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Dietary patterns related to inflammation have garnered great interest in disease prevention. The aims of this study were to evaluate whether a proinflammatory diet affects the incidence of frailty and its reversal in a prospective follow-up study. Data were taken from 5663 community-dwelling individuals ≥ 55 years old in Taiwan. The energy-adjusted dietary inflammatory index (DII) and the Empirical Dietary Inflammatory Patterns-Healthy Aging Longitudinal Study in Taiwan (EDIP-HALT) at baseline were calculated using a food frequency questionnaire. Frailty was assessed with Fried's criteria in 2008–2013 and 2013–2020. Associations with changes in frailty status were assessed with multinominal logistic regressions and adjusted for major confounders. Higher EDIP-HALST scores (proinflammatory) were associated with higher odds of frailty among baseline robust participants in men (OR = 2.44, 95% CI = 1.42–4.21, p-trend < 0.01) and broadline associated in women (OR = 1.96, 95% CI = 0.96–3.98, p-trend = 0.05), but associated with lower odds of reversing back to robust among baseline prefrail participants. However, the later association was only observed in women, and the relationships were stronger in the middle tertile (second vs. first tertile, OR = 0.40, 95% CI = 0.25–0.65). A pro-inflammatory diet pattern was associated with higher odds of frailty onset in baseline robust participants and lower odds of reversal in baseline prefrail female participants. [ABSTRACT FROM AUTHOR]

Background Prognostic indices can enhance personalized predictions of health burdens. However, a simple, practical, and reproducible tool is lacking for clinical use. This study aimed to develop a machine learning-based prognostic index for predicting all-cause mortality in community-dwelling older individuals. Methods We utilized the Healthy Aging Longitudinal Study in Taiwan (HALST) cohort, encompassing data from 5 663 participants. Over the 5-year follow-up, 447 deaths were confirmed. A machine learning-based routine blood examination prognostic index (MARBE-PI) was developed using common laboratory tests based on machine learning techniques. Participants were grouped into multiple risk categories by stratum-specific likelihood ratio analysis based on their MARBE-PI scores. The MARBE-PI was subsequently externally validated with an independent population-based cohort from Japan. Results Beyond age, sex, education level, and BMI, 6 laboratory tests (low-density lipoprotein, albumin, aspartate aminotransferase, lymphocyte count, high-sensitivity C-reactive protein, and creatinine) emerged as pivotal predictors via stepwise logistic regression (LR) for 5-year mortality. The area under curves of MARBE-PI constructed by LR were 0.799 (95% confidence interval [95% CI]: 0.778–0.819) and 0.756 (95% CI: 0.694–0.814) for the internal and external validation data sets, and were 0.801 (95% CI: 0.790–0.811) and 0.809 (95% CI: 0.774–0.845) for the extended 10-year mortality in both data sets, respectively. Risk categories stratified by MARBE-PI showed a consistent dose–response association with mortality. The MARBE-PI also performed comparably with indices constructed with clinical health deficits and/or laboratory results. Conclusions The MARBE-PI is considered the most applicable measure for risk stratification in busy clinical settings. It holds potential to pinpoint older individuals at elevated mortality risk, thereby aiding clinical decision-making. [ABSTRACT FROM AUTHOR]

The cadaver dissection course remains a time-honored tradition in medical education, partly because of its importance in cultivating professional attitudes in students. This study aims to investigate students' attitudes--specifically characterized as "detached concern"--in a cadaver dissection course. An interpretative phenomenological analysis was performed with semi-structured, focus group interviews among 12 third-year medical students from a Taiwanese medical school to reveal their perceptions and learning experiences regarding human cadaver dissection. Based on these interviews, four relevant categories of perspectives were delineated: (1) initial emotional impact, (2) human referents, (3) coping strategies, and (4) ways of perceiving cadavers. Students were divided into two groups based on these categories. Students in Group 1 developed mechanisms described as "detachment" to cope with their initial emotional reactions to cadaveric dissection, which was noted to have disruptive effects on their learning. They considered human referents to be learning obstacles and avoided contact with or thinking about the human referents while performing dissections. Some of them faced a conflict between perceiving the cadaver as a learning tool versus as a human being. This impasse could be resolved if they latently adopted a "perspective switch" between the concept of a learning tool (rational aspect) and a human being (sensitive aspect). The students in Group 2 had no obvious initial emotional reaction. For them, the human referents functioned as learning supports, and the cadavers were consistently perceived as humans. These students held the notion that "cadaver dissection is an act of love"; therefore, they did not experience any need to detach themselves from their feelings during dissection. This alternative attitude revealed that detached concern alone is not sufficient to describe the entire range of medical students' attitudes toward cadaver dissection.

ContextOxidative stress plays a key role in neurodegenerative disorders, including Parkinson’s disease (PD). Rice fermented withMonascus purpureusWent (Monascaceae) NTU 568 (red mould rice) was found to contain antioxidants, including dimerumic acid (DMA) and deferricoprogen (DFC). ObjectiveThe effects of DMA and DFC on 6-hydroxydopamine (6-OHDA)-induced cytotoxicity and potential protective mechanisms in differentiated PC-12 pheochromocytoma cells were investigated. Materials and methodsDMA (0–60 μM) or DFC (0–10 μM) was co-treated with 6-OHDA (200 μM, 24 h exposure) in differentiated PC-12 cells. Cell viability and intercellular reactive oxygen species (ROS) were measured by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) and 2′,7′-dichlorofluorescein-diacetate (DCFH-DA) assays, respectively. Cell apoptosis was determined by DNA fragmentation analysis and propidium iodide staining by flow cytometry. Western blot analysis was used to measure the levels of cell protein expression. ResultsDMA and DFC significantly increased cell viability to 72% and 81% in 6-OHDA-induced differentiated PC-12 cell cultures, respectively. Furthermore, DMA and DFC reduced 6-OHDA-induced formation of extracellular and intercellular ROS by 25% and 20%, respectively, and decreased NADPH oxidase-2 expression in differentiated PC-12 cells. DMA and DFC inhibited 6-OHDA-induced apoptosis and decreased activation of caspase-3 via regulation of Bcl-2-associated X protein (Bax) and Bcl-2 protein expression in differentiated PC-12 cells. ConclusionDMA and DFC may protect against 6-OHDA toxicity by inhibiting ROS formation and apoptosis. These results showed that the metabolites fromM. purpureusNTU 568 fermentation were potential therapeutic agents for PD induced by oxidative damage and should be encouraged for further research. [ABSTRACT FROM AUTHOR]

The cadaver dissection course remains a time-honored tradition in medical education, partly because of its importance in cultivating professional attitudes in students. This study aims to investigate students' attitudes-specifically characterized as 'detached concern'-in a cadaver dissection course. An interpretative phenomenological analysis was performed with semi-structured, focus group interviews among 12 third-year medical students from a Taiwanese medical school to reveal their perceptions and learning experiences regarding human cadaver dissection. Based on these interviews, four relevant categories of perspectives were delineated: (1) initial emotional impact, (2) human referents, (3) coping strategies, and (4) ways of perceiving cadavers. Students were divided into two groups based on these categories. Students in Group 1 developed mechanisms described as 'detachment' to cope with their initial emotional reactions to cadaveric dissection, which was noted to have disruptive effects on their learning. They considered human referents to be learning obstacles and avoided contact with or thinking about the human referents while performing dissections. Some of them faced a conflict between perceiving the cadaver as a learning tool versus as a human being. This impasse could be resolved if they latently adopted a 'perspective switch' between the concept of a learning tool (rational aspect) and a human being (sensitive aspect). The students in Group 2 had no obvious initial emotional reaction. For them, the human referents functioned as learning supports, and the cadavers were consistently perceived as humans. These students held the notion that 'cadaver dissection is an act of love'; therefore, they did not experience any need to detach themselves from their feelings during dissection. This alternative attitude revealed that detached concern alone is not sufficient to describe the entire range of medical students' attitudes toward cadaver dissection. Anat Sci Educ 9: 265-271. © 2015 American Association of Anatomists. [ABSTRACT FROM AUTHOR]