Chronic lithium treatment diminishes the female advantage in lifespan in Drosophila melanogaster

Two studies have concluded that lithium exposure extends the lifespan of Caenorhabditis elegans. However, the effect of lithium on another widely used model organism, Drosophila melanogaster, remains unclear. Here, we demonstrate that chronic treatment with a low to moderate dose of lithium chloride does not extend lifespan in D. melanogaster and that the drug abolishes the female lifespan advantage in flies.     

MNA和SGA在评价炎症性肠病病人营养状况中的应用

目的:探讨炎症性肠病(IBD)病人营养评估的合理方法. 方法:选择微型营养评定法(MNA)联合营养状况主观综合评估(SGA)对IBD病人进行营养状态评估,同时检测血红蛋白(Hb)、总淋巴细胞计数(TLC)、血清前清蛋白(PA)、清蛋白(ALB)以及钠、钾和钙等指标. 结果:Pearson相关分析显示,MNA值与Hb、ALB、和Na+呈显著相关性.Kendall's tau-b相关方法分析证明,MNA与SGA两种营养评估方法具有很好的相关性(r=0.772,P=0.000). 结论:MNA联合SGA对IBD病人进行营养状况评估方法科学和准确.     

Ethical implications of home telecare for older people: a framework derived from a multisited participative study

Context

Telecare and telehealth developments have recently attracted much attention in research and service development contexts, where their evaluation has predominantly concerned effectiveness and efficiency. Their social and ethical implications, in contrast, have received little scrutiny.

Objective

To develop an ethical framework for telecare systems based on analysis of observations of telecare‐in‐use and citizens’ panel deliberations.

Design

Ethnographic study (observation, work shadowing), interviews, older citizens’ panels and a participative conference.

Setting

Participants’ homes, workplaces and familiar community venues in England, Spain, the Netherlands and Norway 2008–2011.

Results

Older respondents expressed concerns that telecare might be used to replace face‐to‐face/hands‐on care to cut costs. Citizens’ panels strongly advocated ethical and social questions being considered in tandem with technical and policy developments. Older people are too often excluded from telecare system design, and installation is often wrongly seen as a one‐off event. Some systems enhance self‐care by increasing self‐awareness, while others shift agency away from the older person, introducing new forms of dependency.

Conclusions

Telecare has care limitations; it is not a solution, but a shift in networks of relations and responsibilities. Telecare cannot be meaningfully evaluated as an entity, but rather in the situated relations people and technologies create together. Characteristics of ethical telecare include on‐going user/carer engagement in decision making about systems: in‐home system evolution with feedback opportunities built into implementation. System design should be horizontal, ‘two‐way’/interactive rather than vertical or ‘one‐way’. An ethical framework for telecare has been developed from these conclusions (Table 1).     

Response to Diazepam in Sons of Alcoholics

Alcohol exerts several of its actions via the chloride channel associated with the central GABA-benzodiazepine receptor complex. To explore a possible role for this receptor complex in risk for alcoholism, and to determine whether risk for alcoholism is associated with risk for benzodiazepine abuse, the authors administered intravenous diazepam to 18 sons of male alcoholics (SOAs) and 18 control subjects. Four logarithmically increasing doses of diazepam and matched volumes of placebo were given in randomized order on separate days about 1 week apart. SOAs were significantly more likely than controls to report euphoric responses to diazepam. At some diazepam doses, SOAs were more likely to report feeling "high" and "intoxicated." SOAs and controls did not differ in feeling "drugged." SOAs and controls may differ in expectations regarding the subjective effects of drugs and/or in the function of the central GABA-benzodiazepine receptor complex. These findings also add further evidence for increased pleasurable effects, and thus possibly increased risk for benzodiazepine abuse, in a subgroup of SOAs.     

Autonomic function in elderly patients with chronic heart failure

AIMS: Autonomic function (AF) is attenuated by heart failure (HF). Reports have been based on studies of young patients with systolic heart failure (SHF). However, HF is a disease of older patients who are more likely to have diastolic heart failure (DHF). We investigated whether age alters AF in elderly HF patients and whether the haemodynamic type of HF influences AF. METHOD AND RESULTS: Thirty-six elderly HF (Framingham criteria) patients (11 with SHF, 25 with DHF) and 21 matched healthy subjects underwent simple bedside AF tests. Compared with the reference values for healthy adults, the mean E:I ratios and the median 30:15 ratios standing were all essentially normal. The median 30:15 ratios tilt and the mean Valsalva ratios were all significantly below the reference value (P for all cases <0.050). Comparing three groups, there were no significant differences for mean E:I ratio (P=0.111), 30:15 tilt (P=0.619) and 30:15 standing (P=0.167), whereas there were significant differences for the mean Valsalva ratios (P=0.001). The mean Valsalva ratio of the SHF patients was significantly lower than that for the DHF patients (P<0.001) which in turn was significantly lower than the result of the healthy subjects (P<0.001). CONCLUSION: There is an age-related impairment in AF with further impairment occurring in patients with HF. However, the severity of autonomic dysfunction is less in patients with DHF compared with patients with SHF.     

Cytomegalovirus contributes partly to uraemia‐associated premature immunological ageing of the T cell compartment

Cytomegalovirus (CMV) infection has been implicated in accelerated T cell ageing. End‐stage renal disease (ESRD) patients have a severely immunologically aged T cell compartment but also a high prevalence of CMV infection. We investigated whether CMV infection contributes to T cell ageing in ESRD patients. We determined the thymic output by the T cell receptor excision circle (TREC) content and percentage of CD31+ naïve T cells. The proliferative history of the T cell compartment by determination of the relative telomere length (RTL) and the T cell differentiation status was determined by immunophenotyping. It appeared that CMV infection did not affect thymic output but reduced RTL of CD8+ T cells in ESRD patients. Moreover, increased T cell differentiation was observed with higher percentages of CD57+ and CD28null CD4+ and CD8+ memory T cells. These CD28null T cells had significantly shorter telomeres compared to CD28+ T cells. Therefore we concluded that CMV infection does not affect the decreased thymic output but increases T cell differentiation as observed in ESRD‐related premature T cell ageing.     

Prevalence of and risk factors associated with sleep disturbances among HPCD exposed to COVID-19 in China

ObjectiveTo assess sleep disturbances and associated factors among front-line healthcare providers who have been called upon for, dispatched (HPCD) and exposed to COVID-19 in China.MethodsThis cross-sectional, survey-based, isolation area-stratified study collected demographic data, sleep status and emotional measurements from 1036 HPCD in nine medical institutions from March 5 to 9, 2020 in Wuhan, China, which was the epicenter of the epidemic. HPCD who worked in isolation areas with COVID-19 were eligible for inclusion. The severity of symptoms of sleep disorders, insomnia and emotional self-efficacy were assessed by the Chinese versions of the 10-item Self-rating sleeping situation scale, the seven-item Insomnia Severity Index and the 12-item Regulatory emotional self-efficacy questionnaire, respectively. Univariate analysis was performed to identify factors associated with sleep disturbances. A structural equation model (SEM) was constructed via AMOS to explore the relationship among the four components.ResultsA total of 1036 out of 1075 contacted individuals completed the survey, with a participation rate of 96.4%. A total of 925 (89.3%) were aged 20–39 years, and 755 (72.9%) were women. Among all participants, 874 (84.4%) were nurses, and 162 (15.6%) were physicians; 538 (51.9%) worked in intensive care isolation units; 843 (81.4%) worked in isolation areas for 4 h straight, and 395 (38.1%) perceived COVID-19 peer exposure. A considerable proportion of participants reported symptoms of sleep disorders (543, 52.4%). Exposure status and length of work were the main factors affecting sleep status, which had indirect effects on sleep status by mediating regulatory emotional self-efficacy.ConclusionsIn this survey of HPCD for patients with COVID-19 in China, participants reported experiencing sleep disturbance burdens, especially those having exposure experience and working long shifts. Regulatory emotional self-efficacy (RESE) is an important resource for alleviating sleep disturbances and improving sleep quality. These findings emphasize the importance of being prepared to support HPCD through psychological interventions.     

Association between sleep quality and subjective cognitive decline: evidence from a community health survey

ObjectivesLittle is known concerning whether subjective cognitive decline (SCD) is associated with sleep quality. This study aimed to identify the association between self-reported quality of sleep and SCD in a large population of middle-aged and older adults in Korea.MethodsWe conducted this study based on data collected from the 2018 Korean Community Health Survey. Individuals aged 40 years and older who responded to the Behavioral Risk Factor Surveillance System (BRFSS) and Pittsburgh Sleep Quality Index (PSQI) assessments and did not lack data about multiple covariates were included. A total of 37,712 respondents with SCD and 135,119 those without SCD were included. Sleep quality was estimated using the PSQI, which includes seven self-reported components for sleep health assessment. SCD was assessed using the BRFSS. Logistic regression models adjusted for confounders were used to examine whether each component of the sleep quality index was related to SCD. Additional analysis of the correlation between quantified scores for each component and SCD-related functional limitations as ordinal variables was performed.ResultsThe mean age was 62.7 years in the SCD group and 56.4 years in the control group. In total, 13,777 (28.9%) respondents were male in the SCD group and 62,439 (50.7%) in the control group. The adjusted odds ratios of SCD were 1.25 for very bad sleep quality, 1.26 for long sleep latency, 1.16 for <5 h of sleep duration, 1.08 for <65% habitual sleep efficiency, 2.29 for high sleep disturbance, 1.26 for use of sleep medication ≥3 times a week, and 2.47 for high daytime dysfunction due to sleep problems compared to good sleep conditions. Furthermore, a higher score for each component of the sleep quality index correlated with greater SCD-related functional limitations.ConclusionsOur study provides evidence that poor sleep quality is closely related to both SCD and SCD-related functional limitations.     

Unpleasant Subjective Emotional Experiencing of Pain

The field of pain medicine that once began as a supportive and compassionate care, adding value to the management of acute and chronic ailments, has now transformed into a vital and essential specialty with structured training programs and service units with professionals dedicating their careers to it. The expansion of understanding of the direct relationship of pain relief to the quality of life, uncovering of neuronal pathways, and technological advances in imaging as well as in interventional techniques have all contributed to this phenomenal growth. However, there is a growing concern whether the training programs and the specialized practitioners are gradually limiting their skilled inputs primarily within the sensory realm of the pain experience with sophisticated interventional techniques and relegating its subjective and emotional dimensions to perfunctory realms within the schema of service provision. While the specialty is still young, if we can understand the inherent aspect of these dimensions within the pain experience and acknowledge the gaps in service provision, it may be possible to champion development of truly comprehensive pain relief programs that responds effectively and ethically to a patient''s felt needs. This article attempts to position the subjectivity of pain experience in context and surface the need to design complete systems of pain relief services inclusive of this dimension. It presents authors’ review of literature on perspectives of ‘unpleasant subjective emotional experiencing of the pain” to elucidate possible clinical implications based on the evidences presented on neuro-biology and neuro-psychology of the pain experience; the aim being to inspire systems of care where this dimension is sufficiently evaluated and managed.