Detecting localized damage in cantilevered structures under nonstationary ambient excitations via Gabor spectral mode transmissibility functions.

A method based on Gabor spectral mode transmissibility functions (GSMTFs) is proposed to detect local damage in a cantilevered structure under nonstationary ambient excitations. Gabor transformation and singular value decomposition are used to reduce the influences of other vibration modes on Gabor spectral mode transmissibility functions and process nonstationary structural responses, respectively. A new state characteristic based on the fundamental structure frequency is formulated on the basis of the GSMTFs, eventually leading to the development of a new damage indicator. The probability density functions of the damage indicator for healthy and damaged states can be estimated from the measured data, and the receiver operating characteristic (ROC) curve derived from these probability distributions and the corresponding area under the ROC curve (AUC) are used to determine the damage location. A six-degree-of-freedom system and a typical transmission tower are numerically studied, and the results show that the proposed method can estimate the structural damage location under nonstationary random loads. The proposed method is further validated with a planar frame in the laboratory, which exhibits multiple damage elements via random force hammer excitations. The results show that the AUC values computed for certain parts of the structure containing the damaged elements are greater than those for other parts of the structure, indicating the effectiveness of the proposed method. Moreover, the proposed method is compared with the dot product difference (DPD) index, and the results from the laboratory planar frame demonstrate that the proposed method can better identify damage.

Isolation and quantification of L1CAM-positive extracellular vesicles on a chip as a potential biomarker for Parkinson's Disease.

Extracellular vesicles (EVs) carry disease-specific molecular profiles, demonstrating massive potential in biomarker discovery. In this study, we developed an integrated biochip platform, termed EVID-biochip (EVs identification and detection biochip), which integrates in situ electrochemical protein detection with on-chip antifouling-immunomagnetic beads modified with CD81 antibodies and zwitterion molecules, enabling efficient isolation and detection of neuronal EVs. The capability of the EVID-biochip to isolate common EVs and detect neuronal EVs associated with Parkinson's disease in human serum is successfully demonstrated, using the transmembrane protein L1-cell adhesion molecule (L1CAM) as a target biomarker. The EVID-biochip exhibited high efficiency and specificity for the detection of L1CAM with a sensitivity of 1 pg/mL. Based on the validation of 76 human serum samples, for the first time, this study discovered that the level of L1CAM/neuronal EV particles in serum could serve as a reliable indicator to distinguish Parkinson's disease from control groups with AUC = 0.973. EVID-biochip represents a reliable and rapid liquid biopsy platform for the analysis of complex biofluids offering EVs isolation and detection in a single chip, requiring a small sample volume (300 µL) and an assay time of 1.5 h. This approach has the potential to advance the diagnosis and biomarker discovery of various neurological disorders and other diseases.

Delayed luminescence to monitor growth stages and assess the entropy of Saccharomyces cerevisiae.

Delayed luminescence (DL) refers to the photon-induced ultra-weak luminescence emitted by samples after the light source is switched off. As a noninvasive method for health monitoring and disease diagnosis, DL has attracted increasing attention. The further development of this technology is valuable for the study of complex biological processes, such as different growth stages. If such studies were to be conducted in humans, large numbers of subjects of all ages would need to be recruited, and individual differences would be inevitable. The budding yeast Saccharomyces cerevisiae (S. cerevisiae) has a short population lifespan, and the growth phases can be monitored within dozens of hours. Therefore, S. cerevisiae is an ideal model organism for research. In this study, we investigated the physiological characteristics and DL emission of S. cerevisiae during growth in glucose-based media and entry into stationary phase, and the results showed that DL kinetic curves of yeast cells in the growing phase were obviously separated from those of stationary phase cells. Moreover, the metabolic and physiological characteristics of the yeast cell population were discussed using the DL emission parameters I0, τ and γ. We also discussed the possibility of assessing entropy using DL emission parameters. Our research demonstrates the potential of this technology to be used in wider applications.

Toward a comprehensive life-cycle carcinogenic impact assessment: A statistical regression approach based on cancer burden.

The current approach to life cycle carcinogenic impact assessment (LCCA) is hindered by its static and linear characteristics. This situation prevents the accurate prediction of the incidence, associated damage, and potential economic burden of cancer. This study explores a highly comprehensive pathway for LCCA assessment. It uses the impacts of Tracheal, bronchus, and lung (TBL) predicted by the LCCA of China's coal power industry through a screened statistical regression model as the research target. The latest global burden of disease estimates is utilized to quantify the health damage from TBL incidence, whereas an approach combining the actual cost of health and human capital is applied to further assess the economic burden of TBL. Findings indicate that the traditional and static LCCA method, which relies on animal toxicity data, can lead to underestimations in actual LCCA. The interaction among spatiotemporal meteorological factors, epidemiological cancer disease burden, and socioeconomic behaviors allows exhibits nonlinearity due to the changes in the combined toxicity of mixed key substances. Following the active implementation of ultralow emission and energy-saving transformations in China's coal power industry, the national percentage of TBL cancer incidence caused by pollutants from the coal power industry decreased from 25.2 % in 2004 to 11.5 % in 2020. Results indicate that the established dynamic LCCA model based on temporal and spatial climate, socioeconomic, and epidemiological cancer data can be feasibly employed for the accurate impact evaluation and mitigation of carcinogens in practical applications.

Simplified Chinese version of the PROMIS Pediatric-25 profile: A validation study among cancer children.

PURPOSE: Pediatric cancer is a significant health concern in China, and evaluating the impact of cancer and its treatment on the well-being of young patients is essential for both clinical care and research purposes. This study aimed to psychometrically validate the Patient-reported Outcomes Measurement Information System Pediatric-25 Profile (PROMIS-Pediatric-25) among Chinese children with cancer. DESIGN AND METHODS: We enrolled a group of 114 children living with cancer between the ages of 8 and 17. Each participant completed questionnaires that covered sociodemographic and clinical information and the PROMIS-Pediatric-25. The floor and ceiling effect was examined. Cronbach's alpha and split-half coefficient were examined to determine the reliability. Factor structure was explored by factor analysis. Three assumptions of Rasch model-based item response theory (IRT) were assessed. Differential item functioning (DIF) was investigated concerning factors of gender, diagnosis, and treatment stage. RESULTS: The floor or ceiling effects were detected for six domains. The reliability was found to be excellent. Furthermore, the factor structure of these six domains was validated. Our analysis confirmed that the assumptions required for IRT were met with acceptable unidimensionality, local independence, and good monotonicity. Additionally, we observed measurement equivalence, with outstanding levels of DIF across factors such as gender, diagnosis, and treatment stage. CONCLUSION: PROMIS-Pediatric 25 is a highly reliable and valid instrument for evaluating key domains of health-related quality of life in Chinese pediatric cancer patients. PRACTICE IMPLICATION: Nursing practice could engage the PROMIS-Pediatric 25 for accurate and quick children symptom and function assessment.

Identification of lignans as ATP citrate lyase (ACLY) inhibitors from the roots of Pouzolzia zeylanica.

A new lignan, named pouzolignan P (1), together with 14 known ones (2 - 15) were isolated from the roots of Pouzolzia zeylanica (L.) Benn. Their structures were deduced based on the detailed spectroscopic analysis. All the isolates were evaluated for their inhibitory activities toward the ATP citrate lyase (ACLY). Among them, four lignans, isopouzolignan K (3), gnemontanins E (5), gnetuhainin I (6), and styraxlignolide D (15) showed excellent ACLY inhibitory effect with IC50 values of 9.06, 0.59, 2.63, and 7.62 µM, respectively. These compounds were further evaluated for their cholesterol-lowing effects on ox-LDL-induced high-cholesterol HepG2 cells. Compound 15 emerges as the most potent ACLY inhibitor, which significantly decreased the TC level in a dose-dependent manner. In addition, molecular docking simulations elucidated that 15 formed a strong hydrogen-bond interaction with Glu599 of ACLY, which was an important site responsible for the enzyme catalytic activity.

Patient-Reported Outcomes Measurement Information System Pediatric Symptom Profiles of Children With Cancer in China: A Latent Profile Analysis.

BACKGROUND: Unpleasant symptoms are common in children with cancer. However, research identifying subgroups of children with cancer who experience similar levels of self-reported symptoms in China is limited. OBJECTIVES: This study aimed to classify the symptom profiles of children with cancer and detect the possible predictors of the profiles and their effect on children's quality of life (QoL). METHODS: A total of 272 children aged 8 to 17 years completed the Chinese version of the Pediatric Patient-Reported Outcomes Measurement Information System short form measures, the Pediatric QOL Inventory general core and cancer modules. Latent profile analysis was used to identify symptom profiles, and ordinal logistic regression and analysis of variance were used to examine predictors of symptom profile membership and profile differences on QoL. RESULTS: The best fit was a 3-profile model: low, moderate, and severe symptom distress. Children who had been inpatients in the past 7 days and were currently under treatment are more likely to have severe symptoms. Participants in the low symptom distress profile reported significantly greater QoL than those in the other profiles. CONCLUSIONS: Children with cancer are heterogeneous in their experience of symptoms. Children's characteristics, such as inpatient history and treatment status, are predictors of profiles; different symptom profiles are associated with QoL. IMPLICATIONS FOR PRACTICE: This study identified distinct groups of patients who predictably experience higher symptoms and their predictors, which could help to place children within a profile and perhaps allow nurses to provide targeted supportive care to match children's specific symptom profile.

Effects of routine collection of patient-reported outcomes on patient health outcomes in oncology settings: A systematic review.

Objective: This study aims to investigate the potential benefits of integrating patient-reported outcomes (PROs) into routine clinical practice for patients undergoing active anticancer treatment. Methods: We conducted a comprehensive systematic review of randomized controlled trials involving cancer patients undergoing active anticancer treatment, spanning various cancer types and stages. The review covered four electronic databases (Medline, EMBASE, Cochrane Library, and CINAHL) up to September 2022. Key inclusion criteria focused on the incorporation of PROs as a routine intervention. Bias assessment followed the Cochrane collaboration's criteria, while the synthesis of results utilized effect size measurements (Cohen's d). The study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Results: Out of 1549 initially screened records, 16 published randomized controlled trials encompassing 5300 patients met the inclusion criteria. The interventions involved 18 different PROs measurements, with prominent tools being EORTC QLQ-C30 (utilized in four trials) and PRO-CTCAE (utilized in four trials). Measured endpoints included overall quality of life (12 trials), physical health (11 trials), mental health (7 trials), and social health (5 trials). Overall, the study revealed a limited number of statistically significant findings, with predominantly small to moderate effect sizes associated with the interventions. Conclusions: The findings suggest that the routine integration of PROs into clinical practice does not yield definitive advantages in terms of PROs. It is apparent that further efforts are necessary to ascertain the impact of these interventions on patient health. Systematic review registration: The review protocol was registered on PROSPERO (ID: CRD42022365456).

A mutation-induced drug resistance database (MdrDB).

Mutation-induced drug resistance is a significant challenge to the clinical treatment of many diseases, as structural changes in proteins can diminish drug efficacy. Understanding how mutations affect protein-ligand binding affinities is crucial for developing new drugs and therapies. However, the lack of a large-scale and high-quality database has hindered the research progresses in this area. To address this issue, we have developed MdrDB, a database that integrates data from seven publicly available datasets, which is the largest database of its kind. By integrating information on drug sensitivity and cell line mutations from Genomics of Drug Sensitivity in Cancer and DepMap, MdrDB has substantially expanded the existing drug resistance data. MdrDB is comprised of 100,537 samples of 240 proteins (which encompass 5119 total PDB structures), 2503 mutations, and 440 drugs. Each sample brings together 3D structures of wild type and mutant protein-ligand complexes, binding affinity changes upon mutation (ΔΔG), and biochemical features. Experimental results with MdrDB demonstrate its effectiveness in significantly enhancing the performance of commonly used machine learning models when predicting ΔΔG in three standard benchmarking scenarios. In conclusion, MdrDB is a comprehensive database that can advance the understanding of mutation-induced drug resistance, and accelerate the discovery of novel chemicals.

Validation of the simplified Chinese version of PROMIS Parent Proxy-25 Profile in parents of children with cancer.

PURPOSE: To determine the psychometric properties of the Patient-reported Outcomes Measurement Information System Parent Proxy-25 Profile (PROMIS-25) in a sample of Chinese parents of children with cancer. DESIGN AND METHODS: A cross-sectional sample (N = 148) of parents with children aged 5-17 years living with cancer was recruited. Each participant completed sociodemographic and clinical questionnaires and PROMIS-25. The flooring and ceiling effects were calculated. Reliability was determined by the Cronbach's alpha and split-half coefficient. Factor structure was examined by factor analysis. Model fit and graphical plots were assessed to test the assumptions of Rasch model-based item response theory (IRT). Differential item functioning (DIF) was assessed in terms of gender, age, and treatment stage. RESULTS: PROMIS-25 demonstrated some flooring and ceiling effect, excellent reliability (Cronbach's α > 0.7 for all six domains), and the six-domain factor structure was supported. The IRT assumptions were met in terms of unidimensionality, local independence, monotonicity, and measurement equivalence with acceptable DIF in terms of gender, age, diagnosis, and treatment stage. CONCLUSION: PROMIS-25 is a highly reliable and valid instrument for evaluating children with cancer that assesses important health-related quality of life domains of child cancer. PRACTICE IMPLICATION: Chinese parents of children with cancer and healthcare providers could use PROMIS-25 to assess the symptoms of children.

Daytime Napping and Metabolic Syndrome: A 4-Year Follow-Up Study of Chinese Middle-Aged and Older Adults.

The current study examined the relationship between napping duration and metabolic syndrome (MetS) among Chinese middle-aged and older adults over 4 years. We included 4,526 individuals aged ≥50 years who completed the 2011 and 2015 waves of the China Health and Retirement Longitudinal Study. General linear models were conducted to analyze the association of napping duration (none, 1 to 29 minutes, 30 to 59 minutes, 60 to 89 minutes, and ≥90 minutes) with MetS. At baseline, a higher prevalence of MetS was observed among participants with longer napping durations (60 to 89 minutes or ≥90 minutes) compared to non-nappers (odds ratio [OR] = 1.27, OR = 1.51, respectively). Among all participants, a napping duration ≥90 minutes at baseline was correlated with an increased risk of MetS 4 years later (OR = 1.58). Among participants without MetS at baseline, excessive napping (≥90 minutes) was predictive of a higher incidence of MetS 4 years later (OR = 1.46). Results revealed that excessive napping was related to an increased prevalence and incidence of MetS among Chinese middle-aged and older adults. [Research in Gerontological Nursing, 16(3), 115-124.].

Associated factors of discrepancy between older adults and their family caregivers in reporting elder abuse.

AIMS AND OBJECTIVES: This study focuses on elder abuse against older adults with mild-to-moderate cognitive and physical impairment who were receiving family care in Chinese context. Specifically, the study examined the associated factors of discrepancy between family caregiver and care recipient reports of elder abuse committed by the caregivers. BACKGROUND: Many studies identified the discrepancies between caregivers and care recipients reports of elder abuse, but they did not examine factors contributing to such discrepancies. Various cultural factors may contribute to the accuracy of elder abuse reports. METHODS: A consecutive sample of 1,002 older adults with mild-to-moderate cognitive and physical impairment and their family caregivers was surveyed. DESIGN: Quantitative study with cross-sectional design. RESULTS: Moderate-to-substantial agreement in caregiver and care recipient reports was found for all forms of abuse (Cohen's kappa = 0.39 to 0.76). Care recipient reports consistently generated higher rates than caregiver reports for psychological abuse (51.1% vs. 42.8%), physical abuse (1.2% vs. 1.0%), caregiver neglect (65.0% vs. 50.2%) and financial exploitation (40.8% vs. 34.2%). Similar factors were found for dyadic discrepancy in the reporting of various forms of elder abuse, which included desire to gain face, fear of losing face and sense of familism in the caregivers, as well as older age, cognitive impairment and female gender of the care recipient. This study was presented in adherence to the Strobe Checklist. CONCLUSIONS: The results suggest that family caregivers might not be reliable as the sole informants to report their care recipients' victimization experiences. Information from multiple parties should be gathered and synthesized to obtain more accurate reporting of the frequency and severity of elder abuse. Meanwhile, cultural factors should be taken into account when seeking information related to elder abuse. RELEVANCE TO CLINICAL PRACTICE: There is a need for multiple parties to provide and report information about the elder abuse. It is also need to consider cultural factors when detecting and intervening elder abuse.

Development and usability test of a symptom management WeChat Mini Program for parents of children with cancer.

Objective: Symptom management is a persistent challenge in pediatric oncology. The WeChat Mini Program, a small smartphone application that functions within WeChat, has the potential to assist in symptom management. This study aimed to develop a symptom management WeChat Mini Program for parents and children with cancer aged 5-17 years old and evaluate its usability. Methods: Based on the semi-structured interviews with parents of children with cancer, experts in pediatric oncology and informatics and a survey of children's symptom experience, multidisciplinary research group meetings were conducted to confirm the structure and main contents of the Mini Program. The iterative method was used to develop the Mini Program. A mixed-method study was conducted to test its usability with 10 pairs of parents and children with cancer. The quantitative data were collected through the Poststudy System Usability Questionnaire, and qualitative data were collected from interviews. Results: The Mini Program "Child SMILE" was developed, which includes a symptom assessment and management module, an information and emotional support module, a communication module among the parents and medical professionals, and a personal information module. Most users reported that the Mini Program is user-friendly, with satisfaction scores on the Poststudy System Usability Questionnaire ranging from 5.2 to 5.7 (out of 7.0) in four dimensions. In qualitative interviews, most participants thought the Mini Program was convenient, easy to use, and helpful. Conclusions: It can be concluded that the Mini Program satisfies the needs of parents of children with cancer and has the potential to benefit the symptom management of children with cancer.

Perceived Support Protects Against Negative Affective Experiences of Momentary Solitude: An Ecological Momentary Assessment Study.

OBJECTIVES: Momentary solitude (the objective state of being alone) has a strong association with negative affective experiences in older people, but little is known about how the role of social relationship characteristics on relationship between momentary solitude and affect. We examined the momentary association between momentary solitude and negative affect (NA), and whether such association was moderated by the structural and functional aspects of social relationships. METHODS: A sample of 153 late-middle-aged and older adults were recruited and provided a total of 6,742 ecological momentary assessment surveys, of which momentary solitudes were reported for 1,885 (28%) surveys. Hierarchical linear model was used to examine how social networks and social support moderated the association of momentary solitude with NA experiences. RESULTS: The association of momentary solitude with NA experiences was significant among middle-aged and older adults (b = 0.025, SE = 0.008, p < .01). Family networks had the main effect on NA. Perceived social support buffered against increased NA in momentary solitude: Individuals with a higher level of perceived support reported fewer increases in NA during momentary solitude than those perceiving a lower level of support. DISCUSSION: Momentary solitude was experienced less negatively for middle-aged and older persons embedded in a context of higher levels of perceived social support. Practitioners need to pay more attention to the promotion of social resources when delivering programs to improve the subjective well-being of late-middle-aged and older adults.

Construction and Analysis of lncRNA-Associated ceRNA Network in Atherosclerotic Plaque Formation.

Atherosclerosis (AS) is a vascular disease with plaque formation. Unstable plaques can be expected to result in cardiovascular disease, such as myocardial infarction and stroke. Studies have verified that long noncoding RNAs (lncRNAs) play a critical role in atherosclerotic plaque formation (APF), including MALAT1, GAS5, and H19. A ceRNA network is a combination of these two interacting processes, which regulate the occurrence and progression of many diseases. However, lncRNA-associated ceRNA network in terms of APF is limited. This study sought to discover novel potential biomarkers and ceRNA network for APF. We designed a triple network based on the lncRNA-miRNA and mRNA-miRNA pairs obtained from lncRNASNP and starBase. Differentially expressed genes (DEGs) and lncRNAs in human vascular tissues derived from the Gene Expression Omnibus database (GSE43292, GSE97210) were systematically selected and analyzed. A ceRNA network was constructed by hypergeometric test, including 8 lncRNAs, 243 miRNAs, and 8 mRNAs. APF-related ceRNA structure was discovered for the first time by combining network analysis and statistical validation. Topological analysis determined the key lncRNAs with the highest centroid. GO and KEGG enrichment analysis indicated that the ceRNA network was primarily enriched in "regulation of platelet-derived growth factor receptor signaling pathway," "negative regulation of leukocyte chemotaxis," and "axonal fasciculation." A functional lncRNA, HAND2-AS1, was identified in the ceRNA network, and the main miRNA (miRNA-570-3p) regulated by HAND2-AS1 was further screened. This present study elucidated the important function of lncRNA in the origination and progression of APF and indicated the potential use of these hub nodes as diagnostic biomarkers and therapeutic targets.

An Adaptive Human Posture Detection Algorithm Based on Generative Adversarial Network.

Human posture equipment technology has advanced significantly thanks to advances in deep learning and machine vision. Even the most advanced models may not be able to predict all body joints accurately. This paper proposes an adaptive generative adversarial network to improve the human posture detection algorithm in order to address this issue. GAN is used in the algorithm to detect human posture improvement. The algorithm uses OpenPose to detect and connect keypoints and then generates heat maps in the GAN system model. During the training process, the confidence evaluation mechanism is added to the system model. The generator predicts posture, while the resolver refines human joints over time. And, by using normalization technologies in the confidence evaluation mechanism, the generator can pay more attention to the prominent body joints, improving the algorithm's body detection accuracy of nodes. In MPII, LSP, and FLIC datasets, the proposed algorithm has shown to have a good detection effect. Its positioning accuracy is about 95.37 percent, and it can accurately locate the joints of the entire body. Several other algorithms are outperformed by this one. The algorithm described in this article has the best simultaneous runtime in the LSP dataset.

Relationship between delayed luminescence emission and mitochondrial status in Saccharomyces cerevisiae.

Delayed luminescence (DL) is gradually used in various detection of biological systems as a rapid detection technique, however, its biological mechanism was still not clear. In this study, a new model of DL detection system for liquid biological samples is established to investigate the DL emission of Saccharomyces cerevisiae cells cultured in different glucose concentrations. We analyzed the relationship between the DL emission and cell growth, cell vitality, mitochondrial morphology, mitochondrial DNA (mtDNA) copy number, adenosine triphosphate (ATP), oxygen consumption rate (OCR), as well as mitochondria membrane potential (MMP) in S. cerevisiae cells cultured with 0.01, 0.05, 0.15, 3, 10 and 20 g/L glucose respectively. It was found that the DL emission had strong correlation with mitochondrial morphology, OCR, and MMP. The results suggested that DL is an indicator of mitochondria status under different glucose supply conditions, and may be an effective method to detect mitochondrial metabolism related disorders.

Spousal concordance in frailty predicting mental and functional health decline: A four-year follow-up study of older couples in urban and rural China.

AIMS AND OBJECTIVES: To examine the joint effects of self and spousal frailty status on functional and mental health in Chinese older adults and determine whether such effects vary by urban versus rural residency. BACKGROUND: Frailty is a clinical syndrome among old adults and would lead to adverse outcomes. However, studies on the interactive patterns of frailty status between spouses and the joint effects of such patterns on health outcomes are scarce. DESIGN: Data were from the China Health and Retirement Longitudinal Study (CHARLS). A total of 2,581 married seniors who participated both 2011 and 2015 waves of the CHARLS were categorised into four groups: robust self-robust spouse (RR), robust self-frail spouse (RF), frail self-robust spouse (FR) and frail self-frail spouse (FF). METHODS: Frailty was measured using the physical frailty phenotype scale. Depressive symptoms were measured using the Center for Epidemiologic Studies Depression Scale (CESD). Functional health was measured by difficulties in activities of daily living (ADL) and instrumental activities of daily living (IADL). The generalised estimating equation was used to estimate the effects of concordant frailty on mental and functional outcomes, stratified by rural/urban residency. This study followed the STROBE checklist. RESULTS: The FF group reported higher levels of ADL/IADL difficulties and depressive symptoms at follow-up than the RR group; urban individuals in the RF group reported higher follow-up depression than the RR group; and rural individuals from the FR or RF groups reported more follow-up ADL/IADL difficulties than the RR group. CONCLUSION: Frailty and subsequent health decline are interdependent in older couples, and the rural/urban context is important for understanding this interdependence in the older Chinese population. RELEVANCE TO CLINICAL PRACTICE: Couples-based intervention strategies are needed to tackle situations in which one or both spouses are concurrently facing frailty.

Association between the metabolic syndrome and muscle weakness among Chinese older adults: results from the China Health and Retirement Longitudinal Study.

BACKGROUND: Metabolic syndrome (MetS) may adversely influence muscle strength. However, the relationship remains poorly understood in China, despite its large older population and the high prevalence of MetS. OBJECTIVES: We aimed to investigate the association between MetS and muscle weakness among older Chinese. METHODS: We included 2,418 older adults who completed the 2011 and 2015 waves of the China Health and Retirement Longitudinal Study (CHARLS) and had normal handgrip strength at baseline. Data were analyzed using descriptive statistics and logistic regressions. RESULTS: Baseline MetS was associated with increased risks for incident muscle weakness (OR = 1.35, 95% CI: 1.08-1.67). Among all the MetS components, baseline central obesity component was predictive of muscle weakness. The association between MetS and declined muscle strength existed in men but not women. CONCLUSION: There was an increased risk of muscle strength decline associated with MetS, which was more prominent in men.

Impact of Subjective and Objective Sleep Quality on Peptic Ulcer Rebleeding in Older Adults.

OBJECTIVE: This study aimed to examine the association of subjective and objective sleep quality with subsequent peptic ulcer rebleeding among older patients. METHODS: Of 1196 older patients with peptic ulcer bleeding (PUB) recruited from 12 grade A hospitals in the People's Republic of China, 1106 achieved full recovery from PUB, and they were followed up for up to 30 days. Using multiple measures at 1-week intervals, patients who presented PUB symptoms were invited to have an esophagogastroduodenoscopy examination. Subjective sleep quality was measured using the Pittsburgh Sleep Quality Index. Objective sleep quality domains were measured using an accelerometer, including sleep onset latency, sleep efficiency, total sleep time, and the number of awakenings. RESULTS: This study documented a 30-day cumulative ulcer rebleeding rate of 15.3%. Multivariate analyses showed that longer sleep onset latency (hazard ratio [HR] = 2.136 [1.336-2.558]) and more nighttime awakenings (HR = 1.698 [1.169-2.666]) increased the risk of ulcer rebleeding. However, a longer total sleep time (HR = 0.768 [0.698-0.887]) and better sleep efficiency (HR = 0.795 [0.682-0.975]) protected against ulcer rebleeding. Older patients who perceived poorer sleep quality were also more likely to experience ulcer rebleeding (HR = 2.295 [1.352-3.925]). CONCLUSIONS: The present results highlight the importance of proper treatment and prevention of sleep problems in older adults after successful PUB treatment. Our results, if replicable in future studies with more rigorous design and representative samples, might shed light on the etiology of ulcer rebleeding and suggest new pathways for preventing this disease.