Background Elevated homocysteine （Hcy） has been reported to be associated with cardiovascular events in atrial fibrillation （AF） pa- tients, while the age-related expression pattern of plasma Hcy in AF remains unk...Background Elevated homocysteine （Hcy） has been reported to be associated with cardiovascular events in atrial fibrillation （AF） pa- tients, while the age-related expression pattern of plasma Hcy in AF remains unknown. The study was aimed to investigate the effect of ad- vanced age on plasma Hcy levels and its association with ischemic stroke in non-valvular AF patients. Methods A total of 2562 consecu- tive patients with non-valvular AF and 535 controls were enrolled and divided into six age groups. Plasma Hcy levels were analyzed among different age groups, and the effect of advanced age on Hcy was investigated. Results Plasma Hcy levels did not show any difference among groups aged below 65 years, while it increased sharply in patients aged 65-74 years and aged over 75 years （15.7 ±4.6 μmol/L, 17.1 ±4.9 μmol/L, both P 〈 0.01 compared with the first four age groups）. Hcy was much higher in AF patients than in controls at the same age group （all P 〈 0.05）. The proportion of patients with hyperhomocysteinemia increased gradually with age from 32.3%, 29.2%, 31.2%, 32.4%, 45.9%, to 51.4% in six age groups. The concentration of Hcy in AF patients with ischemic stroke increased progressively with age, and was higher than those without stroke at the same age. Logistic regression analysis demonstrated that age 65-74 years [odds ratios （OR）： 1.742, 95% confidence interval （CI）： 1.223-2.482, P = 0.002] and age ≥ 75 years （OR： 2.637, 95% CI： 1.605-4.335, P 〈 0.001） were significantly independent predictors of elevated plasma Hcy levels. Conclusions Advanced age was significantly associated with elevated Hcy levels, which may provide a possible explanation for the progressive increase in ischemic stroke especially in elderly AF patients.展开更多
Background: Age-related cognitive and physical decline can impair safe driving performance. Tai Chi exercise benefits cognitive and physical function and may influence safe driving performance in older adults. The pri...Background: Age-related cognitive and physical decline can impair safe driving performance. Tai Chi exercise benefits cognitive and physical function and may influence safe driving performance in older adults. The primary aim of this observational study was to compare cognitive processes and physical function related to safe driving performance among older adult Tai Chi practitioners to normative reference values.Secondary aims were to examine relationships between Tai Chi exercise habits, cognitive processes, and physical function related to safe driving performance and to explore potential predictors of safe driving performance.Methods: The Driving Health Inventory, the Driving Scenes Test, other driving-related cognitive and physical measures, and self-reported measures including the Mindful Attention Awareness Scale(MAAS) and the Vitality Plus Scale(VPS) were collected from current Tai Chi practitioners(n = 58; age 72.9 ± 5.9 years, mean ± SD) with median >3 years Tai Chi practice.Results: Compared to normative reference values, participants performed better on numerous cognitive measures including the Driving Scenes Test(p < 0.001, d = 1.63), maze navigation(p = 0.017, d = 0.27), the Useful Field of View Test(p < 0.001, r = 0.15), and on physical measures including the Rapid Walk Test(p < 0.001, r = 0.20), and the Right Foot Tapping Test,(p < 0.001, r = 0.35). Participants scored higher than normative reference values on MAAS and VPS(p < 0.001, d = 0.75; p = 0.002, d = 0.38, respectively). Statistically significant correlations were found between several study measures. The digit span backward test was the strongest predictor of safe driving performance(β = 0.34,p = 0.009).Conclusion: Tai Chi exercise has the potential to impact cognitive processes and physical function related to safe driving performance. Further study using randomized controlled trials, structured Tai Chi exercise doses, and driving simulator or on-road driving performance as outcome measures are warranted.展开更多
Harmonization of tax policy at European level is the result of compromise that must be achieved between member states＇ sovereignty and obstacles that create differences in legal regime for different categories of tax...Harmonization of tax policy at European level is the result of compromise that must be achieved between member states＇ sovereignty and obstacles that create differences in legal regime for different categories of taxes. The current level of harmonization achieved by the member states clearly shows that the process of reconciliation of taxes will not be a spontaneous, nor will evolve rapidly. With the occasion of European Union [EU] enlargement in 2004 and 2007, disparities in income levels matter between nationals of member states have put more pressure on the cooperation between member states, but some progress has been made including in this area. The idea of harmonization of taxes in the European plan is not new. Context of pertinent and uniform EU position has occurred since the first treaties concluded between member states. The free movements of goods, persons, services and capital, without any obstruction became absolute values. Creating a European tax, set and charged uniformly to all and by all member states, would be possible only if the criteria of budgetary requirements, criteria of efficiency and equity criteria are taken into consideration. Ruling a uniform level of charging would lead to establishing a single tax, mission almost impossible as long as the legal framework on taxation and civil duties remains under the responsibility of each member of EU. This analysis seems to greatly restrict the area of taxes that may meet all requirements listed. EU is still far from time to harmonize VAT （value added tax） levels perceived, but it is noted that the value added tax, income tax and tax on benefits eventually could meet the characteristics of a uniform European tax, achieving unanimous agreement among member states.展开更多
基金This work was supported by grants from the National Natural Science Foundation of China （No. 81670294, 81200141） Beijing Novel Program （No. 2011081, Z131103000413116）.
文摘Background Elevated homocysteine （Hcy） has been reported to be associated with cardiovascular events in atrial fibrillation （AF） pa- tients, while the age-related expression pattern of plasma Hcy in AF remains unknown. The study was aimed to investigate the effect of ad- vanced age on plasma Hcy levels and its association with ischemic stroke in non-valvular AF patients. Methods A total of 2562 consecu- tive patients with non-valvular AF and 535 controls were enrolled and divided into six age groups. Plasma Hcy levels were analyzed among different age groups, and the effect of advanced age on Hcy was investigated. Results Plasma Hcy levels did not show any difference among groups aged below 65 years, while it increased sharply in patients aged 65-74 years and aged over 75 years （15.7 ±4.6 μmol/L, 17.1 ±4.9 μmol/L, both P 〈 0.01 compared with the first four age groups）. Hcy was much higher in AF patients than in controls at the same age group （all P 〈 0.05）. The proportion of patients with hyperhomocysteinemia increased gradually with age from 32.3%, 29.2%, 31.2%, 32.4%, 45.9%, to 51.4% in six age groups. The concentration of Hcy in AF patients with ischemic stroke increased progressively with age, and was higher than those without stroke at the same age. Logistic regression analysis demonstrated that age 65-74 years [odds ratios （OR）： 1.742, 95% confidence interval （CI）： 1.223-2.482, P = 0.002] and age ≥ 75 years （OR： 2.637, 95% CI： 1.605-4.335, P 〈 0.001） were significantly independent predictors of elevated plasma Hcy levels. Conclusions Advanced age was significantly associated with elevated Hcy levels, which may provide a possible explanation for the progressive increase in ischemic stroke especially in elderly AF patients.
基金supported,in part, by the Lange Doctoral Dissertation Research Award, College of Nursing, University of Arizona
文摘Background: Age-related cognitive and physical decline can impair safe driving performance. Tai Chi exercise benefits cognitive and physical function and may influence safe driving performance in older adults. The primary aim of this observational study was to compare cognitive processes and physical function related to safe driving performance among older adult Tai Chi practitioners to normative reference values.Secondary aims were to examine relationships between Tai Chi exercise habits, cognitive processes, and physical function related to safe driving performance and to explore potential predictors of safe driving performance.Methods: The Driving Health Inventory, the Driving Scenes Test, other driving-related cognitive and physical measures, and self-reported measures including the Mindful Attention Awareness Scale(MAAS) and the Vitality Plus Scale(VPS) were collected from current Tai Chi practitioners(n = 58; age 72.9 ± 5.9 years, mean ± SD) with median >3 years Tai Chi practice.Results: Compared to normative reference values, participants performed better on numerous cognitive measures including the Driving Scenes Test(p < 0.001, d = 1.63), maze navigation(p = 0.017, d = 0.27), the Useful Field of View Test(p < 0.001, r = 0.15), and on physical measures including the Rapid Walk Test(p < 0.001, r = 0.20), and the Right Foot Tapping Test,(p < 0.001, r = 0.35). Participants scored higher than normative reference values on MAAS and VPS(p < 0.001, d = 0.75; p = 0.002, d = 0.38, respectively). Statistically significant correlations were found between several study measures. The digit span backward test was the strongest predictor of safe driving performance(β = 0.34,p = 0.009).Conclusion: Tai Chi exercise has the potential to impact cognitive processes and physical function related to safe driving performance. Further study using randomized controlled trials, structured Tai Chi exercise doses, and driving simulator or on-road driving performance as outcome measures are warranted.
文摘Harmonization of tax policy at European level is the result of compromise that must be achieved between member states＇ sovereignty and obstacles that create differences in legal regime for different categories of taxes. The current level of harmonization achieved by the member states clearly shows that the process of reconciliation of taxes will not be a spontaneous, nor will evolve rapidly. With the occasion of European Union [EU] enlargement in 2004 and 2007, disparities in income levels matter between nationals of member states have put more pressure on the cooperation between member states, but some progress has been made including in this area. The idea of harmonization of taxes in the European plan is not new. Context of pertinent and uniform EU position has occurred since the first treaties concluded between member states. The free movements of goods, persons, services and capital, without any obstruction became absolute values. Creating a European tax, set and charged uniformly to all and by all member states, would be possible only if the criteria of budgetary requirements, criteria of efficiency and equity criteria are taken into consideration. Ruling a uniform level of charging would lead to establishing a single tax, mission almost impossible as long as the legal framework on taxation and civil duties remains under the responsibility of each member of EU. This analysis seems to greatly restrict the area of taxes that may meet all requirements listed. EU is still far from time to harmonize VAT （value added tax） levels perceived, but it is noted that the value added tax, income tax and tax on benefits eventually could meet the characteristics of a uniform European tax, achieving unanimous agreement among member states.
