Objectives
In this study we investigated the correlation between depression and frailty in older adults. Additionally, correlations among study designs (prospective vs. cross‐sectional), regions, ...depression indices, frailty indices, covariance corrections, and sexes were explored to support the analysis.
Methods
A systematic literature review and meta‐analysis were conducted. A total of 84,351 older adults, all 65 years of age or older, were analyzed. Both authors independently extracted and examined retrieved articles. Searched keywords included “depression” or “depressive”; “frailty” or “frail”; and “older people,” “elderly,” “geriatric,” or “senior.” Articles published between January 2000 and December 2016 were searched. A literature quality assessment was conducted in accordance with the guidelines of the Preferred Reporting Items for Systematic
Reviews and Meta‐Analyses
Systematic literature searches were conducted on the Embase, PubMed, MEDLINE, Cumulative Index to Nursing and Allied Health Literature, and Cochrane Library databases, and collected studies were analyzed using a random effects model.
Results
Fourteen studies on people 65 years of age or older were collected, and a correlation analysis was conducted for depression and frailty. According to the meta‐analysis, the risk for frailty due to depression was nonsignificant among the subgroups for study design (p for heterogeneity = .149), region (p = .429), depression criteria (p = .934), covariate adjustment (p = .702), and frailty criteria (p = .661). Notably, the risk for frailty due to depression was significantly higher in men than in women (pooled odds ratios for men and women: 4.76 and 2.25, respectively; Qbetween χ2 = 9.93, p = .002).
Conclusion
Older adults with depression are more prone to frailty than are those without depression. Regardless of study design, region, depression index, frailty index, and covariance corrections, no significant differences were observed in the results of studies on depression and frailty in older adults. The only factor that had a significant influence was sex; older men with depression were at a higher risk for frailty than were older women with depression.
Clinical Relevance
Depression and frailty are pertinent health concerns related to geriatric syndromes. Because older adults with depression have a high risk for frailty, nursing personnel should use a depression index as early as possible to screen for depression and further reduce the occurrence of frailty in older adults. Furthermore, based on the aforementioned differences between the sexes, special attention should be paid to older men with depression to reduce their risk for frailty.
Objectives
This research explored the relationship between the stages of frailty and risk for hospitalization in older adults and evaluated the risk for hospitalization among the elderly in relation ...to various frailty assessment indexes.
Methods
A systematic literature review and meta‐analysis were carried out. A total of 32,998 older people, 8,666 of whom were hospitalized, were included in this study. Two of the researchers independently collected and reviewed the literature. The key search terms used were “frailty” or “frail,” “hospitalization,” and “older people” or “older” or “geriatric” or “senior.” Data were recorded from January 2001 to July 2016. The Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines were adopted for quality assessment. A systematic search was carried out using Embase and Scopus to analyze the collected literature.
Findings
A meta‐analysis was conducted on eight studies that discussed the relationship between frailty and hospitalization risk in older adults 65 years of age or older. The results showed that frail older people exhibited the highest risk for hospitalization, following by prefrail and robust older people. Next, different frailty assessment indicators were used to predict the risk for hospitalization among older people. All of these indexes also showed that older persons with frailty had the highest risk for hospitalization, followed by prefrail older people.
Conclusions
Frailty is a vital issue in geriatric care and is a crucial factor in the hospitalization of older people. Frail older people were at the highest risk for hospitalization, following by prefrail and robust older people. Assessing frailty as early as possible can reduce the hospitalization risk among older people.
Clinical Relevance
Professional nursing staff should use frailty indicators in a timely fashion to assess the status of frailty in older people and should effectively develop frailty prevention strategies to decrease the risk for hospitalization and to enhance quality of life for older adults.
Sodium glucose co-transporter 2 inhibitor (SGLT2i), a new class of anti-diabetic drugs acting on inhibiting glucose resorption by kidneys, is shown beneficial in reduction of heart failure ...hospitalization and cardiovascular mortality. The mechanisms remain unclear. We hypothesized that SGLT2i, empagliflozin can improve cardiac hemodynamics in non-diabetic hypertensive heart failure.
The hypertensive heart failure model had been created by feeding spontaneous hypertensive rats (SHR) with high fat diet for 32 weeks (total n = 13). Half SHRs were randomized to be administered with SGLT2i, empagliflozin at 20 mg/kg/day for 12 weeks. After evaluation of electrocardiography and echocardiography, invasive hemodynamic study was performed and followed by blood sample collection and tissue analyses. Empagliflozin exhibited cardiac (improved atrial and ventricular remodeling) and renal protection, while plasma glucose level was not affected. Empagliflozin normalized both end-systolic and end-diastolic volume in SHR, in parallel with parameters in echocardiographic evaluation. Empagliflozin also normalized systolic dysfunction, in terms of the reduced maximal velocity of pressure incline and the slope of end-systolic pressure volume relationship in SHR. In histological analysis, empagliflozin significantly attenuated cardiac fibrosis in both atrial and ventricular tissues. The upregulation of atrial and ventricular expression of PPARα, ACADM, natriuretic peptides (NPPA and NPPB), and TNF-α in SHR, was all restored by treatment of empagliflozin.
Empagliflozin improves hemodynamics in our hypertensive heart failure rat model, associated with renal protection, attenuated cardiac fibrosis, and normalization of HF genes. Our results contribute some understanding of the pleiotropic effects of empagliflozin on improving heart function.
Iron is an essential molecule for biological processes, but its accumulation can lead to oxidative stress and cellular death. Due to its oxidative effects, iron accumulation is implicated in the ...process of aging and neurodegenerative diseases. However, the mechanism for this increase in iron with aging, and whether this increase is localized to specific cellular compartment(s), are not known. Here, we measured the levels of iron in different tissues of aged mice, and demonstrated that while cytosolic non-heme iron is increased in the liver and muscle tissue, only the aged brain cortex exhibits an increase in both the cytosolic and mitochondrial non-heme iron. This increase in brain iron is associated with elevated levels of local hepcidin mRNA and protein in the brain. We also demonstrate that the increase in hepcidin is associated with increased ubiquitination and reduced levels of the only iron exporter, ferroportin-1 (FPN1). Overall, our studies provide a potential mechanism for iron accumulation in the brain through increased local expression of hepcidin, and subsequent iron accumulation due to decreased iron export. Additionally, our data support that aging is associated with mitochondrial and cytosolic iron accumulation only in the brain and not in other tissues.
Electroencephalography (EEG) signals are often contaminated with artifacts. It is imperative to develop a practical and reliable artifact removal method to prevent the misinterpretation of neural ...signals and the underperformance of brain–computer interfaces. Based on the U-Net architecture, we developed a new artifact removal model, IC-U-Net, for removing pervasive EEG artifacts and reconstructing brain signals. IC-U-Net was trained using mixtures of brain and non-brain components decomposed by independent component analysis. It uses an ensemble of loss functions to model complex signal fluctuations in EEG recordings. The effectiveness of the proposed method in recovering brain activities and removing various artifacts (e.g., eye blinks/movements, muscle activities, and line/channel noise) was demonstrated in a simulation study and four real-world EEG experiments. IC-U-Net can reconstruct a multi-channel EEG signal and is applicable to most artifact types, offering a promising end-to-end solution for automatically removing artifacts from EEG recordings. It also meets the increasing need to image natural brain dynamics in a mobile setting. The code and pre-trained IC-U-Net model are available at https://github.com/roseDwayane/AIEEG.
Excess cellular iron increases reactive oxygen species (ROS) production and causes cellular damage. Mitochondria are the major site of iron metabolism and ROS production; however, few studies have ...investigated the role of mitochondrial iron in the development of cardiac disorders, such as ischemic heart disease or cardiomyopathy (CM). We observe increased mitochondrial iron in mice after ischemia/reperfusion (I/R) and in human hearts with ischemic CM, and hypothesize that decreasing mitochondrial iron protects against I/R damage and the development of CM. Reducing mitochondrial iron genetically through cardiac‐specific overexpression of a mitochondrial iron export protein or pharmacologically using a mitochondria‐permeable iron chelator protects mice against I/R injury. Furthermore, decreasing mitochondrial iron protects the murine hearts in a model of spontaneous CM with mitochondrial iron accumulation. Reduced mitochondrial ROS that is independent of alterations in the electron transport chain's ROS producing capacity contributes to the protective effects. Overall, our findings suggest that mitochondrial iron contributes to cardiac ischemic damage, and may be a novel therapeutic target against ischemic heart disease.
Synopsis
Modulation of mitochondrial iron is shown to be a viable therapeutic approach against ischemic heart disease and heart failure, highlighting the need to develop more targeted iron chelators.
Mitochondrial iron increases during and after I/R injury.
Baseline mitochondrial iron contributes to ischemia/reperfusion injury.
Decreasing mitochondrial iron at baseline is sufficient to protect against ischemia/reperfusion injury.
Lower baseline mitochondrial iron is associated with decreased ROS production during cellular and tissue injury.
Modulation of mitochondrial iron is shown to be a viable therapeutic approach against ischemic heart disease and heart failure, highlighting the need to develop more targeted iron chelators.
This paper describes a linearization method to enhance the third-order distortion performance of a subthreshold common-source cascode low-noise amplifier (LNA) without extra power consumption by ...using passive components. An inductor between the gate of the cascode transistor and the power supply in combination with a digitally programmable capacitor between the gate and the drain of the cascode transistor enable to improve the third-order intermodulation intercept point (IIP3) of a subthreshold LNA. The theoretical mechanisms that underlie the linearity improvement are analyzed comprehensively under the consideration of the LNA's input stage, cascode stage, reverse isolation, and stability. A 1.8-GHz LNA was designed and fabricated using 0.11-<inline-formula> <tex-math notation="LaTeX">\mu \text{m} </tex-math></inline-formula> CMOS technology to prove the concept. Measurement results reveal that the linearized low-power LNA has a 14.8-dB voltage gain, a 3.7-dB noise figure, and a −3.7-dBm IIP3 with a power consumption of 0.336 mW.
Myometrial invasion affects the prognosis of endometrial cancer. However, discrepancies exist between pre-operative magnetic resonance imaging staging and post-operative pathological staging. This ...study aims to validate the accuracy of artificial intelligence (AI) for detecting the depth of myometrial invasion using a deep learning technique on magnetic resonance images. We obtained 4896 contrast-enhanced T1-weighted images (T1w) and T2-weighted images (T2w) from 72 patients who were diagnosed with surgico-pathological stage I endometrial carcinoma. We used the images from 24 patients (33.3%) to train the AI. The images from the remaining 48 patients (66.7%) were used to evaluate the accuracy of the model. The AI then interpreted each of the cases and sorted them into stage IA or IB. Compared with the accuracy rate of radiologists’ diagnoses (77.8%), the accuracy rate of AI interpretation in contrast-enhanced T1w was higher (79.2%), whereas that in T2w was lower (70.8%). The diagnostic accuracy was not significantly different between radiologists and AI for both T1w and T2w. However, AI was more likely to provide incorrect interpretations in patients with coexisting benign leiomyomas or polypoid tumors. Currently, the ability of this AI technology to make an accurate diagnosis has limitations. However, in hospitals with limited resources, AI may be able to assist in reading magnetic resonance images. We believe that AI has the potential to assist radiologists or serve as a reasonable alternative for pre-operative evaluation of the myometrial invasion depth of stage I endometrial cancers.
Theranostic nanohybrids are promising for effective delivery of therapeutic drug or energy and for imaging‐guided therapy of tumors, which is demanded in personalized medicine. Here, a ...size‐changeable graphene quantum dot (GQD) nanoaircraft (SCNA) that serves as a hierarchical tumor‐targeting agent with high cargo payload is developed to penetrate and deliver anticancer drug into deep tumors. The nanoaircraft is composed of ultrasmall GQDs (less than 5 nm) functionalized with a pH‐sensitive polymer that demonstrates an aggregation transition at weak acidity of tumor environment but is stable at physiological pH with stealth function. A size conversion of the SCNA at the tumor site is further actuated by near‐infrared irradiation, which disassembles 150 nm of SCNA into 5 nm of doxorubicin (DOX)/GQD like a bomb‐loaded jet, facilitating the penetration into the deep tumor tissue. At the tumor, the penetrated DOX/GQD can infect neighboring cancer cells for repeated cell killing. Such a SCNA integrated with combinational therapy successfully suppresses xenograft tumors in 18 d without distal harm. The sophisticated strategy displays the hierarchically targeted and penetrated delivery of drugs and energy to deep tumor and shows potential for use in other tumor therapy.
Size‐changeable nanoaircrafts carrying graphene quantum dots (GQDs) loaded with the anticancer drug doxorubicin (DOX) can achieve penetrating drug delivery hierarchically, on demand, and in vivo. pH‐sensitive enhanced aggregation and photopenetrating thermal‐chemotherapy allow a shuriken‐like penetration of DOX/GQDs, which also improves homogeneous treatment in the tumor via hyperthermia and ultrasmall GQDs, all contributing to the killing of cells.
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