BACKGROUND & AIMS: :Baroreflex control of the heart rate is significantly reduced during aging. However, neural mechanisms that underlie such a functional reduction are not fully understood. We injected the tracer DiI into the left nucleus ambiguus (NA), then used confocal microscopy and a Neurolucida Digitization System to examine qualitatively and quantitatively vagal efferent projections to cardiac ganglia of young adult (5-6 months) and aged (24-25 months) rats (Sprague Dawley). Fluoro-Gold was injected intraperitoneally to counterstain cardiac ganglionic principal neurons (PNs). In aged, as in young rats, NA axons projected to all cardiac ganglia and formed numerous basket endings around PNs in the hearts. However, significant structural changes were found in aged rats compared with young rats. Vagal efferent axons contained abnormally swollen axonal segments and exhibited reduced or even absent synaptic-like terminals around PNs, such that the numbers of vagal fibers and basket endings around PNs were substantially reduced (P < 0.01). Furthermore, synaptic-like varicose contacts of vagal cardiac axons with PNs were significantly reduced by approximately 50% (P < 0.01). These findings suggest that vagal efferents continue to maintain homeostatic control over the heart during aging. However, the marked morphological reorganization of vagal efferent axons and terminals in cardiac ganglia may represent the structural substrate for reduced vagal control of the heart rate and attenuated baroreflex function during aging.

背景与目标： : 衰老期间心率的压力反射控制明显降低。但是，尚不完全了解这种功能降低的神经机制。我们将示踪剂DiI注射到左核歧义 (NA) 中，然后使用共聚焦显微镜和神经清醒数字化系统定性和定量地检查迷走神经传出对年轻成人 (5-6个月) 和年龄 (24-25岁) 大鼠 (Sprague Dawley)。腹膜内注射氟金以反染色心脏神经节主要神经元 (PNs)。在年龄较大的大鼠中，NA轴突投射到所有心脏神经节，并在心脏PNs周围形成许多篮状末端。然而，与年轻大鼠相比，老年大鼠发现了明显的结构变化。迷走神经传出轴突包含异常肿胀的轴突段，并在PNs周围表现出减少或甚至不存在突触样末端，使得PNs周围迷走神经纤维和篮状末端的数量显著减少 (P <0.01)。此外，迷走神经心脏轴突与PNs的突触样静脉曲张接触显着减少了约50% (P <0.01)。这些发现表明，在衰老过程中，迷走神经传出继续保持对心脏的稳态控制。然而，心脏神经节中迷走神经传出轴突和终末的明显形态重组可能代表了衰老过程中迷走神经对心率的控制降低和压力反射功能减弱的结构底物。

BACKGROUND & AIMS: BACKGROUND AND OBJECTIVE:To (i) determine if the prevalence of asthma has altered in two previously studied communities and (ii) obtain baseline measures in two further communities in the Torres Strait region, Australia. METHODS:A population-based cross-sectional study of school-aged children was conducted. Five schools in four communities were selected: 361 children aged 5-17 years participated. The study used the same epidemiological tool that had been utilized to measure asthma prevalence (locally adapted International Study of Asthma and Allergy in Childhood questionnaire). RESULTS:The overall response rate was 30%; response rates in individual communities ranged from 23% to 100%. The prevalence of self-reported wheezing in the last 12 months decreased from 10.7% to 6.6% (P = 0.109) on Thursday Island and from 3.1% to zero (P = 0.358) on Warraber Island. The percentage of children with asthma symptoms was lower in this current study but changes were not statistically significant. Overall self-reported prevalence of ever wheezing was 12.5%; 5.4% reported wheezing in the previous 12 months, 5.9% reported wheezing after exercise and 12.2% reported ever having asthma. There was considerable inter-community variation in the prevalence of symptoms. CONCLUSIONS:Asthma prevalence in school-aged children living in the Torres Strait region remains high but, as in mainstream Australian children, the prevalence is stable.

背景与目标：

BACKGROUND & AIMS: :This study examines the effect of age on oedema and brain swelling, and associated glial cell involvement on the size of the lesion in two models of permanent, focal cerebral ischaemia. Ischaemia was induced in male C57BL/Icrfat mice (4-6 and 26-31-month-old) by middle cerebral artery (MCA) occlusion using either electrocoagulation after craniotomy (MCA/craniotomy), or by an intraluminal filament through the carotid artery (MCA/icf). Twenty-four hours after inducing ischaemia, brain swelling and lesion size were measured in young and aged mice, and cerebral oedema by wet/dry brain weights. Histopathology and immunocytochemistry were performed on a separate set of perfusion fixed brains. The MCA/icf technique produced a significantly larger lesion than MCA/craniotomy in both age groups. The percentage of water taken into the brain was significantly greater after MCA/icf, with aged mice showing the greatest increase. When lesion size was corrected for brain swelling there was no age-related increase in the size of the lesion. The numbers of microglia and astroglia increased significantly in the parietal cortex of aged control animals, and there were qualitative differences in the glial response between the two stroke models. This study emphasizes the importance of age in models of permanent focal ischaemia, with oedema clearly being a significant factor. Differ-ences in the responsiveness of the glial cell population with age may be of fundamental importance in the progress of ischaemic brain damage.

背景与目标： : 这项研究在两种永久性局灶性脑缺血模型中检查了年龄对水肿和脑肿胀以及相关的神经胶质细胞受累对病变大小的影响。在雄性C57BL/Icrfat小鼠 (4-6和26-31个月大) 中，通过开颅手术后的电凝 (MCA/开颅) 或通过腔内细丝通过大脑中动脉 (MCA) 闭塞诱发了缺血。颈动脉 (MCA/icf)。诱导缺血后24小时，在年轻和老年小鼠中测量脑肿胀和病变大小，并通过湿/干脑重量测量脑水肿。组织病理学和免疫细胞化学是在一组单独的灌注固定大脑上进行的。在两个年龄组中，MCA/icf技术产生的病变明显大于MCA/开颅手术。MCA/icf后，进入大脑的水百分比显着更高，其中衰老的小鼠显示出最大的增加。当将病变大小校正为脑肿胀时，病变大小没有与年龄相关的增加。老年对照动物的顶叶皮质中小胶质细胞和星形胶质细胞的数量显着增加，并且两种中风模型之间的神经胶质反应存在质的差异。这项研究强调了年龄在永久性局灶性缺血模型中的重要性，而水肿显然是一个重要因素。神经胶质细胞群体的反应性随年龄的变化可能对缺血性脑损伤的进展至关重要。

BACKGROUND & AIMS: :Schistosomiasis control programs aim to reduce morbidity but are evaluated by infection prevalence and intensity reduction. We present baseline cross-sectional data from a nested cohort study comparing indicators of morbidity for measuring program impact. Eight hundred twenty-two schoolchildren 7-8 years of age from Nyanza Province, Kenya, contributed stool for diagnosis of Schistosoma mansoni and soil-transmitted helminths (STH) and blood smears for malaria, and were evaluated for anemia, quality of life, exercise tolerance, anthropometry, and ultrasound abnormalities. Schistosoma mansoni, STH, and malaria infection prevalence were 69%, 25%, and 8%, respectively. Only anemia and S. mansoni infection (adjusted odds ratio [aOR] = 1.70; confidence interval [CI] = 1.03-2.80), and hepatomegaly and heavy S. mansoni infection (aOR = 2.21; CI = 1.19-4.11) were associated. Though anemia and hepatomegaly appeared most useful at baseline, additional morbidity indicators may be sensitive longitudinal measures to evaluate schistosomiasis program health impact.

背景与目标： : 血吸虫病控制计划旨在降低发病率，但通过感染率和强度降低来评估。我们提供了一项嵌套队列研究的基线横断面数据，比较了发病率指标以衡量计划的影响。来自肯尼亚Nyanza省的82名7-8岁的学童为诊断曼氏血吸虫和土壤传播的蠕虫 (STH) 和血液涂片提供了粪便，并评估了贫血，生活质量，运动耐受性，人体测量学和超声异常。曼氏血吸虫，STH和疟疾感染率分别为69%，25% 和8%。仅贫血和曼氏沙氏菌感染 (调整后的比值比 [aOR] = 1.70; 置信区间 [CI] = 1.03-2.80)，以及肝肿大和重度曼氏沙氏菌感染 (aOR = 2.21; CI = 1.19-4.11) 相关。尽管贫血和肝肿大在基线时似乎最有用，但其他发病率指标可能是评估血吸虫病计划对健康影响的敏感纵向指标。

BACKGROUND & AIMS: BACKGROUND:The incidence of heart failure (HF) is decreasing in older ages, but increasing rates have been observed among younger persons in Sweden. Therefore, we investigated the relationship between risk of hospitalization for HF and body mass index (BMI). METHODS:This was a prospective registry-based cohort study. We included 1,374,031 women aged 18-45 years (mean age 27.9 years) who gave birth during 1982-2014, and were registered in the Medical Birth Register. Information on hospitalization because of HF was collected through linkage to the National Inpatient Register. RESULTS:Compared to women with a BMI of 20-<22.5 kg/m2, women with a BMI of 22.5-<25.0 had a hazard ratio (HR) of 1.24 (95% confidence interval (CI), 1.10-1.39) for HF after adjustment for age, year, parity, baseline disorders, smoking, and education. The HR (95% CI) increased to 1.56 (1.36-1.78), 2.39 (2.05-2.78), 2.82 (2.43-3.28), and 4.51 (3.63-5.61) in women with a BMI of 25-<27.5, 27.5-<30, 30-<35, and ≥35 kg/m2, respectively. The multiple-adjusted HRs (95% CI) associated with risk of HF per one-unit increase in BMI in women with a BMI ≥ 22.5 kg/m2 ranged from 1.01 (0.97-1.06) for HF related to valvular disease to 1.14 (1.12-1.15) for coronary heart disease, diabetes, or hypertension. CONCLUSION:Increasing body weight was strongly associated with the risk of early HF in women. Compared with lean women, the risk for HF started to increase at high-normal BMI levels, and was nearly five-fold in women with a BMI ≥ 35 kg/m2.

背景与目标：

BACKGROUND & AIMS: AIM:The aim of the present study was to describe the clinical presentation of patients aged ≥80 years with coronavirus disease 2019 (COVID-19), and provide insights regarding the prognostic factors and the risk stratification in this population. METHODS:This was a single-center, retrospective, observational study, carried out in a referral center for COVID-19 in central Italy. We reviewed the clinical records of patients consecutively admitted for confirmed COVID-19 over a 1-month period (1-31 March 2020). We excluded asymptomatic discharged patients. We identified risk factors for death, by a uni- and multivariate Cox regression analysis. To improve model fitting and hazard estimation, continuous parameters where dichotomized by using Youden's index. RESULTS:Overall, 69 patients, aged 80-98 years, met the inclusion criteria and were included in the study cohort. The median age was 84 years (82-89 years is interquartile range); 37 patients (53.6%) were men. Globally, 14 patients (20.3%) presented a mild, 30 (43.5%) a severe and 25 (36.2%) a critical COVID-19 disease. A total of 23 (33.3%) patients had died at 30 days' follow up. Multivariate Cox regression analysis showed that severe dementia, pO2 ≤90 at admission and lactate dehydrogenase >464 U/L were independent risk factors for death. CONCLUSIONS:The present data suggest that risk of death could be not age dependent in patients aged ≥80 years, whereas severe dementia emerged is a relevant risk factor in this population. Severe COVID-19, as expressed by elevated lactate dehydrogenase and low oxygen saturation at emergency department admission, is associated with a rapid progression to death in these patients. Geriatr Gerontol Int 2020; ••: ••-••.

背景与目标：

BACKGROUND & AIMS: :Experimental studies showed that tea polyphenols may inhibit growth of Mycobacterium tuberculosis. However, no prospective epidemiologic study has investigated tea drinking and the risk of active tuberculosis. We investigated this association in the Singapore Chinese Health Study, a prospective population-based cohort of 63,257 Chinese aged 45-74 years recruited between 1993 and 1998 in Singapore. Information on habitual drinking of tea (including black and green tea) and coffee was collected via structured questionnaires. Incident cases of active tuberculosis were identified via linkage with the nationwide tuberculosis registry up to 31 December 2014. Cox proportional hazard models were used to estimate the relation of tea and coffee consumption with tuberculosis risk. Over a mean 16.8 years of follow-up, we identified 1249 incident cases of active tuberculosis. Drinking either black or green tea was associated with a dose-dependent reduction in tuberculosis risk. Compared to non-drinkers, the hazard ratio (HR) (95% confidence interval (CI)) was 1.01 (0.85-1.21) in monthly tea drinkers, 0.84 (0.73-0.98) in weekly drinkers, and 0.82 (0.71-0.96) in daily drinkers (p for trend = 0.003). Coffee or caffeine intake was not significantly associated with tuberculosis risk. In conclusion, regular tea drinking was associated with a reduced risk of active tuberculosis.

背景与目标： 实验研究表明，茶多酚可抑制结核分枝杆菌的生长。然而，没有前瞻性流行病学调查调查饮茶和活动性结核病的风险。我们在新加坡中国健康研究 (Singapore Chinese Health Study) 中调查了这一关联，该研究是一项基于人群的前瞻性队列，63,257名年龄在45-74岁的中国人在新加坡招募1993年和1998名。通过结构化问卷收集有关习惯性喝茶 (包括红茶和绿茶) 和咖啡的信息。到2014年12月31日，通过与全国结核病登记处的联系，确定了活动性结核病的事件病例。Cox比例风险模型用于估计茶和咖啡消费与结核病风险的关系。在平均16.8年的随访中，我们确定了1249例活动性结核病病例。喝红茶或绿茶与结核病风险的剂量依赖性降低有关。与不饮酒者相比，每月饮茶者的风险比 (HR) (95% 置信区间 (CI)) 为1.01 (0.85-1.21)，每周饮酒者为0.84 (0.73-0.98)，每日饮酒者为0.82 (0.71-0.96) (趋势p = 0.003)。咖啡或咖啡因的摄入与结核病风险没有显着相关。总之，经常喝茶与降低活动性结核病的风险有关。

BACKGROUND & AIMS: :We conducted a literature review to assess the current status of general practitioner services in residential aged-care facilities (RACFs) in Australia and the impact of recent initiatives to enhance access by RACF residents to these services. Of 400 publications identified, 22 were selected as relevant to our study. We also analysed publicly available statistical data on GP services in RACFs. Recent initiatives to improve quality of care and facilitate access to GP services for RACF residents include the Aged Care GP Panels Initiative, the Enhanced Primary Care program, and an expanded role of palliative care. Despite these initiatives, many GPs still find RACF services unappealing due to a perceived poor level of remuneration for the effort involved. Further improvements in access to and quality of GP services to RACFs may require new models of care delivery and financing.

背景与目标： : 我们进行了文献综述，以评估澳大利亚老年护理机构 (RACF) 中全科医生服务的现状，以及最近为增加RACF居民获得这些服务而采取的举措的影响。在确定的400份出版物中，选择了22份与我们的研究相关。我们还分析了RACFs中GP服务的公开统计数据。最近为提高护理质量和促进RACF居民获得全科医生服务而采取的举措包括老年护理全科医生小组倡议，增强的初级保健计划以及姑息治疗的扩大作用。尽管采取了这些举措，但由于所涉及的工作报酬低，许多全科医生仍然认为RACF服务没有吸引力。Rcf获得全科医生服务的机会和质量的进一步提高可能需要新的护理提供和融资模式。

BACKGROUND & AIMS: :The objective of this study was to study the association between total sugar intake (TSI) levels of children aged 6-8 years old, nutrient intake and anthropometry. Food and beverage intakes were collected by a prospective three-day recall questionnaire. The 2237 children were distributed into three groups according to TSI percentiles. Mean TSI was 93.77 ± 25.72 g/day, 22%-25% of total caloric intake, with boys presenting an intake of 96.24 ± 24.34 g/day and girls 91.38 ± 26.78 g/day. Greater TSI was associated with higher body fat, parental education, energy intake, nutrients/1000 kcal, and lower weight z-scores, BMI z-scores, waist circumferences, and hip circumferences. Weight, height, and waist circumference had the highest R2 while body fat had the lowest. The percentage of total energy derived (%E) from protein decreased as the %E from TSI increased, while the opposite was true for carbohydrates and saccharides, while for fiber intake, the medium groups presented the highest intake/1000 kcal. For the remaining macronutrients studied, intake/1000 kcal decreased when the %E from TSI increased. Calcium, iodine, magnesium, vitamin B2, folate, and vitamin C intake increased as the %E from TSI increased, while the opposite was true for vitamin B12. Fiber, ω-6 PUFA, iodine, folate, vitamin D, and vitamin E intakes were insufficient across most of the sample. TSI levels in children were identified to exceed adult recommendations. It is not clear what the effect of up to an average of 21% of energy coming from total sugars has on childhood obesity and further research is needed in the pediatric population, however, opportunities exist to improve sugar intake patterns.

背景与目标： : 这项研究的目的是研究6-8岁儿童的总糖摄入量 (TSI) 水平，营养素摄入量和人体测量学之间的关系。食品和饮料摄入量是通过为期三天的前瞻性召回问卷收集的。根据TSI百分位数将2237名儿童分为三组。平均TSI为93.77 ± 25.72g/天，占总热量摄入量的22%-25%，男孩的摄入量为96.24 ± 24.34g/天，女孩的摄入量为91.38 ± 26.78g/天。较大的TSI与较高的体脂，父母教育，能量摄入，营养素/1000 kcal以及较低的体重z评分，BMI z评分，腰围和臀围有关。体重，身高和腰围的R2最高，而体脂最低。来自蛋白质的总能量百分比 (% E) 随着来自TSI的 % E的增加而降低，而碳水化合物和糖则相反，而对于纤维摄入，培养基组呈现最高摄入量/1000 kcal。对于所研究的其余大量营养素，当来自TSI的 % E增加时，摄入量/1000 kcal降低。钙，碘，镁，维生素B2，叶酸和维生素c的摄入量随着TSI % E的增加而增加，而维生素b12则相反。在大多数样本中，纤维，ω-6pufa，碘，叶酸，维生素d和维生素e的摄入量不足。儿童的TSI水平被确定超过成人建议。目前尚不清楚来自总糖的平均能量21% 对儿童肥胖的影响，需要在儿科人群中进行进一步的研究，但是，存在改善糖摄入模式的机会。

BACKGROUND & AIMS: :Seven-valent pneumococcal conjugate vaccine (PCV7) was introduced to Sweden in 2009 and replaced by pneumococcal non-typeable Haemophilus influenzae protein D conjugate vaccine (PHiD-CV) or 13-valent PCV (PCV13) from late 2009. A retrospective cohort study assessed the impact of PCVs on otitis media/acute otitis media (OM) in children aged ≤5 years (NCT02742753) living in Skåne (PCV7 then PHiD-CV) or Västra Götalandsregionen (PCV7 then PCV13) between 2005 and 2013 using linked regional and national databases. Time-series analyses described differences between pre-PCV and post-PCV eras. Adjusted age-period-cohort (APC) predictive models estimated vaccine effectiveness and OM incidence ratios between PCV cohorts. Time-to-first OM diagnosis was estimated in ≤2 year-olds by survival analysis using a Cox proportional hazards model. Descriptive interrupted time-series analyses showed OM incidence in ≤2 year-olds declined by 42% (Skåne) and 25% (Västra Götalandsregionen) after PHiD-CV/PCV13, respectively, versus pre-PCV, but baseline OM incidence and duration of PCV7 use differed between regions. In adjusted APC models, OM incidence decreased after PHiD-CV by 9.9% (95% confidence interval [CI]: 4.4; 15.1, p < .001) and PCV13 by 2.3% (95%CI: -3.2; 7.6, p = .401) compared with pre-PCV. Both PHiD-CV and PCV13 decreased the risk of first OM diagnosis: hazard ratio (95%CI) for PHiD-CV relative to pre-PCV 0.67 (0.65; 0.69); 0.87 (0.85; 0.89) for PCV13 relative to pre-PCV; p < .001 for both comparisons. Within the limitations of this study conducted in two large Swedish regions, descriptive time-series analyses showed that OM incidence rates declined following the introduction of PHiD-CV and PCV13; however, this reduction only reached statistical significance for PHiD-CV in the adjusted APC models.

背景与目标： : 七价肺炎球菌结合疫苗 (PCV7) 2009年引入瑞典，由2009年的肺炎球菌不可分型流感嗜血杆菌蛋白D结合疫苗 (phid-cv) 或13价PCV (PCV13) 取代。一项回顾性队列研究评估了PCVs对生活在skne (PCV7然后是phid-cv) 或v ä stra g ö talandschregionen (PCV7然后是PCV13) 2005年和2013的5岁以下儿童 (NCT02742753) 的中耳炎/急性中耳炎 (OM) 的影响使用链接的区域和国家数据库。时间序列分析描述了PCV前和PCV后era之间的差异。校正年龄周期队列 (APC) 预测模型估计的疫苗有效性和PCV队列之间的OM发生率比。使用Cox比例风险模型通过生存分析估算 ≤ 2岁儿童的首次OM诊断时间。描述性中断时间序列分析显示，与PCV前相比，phid-cv/PCV13后 ≤ 2岁儿童的OM发生率分别下降了42% (sk å ne) 和25% (v ä stra g ö talandsregionen)，但基线OM发生率和PCV7的使用持续时间在不同地区之间有所不同。在校正的APC模型中，与PCV前相比，phid-cv 9.9% 后OM发生率降低 (95% 置信区间 [CI]: 4.4; 15.1，p <.001)，PCV13 2.3% 降低 (95% CI: -3.2; 7.6，p = .401)。Phid-cv和PCV13均降低了首次OM诊断的风险: phid-cv相对于PCV前0.67的风险比 (95% CI) (0.65; 0.69); PCV13相对于PCV前的风险比0.87 (0.85; 0.89); 两种比较的p <0.001。在两个大型瑞典地区进行的这项研究的局限性内，描述性时间序列分析表明，在引入phid-cv和PCV13后，OM发病率下降; 然而，在调整后的APC模型中，这种降低仅达到phid-cv的统计学意义。

BACKGROUND & AIMS: :While cell therapy is emerging as a promising option for patients with ischemic cardiomyopathy (ICM), the influence of advanced donor age and a history of ischemic injury on the reparative performance of these cells are not well defined. As such, intrinsic changes that result from advanced donor age and ischemia are explored in hopes of identifying a molecular candidate capable of restoring the lost reparative potency of heart explant-derived cells (EDCs) used in cell therapy. EDCs were cultured from myocardial biopsies obtained from young or old mice 4 weeks after randomization to experimental myocardial infarction or no intervention. Advanced donor age reduces cell yield while increasing cell senescence and the secretion of senescence-associated cytokines. A history of ischemic injury magnifies these effects as cells are more senescent and have lower antioxidant reserves. Consistent with these effects, intramyocardial injection of EDCs from aged ischemic donors provided less cell-mediated cardiac repair. A transcriptome comparison of ICM EDCs shows aging modifies many of the pathways responsible for effective cell cycle control and DNA damage/repair. Over-expression of the barely explored antisenescent transcription factor, Mybl2, in EDCs from aged ICM donors reduces cell senescence while conferring salutary effects on antioxidant activity and paracrine production. In vivo, we observed an increase in cell retention and vasculogenesis after treatment with Mybl2-over-expressing EDCs which improved heart function in infarcted recipient hearts. In conclusion, Mybl2 over-expression rejuvenates senescent EDCs sourced from aged ICM donors to confer cell-mediated effects comparable to cells from young nonischemic donors.

背景与目标： : 尽管细胞治疗已成为缺血性心肌病 (ICM) 患者的有希望的选择，但晚期供体年龄和缺血性损伤史对这些细胞修复性能的影响尚不明确。因此，探索了由晚期供体年龄和缺血引起的内在变化，以期找到能够恢复细胞治疗中使用的心脏外植体衍生细胞 (edc) 丧失的修复能力的分子候选者。随机分组至实验性心肌梗死或无干预4周后，从年轻或老年小鼠获得的心肌活检中培养edc。晚期供体年龄降低细胞产量，同时增加细胞衰老和衰老相关细胞因子的分泌。缺血性损伤的历史会放大这些作用，因为细胞更衰老且抗氧化剂储备较低。与这些作用一致，从老年缺血供体的心肌内注射EDCs可提供较少的细胞介导的心脏修复。ICM edc的转录组比较显示，衰老修饰了许多负责有效细胞周期控制和DNA损伤/修复的途径。在来自老年ICM供体的edc中，几乎未探索的抗衰老转录因子Mybl2的过度表达可减少细胞衰老，同时对抗氧化活性和旁分泌产生有益的作用。在体内，我们观察到用Mybl2-over-expressing EDCs治疗后细胞保留和血管生成的增加，这改善了梗塞受体心脏的心脏功能。总之，Mybl2过表达可使来自老年ICM供体的衰老edc恢复活力，从而赋予细胞介导的作用，与年轻的非缺血供体的细胞相当。

BACKGROUND & AIMS: BACKGROUND:China has achieved nearly universal coverage of the Social Basic Medical Insurance (SBMI), which aims to reduce the disease burden and improve the utilization of health services. We investigated the association between China's health insurance schemes and health service utilization of middle-aged and older adults at different quantiles, and then explored whether the SBMI could help reduce the underutilization of health services among the middle-aged and older adults in China. METHODS:Survey data of middle-aged and older adults were drawn from the China Health and Retirement Longitudinal Study (CHARLS). A linear quantile mixed regression model was utilized to provide a comprehensive understanding of the relationship between SBMI and health service utilization, which was measured by the total medical expenditure. We took the New Rural Cooperative Medical Scheme (NCMS) as the reference level and examined the associations of the Urban Employee Basic Medical Insurance (UEBMI) and the Urban Resident Basic Medical Insurance (URBMI) with health service utilization. RESULTS:The quantile regression analysis revealed a significant positive association between URBMI and health service utilization at the 0.75 (β = 1.608, p < 0.01), 0.8 (β = 1.578, p < 0.01), 0.85 (β = 1.473, p < 0.01), 0.9 (β = 1.403, p < 0.01) and 0.95 (β = 1.152, p < 0.01) quantiles, and also a significant positive association between UEBMI and health service utilization at the 0.85 (β = 1.196, p < 0.01), 0.9 (β = 1.070, p < 0.01) and 0.95 (β = 0.736, p < 0.01) quantiles. Results showed that URBMI was significantly associated with an improvement in inpatient health service utilization of the middle-aged and older adults, and a significant positive association between UEBMI and inpatient health service utilization was observed at 0.1 (β = 0.559, p < 0.01), 0.25 (β = 0.420, p < 0.05), 0.5 (β = 0.352, p < 0.05), and 0.75 (β = 0.306, p < 0.05) quantiles. CONCLUSIONS:Inequity in health service utilization exists among the middle-aged and older adults across urban and rural Chinese areas, and it can be explained by the different reimbursement benefits of SBMI types.

背景与目标：

BACKGROUND & AIMS: BACKGROUND:Soluble Klotho (S-Klotho) is an aging suppressor with a close link with inflammation. However, it is still unknown whether the dietary inflammatory potential is associated with S-Klotho plasma level. We aimed to investigate the association of the Dietary Inflammatory Index (DII) with S-Klotho plasma levels in middle-aged sedentary adults. METHODS:73 middle-aged sedentary adults (40-65 years old) participated in the present study. DII was determined from 28 dietary items obtained by 24 h recalls and food frequency questionnaires. The S-Klotho plasma levels were measured using a solid-phase sandwich enzyme-linked immunosorbent assay. RESULTS:a weak positive association was observed between DII and S-Klotho plasma levels (β = 52.223, R2 = 0.057, p = 0.043), which disappeared after controlling for body mass index (p = 0.057). CONCLUSIONS:A pro-inflammatory dietary pattern measured with the DII was slightly and positively associated with S-Klotho plasma levels in middle-aged sedentary adults.

背景与目标：

BACKGROUND & AIMS: :The prevalence of habitual snoring has been extensively explored in paediatric populations. Although exposure to cigarette smoke increases the risk of habitual snoring in a dose-dependent fashion, the potential contribution of air quality to habitual snoring remains unclear. 6000 questionnaires were distributed to 6- to 12-year-old children attending public schools in five distinct neighbourhoods within the city of Tehran, Iran, that were preselected based on air quality measures. Habitual snoring was defined as loud snoring ≥3 nights per week. Information regarding clinical and family-related habitual snoring risk factors was also obtained. Descriptive statistics followed by adjusted risk assessments were conducted. Among the 4322 (72%) completed datasets, the prevalence of habitual snoring was 11.6%. Partition of habitual snoring rates according to neighbourhood air quality characteristics revealed significantly higher habitual snoring frequencies among children residing in neighbourhoods with greatest pollution (24.5% and 12.1% in South and Central neighbourhoods versus 7.0% and 7.7% in North and East neighbourhoods, respectively). The regional variance in habitual snoring was primarily accounted for by an integrated measure of air quality, even after controlling for other risk factors. Environmental air quality emerges as a significant and potentially modifiable contributor to the risk for developing habitual snoring during childhood.

背景与目标： : 习惯性打鼾的患病率已在儿科人群中得到广泛探讨。尽管暴露于香烟烟雾会以剂量依赖的方式增加习惯性打鼾的风险，但空气质量对习惯性打鼾的潜在贡献仍不清楚。向伊朗德黑兰市五个不同社区的公立学校就读的6至12岁儿童分发了6000份问卷，这些问卷是根据空气质量指标预先选择的。习惯性打鼾被定义为每周大声打鼾 ≥ 3晚。还获得了有关临床和家庭相关的习惯性打鼾危险因素的信息。进行描述性统计，然后进行调整后的风险评估。在4322 (72%) 完成的数据集中，习惯性打鼾的患病率为11.6%。根据邻里空气质量特征对习惯性打鼾率的划分表明，居住在污染最大的社区中的儿童习惯性打鼾频率明显更高 (南部和中部分别为24.5% 和12.1%，北部和东部分别为7.0% 和7.7%)。即使在控制了其他危险因素之后，习惯性打鼾的区域差异也主要是通过对空气质量的综合衡量来解释的。环境空气质量成为导致儿童时期习惯性打鼾风险的重要且潜在的可改变因素。

BACKGROUND & AIMS: PURPOSE:To describe the prevalence of strabismus and strabismus surgery in the aged Medicare fee-for-service population. METHODS:A 5% random sample of Medicare Part B physician claims was used to identify beneficiaries ≥ 65 years of age with strabismus and those undergoing strabismus surgery between 2002 and 2010. RESULTS:In 2010 there were 1,237,469 beneficiaries. The diagnosis of strabismus was made in 8,470 (0.68%), more often in females (56%) and in whites (92%). Common diagnoses were paralytic strabismus, exotropia, and esotropia, with each reported in 22%. Strabismus surgery in 2010 was performed on 197 patients (0.016% of all beneficiaries), or approximately 2.3% of patients with the diagnosis of strabismus. Horizontal surgical codes were reported most frequently (68%). Reoperations were reported for 23% and adjustable sutures for 23% of cases. The prevalence of strabismus surgery ranged from 183 to 236 cases annually (0.015%-0.018%). Review of pooled data (2002-2010) found that the prevalence of strabismus increased with age from 65 to 89 years of age (P < 0.0001) and that whites underwent strabismus surgery more often than African Americans (0.017% vs 0.007%, respectively; P < 0.0001). CONCLUSIONS:Less than 1% of aged Medicare beneficiaries are diagnosed with strabismus each year, with the rate increasing significantly with age. Strabismus surgery is performed annually in 16 of 100,000 of aged Medicare beneficiaries; the surgery rate is significantly lower among African Americans. Understanding the reasons for the difference by race/ethnicity deserve further study.

背景与目标：