Background and objectives
Early identification of risk factors and timely intervention can reduce the occurrence of cognitive frailty in elderly patients with multimorbidity and improve their quality of life. To explore the risk factors, a risk prediction model is established to provide a reference for early screening and intervention of cognitive frailty in elderly patients with multimorbidity.
Methods
Nine communities were selected based on multi-stage stratified random sampling from May–June 2022. A self-designed questionnaire and three cognitive frailty rating tools [Frailty Phenotype (FP), Montreal Cognitive Assessment (MoCA), and Clinical Qualitative Rating (CDR)] were used to collect data for elderly patients with multimorbidity in the community. The nomogram prediction model for the risk of cognitive frailty was established using Stata15.0.
Results
A total of 1200 questionnaires were distributed in this survey, and 1182 valid questionnaires were collected, 26 non-traditional risk factors were included. According to the characteristics of community health services and patient access and the logistic regression results, 9 non-traditional risk factors were screened out. Among them, age OR = 4.499 (95%CI:3.26–6.208), marital status OR = 3.709 (95%CI:2.748–5.005), living alone OR = 4.008 (95%CI:2.873–5.005), and sleep quality OR = 3.71(95%CI:2.730–5.042). The AUC values for the modeling and validation sets in the model were 0. 9908 and 0.9897. Hosmer and Lemeshow test values for the modeling set were χ2 = 3.857, p = 0.870 and for the validation set were χ2 = 2.875, p = 0.942.
Conclusion
The prediction model could help the community health service personnel and elderly patients with multimorbidity and their families in making early judgments and interventions on the risk of cognitive frailty.
A comprehensive chemostratigraphic study, including evaluation
of rare earth elements and trace elements, was conducted to explain
the paleoenvironments of the northern margin of the Upper Yangtze
Platform. Trace elements, like Ba, U, V, Cu, and Zn, tended to be
more abundant in these formations than in the upper continental crust.
The authigenic abundances of Al-normalized U and V, as well as the
Th/U and V/Sc ratios, were used as indicators of the redox circumstances.
In the Nanjiang area, the redox circumstances of the bottom water
during the Ordovician–Silurian transition changed from oxic
in the Late Katian to slightly anoxic in the Hirnantian and then gradually
became anoxic in the Early Rhuddanian. In the Chengkou area, the redox
circumstances of the bottom water during the Ordovician–Silurian
transition abruptly changed from oxic in the Late Katian to strongly
anoxic in the Hirnantian and continued to become more anoxic until
the Rhuddanian. The total organic carbon concentrations were well
correlated with the redox circumstances of the bottom water. We conclude
that the transient hydrothermal activity was not widely distributed
during the Late Ordovician–Early Silurian transition, and it
might also have been only a local event in the Upper Yangtze Platform.
The enrichment in organic matter was mostly sourced from the photic
zone and was governed by the redox circumstances of the bottom water.
Trichophyton rubrum and T. mentagrophytes are the most common agents of dermatomycosis, a disease affecting millions worldwide. It has been widely recognized that secreted proteases are a key factor for host colonization. Dermatophytes have an unusually high amount of secreted protease, differentially expressed, and influenced by various conditions. This study analyzed the rule and expression of secreted deuterolysin protease of the M35 protein family in these two representative dermatophyte species. All strains secreted protease and could grow on keratin as the sole carbon and nitrogen source. Adding glucose to the keratin medium reduced the growth rate. Deuterolysin genes were most strongly expressed at acid conditions. NPIIc and NPIId expression was significantly higher than the other three deuterolysins. NPIIc had a high expression level in the two T. rubrum strains but a low expression in T. mentagrophytes strains. Both T. mentagrophytes strains had a high NPIId expression at low pH. NPIIc and NPIId deletion in T. rubrum caused a minor reduction in total protease activity, indicating the redundancy of protease in dermatophytes. It was postulated that protease gene enrichment in dermatophytes allows a sophisticated regulation of protease secretion to cope with changing conditions.
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