successful cancer therapy and MDR-associated proteins (MRPs)-mediated drug efflux is the key factor ...for MDR. In this study, a redox-responsive polymer based on dextran (DEX) and indomethacin (IND), which could reduce MRPs-mediated efflux of chemotherapeutics, was synthesized, and the obtained polymer could spontaneously form stable micelles with well-defined core-shell structure and a uniform size distribution with an average diameter of 50 nm and effectively encapsulate doxorubicin (DOX); the micelles contain a disulfide bridge (cystamine, SS) between IND and DEX (DEX-SS-IND). In vitro drug release results indicated that DEX-SS-IND/DOX micelles could maintain good stability in a stimulated normal physiological environment and promptly depolymerized and released DOX in a reducing environment. After incubating DEX-SS-IND/DOX micelles with drug-resistant tumor (MCF-7/ADR) cells, the intracellular accumulation and retention of DOX were significantly increased under the synergistic effects of redox-responsive delivery and the inhibitory effect of IND on MRPs. In vitro cytotoxicity showed that DEX-SS-IND/DOX micelles exhibited higher cytotoxicity against MCF-7/ADR cells. Moreover, DEX-SS-IND/DOX micelles showed significantly enhanced inhibition of tumor in BALB/c nude mice bearing MCF-7/ADR tumors and reduced systemic toxicity. Overall, the cumulative evidence indicates that DEX-SS-IND/DOX micelles hold significant promise for overcoming MDR for cancer therapy.
Abstract Background Recent clinical trials highlight the need for better models to identify patients at higher risk of sudden death. Objectives The authors hypothesized that the Seattle Heart Failure ...Model (SHFM) for overall survival and the Seattle Proportional Risk Model (SPRM) for proportional risk of sudden death, including death from ventricular arrhythmias, would predict the survival benefit with an implantable cardioverter-defibrillator (ICD). Methods Patients with primary prevention ICDs from the National Cardiovascular Data Registry (NCDR) were compared with control patients with heart failure (HF) without ICDs with respect to 5-year survival using multivariable Cox proportional hazards regression. Results Among 98,846 patients with HF (87,914 with ICDs and 10,932 without ICDs), the SHFM was strongly associated with all-cause mortality (p < 0.0001). The ICD−SPRM interaction was significant (p < 0.0001), such that SPRM quintile 5 patients had approximately twice the reduction in mortality with the ICD versus SPRM quintile 1 patients (adjusted hazard ratios HR: 0.602; 95% confidence interval CI: 0.537 to 0.675 vs. 0.793; 95% CI: 0.736 to 0.855, respectively). Among patients with SHFM-predicted annual mortality ≤5.7%, those with a SPRM-predicted risk of sudden death below the median had no reduction in mortality with the ICD (adjusted ICD HR: 0.921; 95% CI: 0.787 to 1.08; p = 0.31), whereas those with SPRM above the median derived the greatest benefit (adjusted HR: 0.599; 95% CI: 0.530 to 0.677; p < 0.0001). Conclusions The SHFM predicted all-cause mortality in a large cohort with and without ICDs, and the SPRM discriminated and calibrated the potential ICD benefit. Together, the models identified patients less likely to derive a survival benefit from primary prevention ICDs.
The interaction between apoptosis-inducing factor (AIF) and cyclophilin A (CypA) has been shown to contribute to caspase-independent apoptosis. Blocking the AIF/CypA interaction protects against ...glutamate-induced neuronal cell death in vitro, and the purpose of this study was to determine the in vivo effect of an AIF/CypA interaction blocking peptide (AIF(370-394)-TAT) on neonatal mouse brain injury after hypoxia-ischemia (HI). The pups were treated with AIF (370-394)-TAT peptide intranasally prior to HI. Brain injury was significantly reduced at 72 h after HI in the AIF(370-394)-TAT peptide treatment group compared to vehicle-only treatment for both the gray matter and the subcortical white matter, and the neuroprotection was more pronounced in males than in females. Neuronal cell death was evaluated in males at 8 h and 24 h post-HI, and it was decreased significantly in the CA1 region of the hippocampus and the nucleus habenularis region after AIF(370-394)-TAT treatment. Caspase-independent apoptosis was decreased in the cortex, striatum, and nucleus habenularis after AIF(370-394)-TAT treatment, but no significant change was found on caspase-dependent apoptosis as indicated by the number of active caspase-3-labeled cells. Further analysis showed that both AIF and CypA nuclear accumulation were decreased after treatment with the AIF(370-394)-TAT peptide. These results suggest that AIF(370-394)-TAT inhibited AIF/CypA translocation to the nucleus and reduced HI-induced caspase-independent apoptosis and brain injury in young male mice, suggesting that blocking AIF/CypA might be a potential therapeutic target for neonatal brain injury.
•Apoptotic cell death is more prominent in the immature brain after insult.•Apoptosis inducing factor (AIF) plays a crucial role in the process of apoptosis in the immature brain after injury.•AIF induces apoptosis require interaction with cyclophilin A.•Blocking interaction of AIF and cyclophilin A reduces caspase-independent cell death and brain injury only in males.
A model using administrative claims data that is suitable for profiling hospital performance for acute myocardial infarction would be useful in quality assessment and improvement efforts. We sought ...to develop a hierarchical regression model using Medicare claims data that produces hospital risk-standardized 30-day mortality rates and to validate the hospital estimates against those derived from a medical record model.
For hospital estimates derived from claims data, we developed a derivation model using 140,120 cases discharged from 4664 hospitals in 1998. For the comparison of models from claims data and medical record data, we used the Cooperative Cardiovascular Project database. To determine the stability of the model over time, we used annual Medicare cohorts discharged in 1995, 1997, and 1999-2001. The final model included 27 variables and had an area under the receiver operating characteristic curve of 0.71. In a comparison of the risk-standardized hospital mortality rates from the claims model with those of the medical record model, the correlation coefficient was 0.90 (SE=0.003). The slope of the weighted regression line was 0.95 (SE=0.007), and the intercept was 0.008 (SE=0.001), both indicating strong agreement of the hospital estimates between the 2 data sources. The median difference between the claims-based hospital risk-standardized mortality rates and the chart-based rates was <0.001 (25th and 75th percentiles, -0.003 and 0.003). The performance of the model was stable over time.
This administrative claims-based model for profiling hospitals performs consistently over several years and produces estimates of risk-standardized mortality that are good surrogates for estimates from a medical record model.
In this paper, two observer-based adaptive fuzzy output feedback control schemes are presented for a class of uncertain continuous-time multi-input–multi-output (MIMO) nonlinear dynamics systems ...whose states are not available. Within these schemes, fuzzy logic systems are employed to approximate the plant's unknown nonlinear functions and then the state observer is designed for estimating the states of the plant, upon which a fuzzy adaptive output feedback controller is firstly investigated. In order to overcome the controller singularity problem and relax the requirement of bounding parameter values, a second modified fuzzy adaptive output feedback controller is proposed by using a regularized inverse and a robustifying control term. All parameter adaptive laws and robustifying control terms are derived based on Lyapunov stability analysis, so that convergence to zero of tracking errors and boundedness of all signals in the closed-loop system can be guaranteed. Simulations performed on a two-link robot manipulator illustrate the approach and exhibit its performance.
Background and aimsCardiovascular events are the leading cause of death or disability in people with systemic lupus erythematosus (SLE). However, the real mechanism that causes the risk increments ...for the major adverse cardiovascular events (MACEs) is still not fully understood. The Age-Adjusted Charlson Comorbidity index (ACCI) score is a prognostic classification that was initially developed for a patient who may have a range of co-morbid conditions and has been validated in many clinical settings.MethodsThe data for this study were collected from Taiwan’s National Health Institute Research Database (NHIRD) for the years 2004 to 2007, 5998 participants were enrolled. All patients’ sequential clinically diagnosed SLE data were reviewed from 2002 to 2009 in order to determine their MACEs risk by using ACCI score.ResultsCox proportional hazard ratio model showed that AAC score as a continuous variable conferred 25% increased risk of MACE in average for each AAC point starting from zero. And when patients were divided into different groups by AAC scores, patients with AAC score more than 6 conferred an adjusted hazard ratio 4.88 (95% CI 3.84–6.19, p<0.001), compared to those with AAC score 0–1.ConclusionsThis is a national cohort study for the evaluation of MACEs for SLE patients. Our results demonstrated that SLE patients with higher ACCI score show significantly higher risk of cardiovascular events and the ACCI score could be applied as an index for MACEs evaluation.
Tumor microenvironment plays an important role in the chemoresistance of oral squamous cell carcinoma (OSCC). Hypoxia in the microenvironment is one of the important factors that contributes to OSCC ...chemoresistance; therefore overcoming hypoxia-mediated chemoresistance is one of the great challenges in clinical practice.
In this study, we developed a drug delivery system based on Pt-loaded, polyethylene glycol-modified graphene quantum dots via chemical oxidation and covalent reaction.
Our results show that synthesized polyethylene glycol-graphene quantum dots-Pt (GPt) is about 5 nm in diameter. GPt sensitizes OSCC cells to its treatment in both normoxia and hypoxia conditions. Inductively coupled plasma-mass spectrometry assay shows that GPt enhances Pt accumulation in cells, which leads to a notable increase of S phase cell cycle arrest and apoptosis of OSCC cells in both normoxia and hypoxic conditions. Finally, compared with free cisplatin, GPt exhibits a strong inhibitory effect on the tumor growth with less systemic drug toxicity in an OSCC xenograft mouse tumor model.
Taken together, our results show that GPt demonstrates superiority in combating hypoxia-induced chemoresistance. It might serve as a novel strategy for future microenvironment-targeted cancer therapy.
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