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Used as traditional Chinese medicine, Astragalus membranaceus (Fisch.) Bge. ( A. membranaceus ) roots are also used as tonic food material in a wide range of applications, while the leaves are left in the field, unused. Therefore, comprehensively exploring and utilizing the leaves will inevitably reduce the associated resource waste and environment pollution. In this study, the plant leaves were processed into tea using green tea processing technology. Bioactive components, antioxidant and antibacterial activities of the Leaf Tea (LT) and Dry Leaves (DL) were studied, and compared to that of the Dry Roots (DR). The results showed that the polysaccharides content (POL) in the DR (20.44%) was twice as high as the DL (10.18%) and LT (8.68%). However, the DL contained 36.85% more water-soluble extracts (WSE), 35.09% more ethanol-soluble extracts (ESE), 409.63% more total flavonoid content (TFC), 221.01% more total phenolic content (TPC) and 94.34% more proteins, and the LT contained 26.21% more WSE, 40.64% more ESE, 326.93% more TFC, 191.90% more TPC and 37.71% more proteins. The total amino acid (AA) content in the DR was 8.89%, while in that of the DL and LT were 24.18% and 28.96% respectively, nearly 3-times higher than that of the DR. The antioxidant activity of DR was much lower than those of DL and LT, both of which had antioxidant activity closer to that of Vitamin C (V C ) and the antioxidant activities were even stronger when the optimal concentration was reached. Except for Aspergillus niger and Staphylococcus aureus, the DL and DR exhibited inhibition activities to Salmonella , Bacillus subtilis, Escherichia coli and yeast , while the LT had antimicrobial activities against all the strains except for A. niger . In summary, compared with the most commonly used DR, the DL and LT from A. membranaceus contained higher bioactive components, and stronger antioxidant and antimicrobial activities. Producing leaf tea may be an appropriate way to economically and reasonably utilize the plant leaves which are by-products.

Causal estimates of the benefits of increased schooling using US state schooling laws as instruments typically rely on specifications which assume common trends across states in the factors affecting different birth cohorts. Differential changes across states during this period, such as relative school quality improvements, suggest that this assumption may fail to hold. Across a number of outcomes including wages, unemployment, and divorce, we find that statistically significant causal estimates become insignificant and, in many instances, wrong-signed when allowing year of birth effects to vary across regions.

In this study, a gold nanoparticles colorimetric probe (AuNPs) with direct response to mercury ions (Hg 2+ ) were developed using treated N-methylpyrrolidone (NMP) and chloroauric acid (HAuCl 4 ) as precursors. NMP showed good reducibility after high temperature hydrolysis and could be used as reducing and stabilizing agent to synthesize AuNPs. The prepared AuNPs have obvious characteristic absorption peaks and appear wine-red. At the same time, it was found that the presence of Hg 2+ can cause the aggregation of AuNPs, increased the absorbance at 700 nm, and changed the color of the solution into blue-gray. This method is capable of sensitive and specific determination of Hg 2+ ranging from 1 to 30 μM, with the limit of detection (LOD) at 0.3 μM. The method showed good specificity for the determination of Hg 2+ and has the potential to be applied to Hg 2+ detection in sewage samples in the environment.

Background Frail patients with chronic obstructive pulmonary disease (COPD) face a higher risk of adverse outcomes, but there is no clear consensus on which frailty measures are most suitable for COPD patients. Herein we evaluated the ability of frailty measurements in predicting 1-year acute exacerbation, hospitalization, and mortality in older patients with COPD. Methods A total of 302 patients [median age: 86 years (IQR: 80–90), 22.2% female] were admitted to the Department of Geriatric Medicine were prospectively enrolled in this study. Frailty status was assessed using the Fried Frailty Phenotype (FFP), Clinical Frailty Scale (CFS), Frailty Index of Accumulative Deficits (FI-CD), and Short Physical Performance Battery (SPPB). Cox proportional hazard regression and Poisson regression were used to evaluating the association of the adverse outcomes with frailty as assessed using the four instruments. The discrimination accuracy of these tools in predicting the 1-year all-cause mortality was also compared. Results Prevalence of frailty ranged from 51% (using FFP) to 64.2% (using CFS). The four frail instruments were associated with 1-year mortality. After an average follow-up time of 2.18 years (IQR: 1.56–2.62 years), frailty as defined by four instruments (except for FI-CD), was associated with death [FFP: Hazard ratio (HR) = 3.11, 95% confidence interval (CI) 1.30–7.44; CFS: HR = 3.68, 95% CI 1.03–13.16; SPPB: HR = 3.74, 95% CI 1.39–10.06). Frailty was also associated with acute exacerbation (using FFP) and hospitalization (using FFP, CFS, and FI-CD). Frail showed a moderate predictive ability [area under the curve ranging (AUC) 0.70–0.80] and a high negative predictive value (0.98–0.99) for 1-year mortality. Conclusions With the four different frailty assessment tools, frailty was associated with poor prognosis in older patients with stable COPD. The FFP, CFS, FI-CD, and SPPB instruments showed similar performance in predicting 1-year mortality.

For the high prevalence of frail in patients with chronic obstructive pulmonary disease (COPD), further study should explore an in-depth understanding of the relationship between frailty and prognosis of COPD. To determine the correlation between frailty and risk of acute exacerbation, hospitalizations, and mortality in older patients with stable COPD. Consecutive older adults (≥65) diagnosed with stable COPD from January 2018 to July 2019, with an average follow-up of 546 days (N = 309). Frailty was defined by the Fried frailty phenotype. Poisson regression was performed to assess the influence of frailty on the incidence of acute exacerbations of COPD (AECOPD) and all-cause hospitalizations in a year. Cox regression was performed to evaluate the effect of frailty on all-cause mortality in patients with stable COPD. The prevalence of frailty was 49.8%. The most common phenotypic characteristics were weakness (99.4%) followed by slowness (92.9%). After adjustment, frailty increased the incidence of AECOPD (IRR = 1.75, 95% CI: 1.09-2.82) and all-cause hospitalizations (IRR = 1.39, 95% CI 1.04-1.87) within a year. Slowness was associated with AECOPD (IRR = 1.77, 95% CI: 1.03-3.03), and weakness was associated with increased all-cause hospitalizations (IRR = 1.53, 95% CI: 1.04-2.25). The all-cause mortality risk was more than twofold higher in frail patients (HR = 2.54, 95% CI: 1.01-6.36) than non-frail patients. Low physical activity (HR = 2.66, 95% CI: 1.17-6.05) and weight loss (HR = 2.15, 95% CI: 1.02-4.51) were significantly associated with increased all-cause mortality in patients with COPD. Frailty increased the incidence of acute exacerbation and hospitalization, as well as increased mortality in older patients with stable COPD. This knowledge will help physicians identify high-risk groups with COPD and frailty who may benefit from targeted interventions to prevent disease progression.

Intracerebral hemorrhage (ICH) is a cerebrovascular disease with high mortality and morbidity, and the effective treatment is still lacking. We designed this study to investigate the therapeutic effects and mechanisms of melatonin on the secondary brain injury (SBI) after ICH. An in vivo ICH model was induced via autologous whole blood injection into the right basal ganglia in Sprague-Dawley (SD) rats. Primary rat cortical neurons were treated with oxygen hemoglobin (OxyHb) as an in vitro ICH model. The results of the in vivo study showed that melatonin alleviated severe brain edema and behavior disorders induced by ICH. Indicators of blood-brain barrier (BBB) integrity, DNA damage, inflammation, oxidative stress, apoptosis, and mitochondria damage showed a significant increase after ICH, while melatonin reduced their levels. Meanwhile, melatonin promoted further increasing of expression levels of antioxidant indicators induced by ICH. Microscopically, TUNEL and Nissl staining showed that melatonin reduced the numbers of ICH-induced apoptotic cells. Inflammation and DNA damage indicators exhibited an identical pattern compared to those above. Additionally, the in vitro study demonstrated that melatonin reduced the apoptotic neurons induced by OxyHb and protected the mitochondrial membrane potential. Collectively, our investigation showed that melatonin ameliorated ICH-induced SBI by impacting apoptosis, inflammation, oxidative stress, DNA damage, brain edema, and BBB damage and reducing mitochondrial membrane permeability transition pore opening, and melatonin may be a potential therapeutic agent of ICH.

Unlike other forms of martial arts, Chinese Wushu can fortify both the physical and mental health of adolescents. However, limited research has been conducted on the social benefits derived from Chinese martial arts. Grounded in the principles of embodied cognition theory, this study employs the technique of a randomized controlled trial to establish a causal link between Chinese martial arts and the development of interpersonal skills in adolescents. It further explores the mediating role of psychological quality and the potential moderating influence of an only-child status. The practice of Chinese martial arts exhibits a substantial positive impact on interpersonal skills (β=0.161, p

Emergency general surgery (EGS) conditions account for over 3 million or 7.1% of hospitalizations per year in the US. Patients are increasingly transferred from community emergency departments (EDs) to larger centers for care, and a growing demand for treating EGS conditions mandates a better understanding of how ED clinicians transfer patients. We identify patient, clinical, and organizational characteristics associated with interhospital transfers of EGS patients originating from EDs in the United States. We analyze data from the Agency for Healthcare Research and Quality Nationwide Emergency Department Sample (NEDS) for the years 2010–2014. Patient-level sociodemographic characteristics, clinical factors, and hospital-level factors were examined as predictors of transfer from the ED to another acute care hospital. Multivariable logistic regression analysis includes patient and hospital characteristics as predictors of transfer from an ED to another acute care hospital. Of 47,442,892 ED encounters (weighted) between 2008 and 2014, 1.9% resulted in a transfer. Multivariable analysis indicates that men (Odds ratio (OR) 1.18 95% Confidence Interval (95% CI) 1.16–1.21) and older patients (OR 1.02 (95% CI 1.02–1.02)) were more likely to be transferred. Relative to patients with private health insurance, patients covered by Medicare (OR 1.09 (95% CI 1.03–1.15) or other insurance (OR 1.34 (95% CI 1.07–1.66)) had a higher odds of transfer. Odds of transfer increased with a greater number of comorbid conditions compared to patients with an EGS diagnosis alone. EGS diagnoses predicting transfer included resuscitation (OR 36.72 (95% CI 30.48–44.22)), cardiothoracic conditions (OR 8.47 (95% CI 7.44–9.63)), intestinal obstruction (OR 4.49 (95% CI 4.00–5.04)), and conditions of the upper gastrointestinal tract (OR 2.82 (95% CI 2.53–3.15)). Relative to Level I or II trauma centers, hospitals with a trauma designation III or IV had a 1.81 greater odds of transfer. Transfers were most likely to originate at rural hospitals (OR 1.69 (95% CI 1.43–2.00)) relative to urban non-teaching hospitals. Medically complex and older patients who present at small, rural hospitals are more likely to be transferred. Future research on the unique needs of rural hospitals and timely transfer of EGS patients who require specialty surgical care have the potential to significantly improve outcomes and reduce costs.

Carbon dots (CDs) were used to develop a sensitive sensing technique for detecting Cr(VI). CDs were made using a hydrothermal technique from citric acid and glutamic acid. These prepared CDs emitted blue fluorescence under excitation of 350 nm (λem = 420 nm), and the fluorescence quantum yield was 48.41%. Transmission electron microscope was used to examine the morphology of the CDs, which had an average size of 2.21 ± 0.39 nm. The elementary composition and bonding structure of the CDs were conducted by XPS and FT-IR spectrum. Cr(VI) quenched the fluorescence of CDs through a static quenching effect and an inner filter effect, allowing Cr(VI) to be detected quantitatively. This approach was used to detect Cr(VI) in two samples of water, with the findings demonstrating that it is reliable and accurate. The fluorescence intensity change was linearly related to the concentration of Cr(VI) in the range from 0.5 to 400 μM, with the detection limit being 0.10 μM. This approach has the virtues of wide detection range, low cost and fast response. The strategy has a great application prospect for detecting Cr(VI) in practical samples.