Stochastic mortality models have a wide range of applications. They are particularly important for analysing Chinese mortality, which is subject to rapid and uncertain changes. However, owing to ...data-related problems, stochastic modelling of Chinese mortality has not been given adequate attention. We attempt to use a Bayesian approach to model the evolution of Chinese mortality over time, taking into account all of the problems associated with the data set. We build on the Gaussian state space formulation of the Lee–Carter model, introducing new features to handle the missing data points, to acknowledge the fact that the data are obtained from different sources and to mitigate the erratic behaviour of the parameter estimates that arises from the data limitations. The approach proposed yields stochastic mortality forecasts that are in line with both the trend and the variation of the historical observations. We further use simulated pseudodata sets with resembling limitations to validate the approach. The validation result confirms our approach’s success in dealing with the limitations of the Chinese mortality data.
Background
Cognitive impairment (CI) is common among patients on peritoneal dialysis (PD), but it is under-recognized and systematic review on its prevalence and impact across different geographical ...locations or patient characteristics is lacking.
Methods
A search of the literature on CI in PD patients published between 1 Jan 1980 and 25
.
April 2019 was conducted. Meta-analysis using a random effects model was performed to determine the pooled estimate of the prevalence of CI. Meta-regression was performed to identify factors contributing to the variance of prevalence rate. A systematic review was also performed to study risk factors of CI and its impact on clinical outcomes.
Results
Eight studies were included and the relevant data from 1736 patients were extracted for analysis. Meta-analysis revealed a pooled prevalence of CI at 28.7% (95% CI 15.9–46%). Meta-regression analyses showed that the prevalence of CI was unrelated to patient’s age, gender, duration of PD, healthcare policy of dialysis modality, the prospective or retrospective nature of studies, or year of publication. Systematic review of 20 studies showed that older age, female sex and lower education were risk factors for CI. Potential reversible factors for CI include electrolytes disturbances, depression and vitamin D deficiency. Also, CI was associated with a higher risk of hospitalization, mostly due to PD-related peritonitis.
Conclusions
CI is common in patients on long-term PD. Screening for CI should be considered in PD patients with increased risk.
Knowledge of the factors that affect microbial transfer during surface touch is essential for controlling the risk of infection by fomite transmission. Thirteen factors that affect the microbial ...transfer rate were identified by reviewing the published data. Principal component analysis was performed. Stepwise multiple linear regression revealed donor wetness, microbial transfer direction, donor roughness and existence of rubbing to be the most significant factors.
The transfer rate during surface touch was newly measured using a purpose-made touch machine. The microbial transfer rate was quantified by polymerase chain reaction. In addition to the four significant factors determined by data analysis, five other factors were investigated, including three that have received wide attention (surface material, bacterial species and touch force) and two that were recently found to be significant (bacterial suspension medium and bacterial growth phase).
The relative standard deviation of the measured transfer rate was reduced to 35.6%. The average metal-to-fingerpad transfer rate of Staphylococcus aureus was 15.6% in the baseline condition. It increased to more than 35% under positive conditions such as rubbing during the touch and decreased to less than 5% when water was used as the bacterial suspension medium. Furthermore, the transfer rate increased with a decrease in the donor roughness or an increase in the touch force. No significant difference was observed when the metal surface was replaced with glass and quartz or between the S. aureus and Escherichia coli experiments. These results offer insights into the factors that affect microbial transfer during surface touch.
•Thirteen factors affecting microbial transfer during surface touch were identified by reviewing the published data.•Deviations in the measured microbial transfer rate were reduced significantly by using a purpose-made touch machine.•The average metal-to-fingerpad transfer rate of Staphylococcus aureus was 15.6% at baseline conditions.•Nine factors were experimentally analysed, seven of which affected microbial transfer.•The measured transfer rates were not significantly different between types of surfaces or bacteria.
In this paper, a welding defect prediction model has been developed and investigated through training an artificial neural network (ANN) based model. The input data were three welding process ...measurements (welding current, travel speed, and protective gas flow). The output data were non-destructive test results of respective weldments on four defect types (underfill, lack of penetration,incomplete fusion, and porosity) to ensure the consistency of the welding following the designed parameters; all data were obtained from 289 specimens produced by an automated GMAW welding manufacturing system. The 2-stages model comprises 13 inputs, hidden layers with 80–100 neurons and 4 outputs. The outputs were used to evaluate the classification accuracy in the confusion matrix for the prediction of weld quality. A further 73 specimens were used to test the accuracy of the trained ANN model. The model achieved 85% accuracy.
Aim
To study the prevalence and risk factors of delirium and subsyndromal delirium (SSD) in Chinese older adults with acute medical illnesses.
Methods
A prospective cohort study was carried out in ...acute general medical wards in a university‐affiliated hospital in Hong Kong. Patients were assessed by the confusion assessment method by geriatricians within 6 h after admission and classified into three mutually exclusive groups, namely delirium, SSD and those without both conditions. Predisposing factors and precipitating factors of delirium and SSD were retrieved from collateral information, clinical charts and electronic clinical records.
Results
A total of 575 patients with mean age of 80.8 years were recruited. A total of 73% of the patients did not have delirium, 15.8% of patients had delirium and 11.3% of patients had SSD. On multivariate analysis, patients with delirium or SSD were more likely to be current users of psychotropic medications, had hearing and visual impairment, had a major neurocognitive disorder as defined by the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, and with a lower Barthel Index 20 points version than those without both conditions. Significant predisposing and precipitating factors of delirium included psychotropic medications, acute stroke and other causes of organic brain syndromes. Predisposing and precipitating factors of delirium and SSD were almost identical.
Conclusions
Delirium and SSD are common among Chinese older adults with acute medical illnesses, with a combined prevalence of delirium and SSD of 27%. Important precipitating and predisposing factors include psychotropic medications, acute ischemic stroke and other causes of organic brain syndromes. Geriatr Gerontol Int 2018; 18: 1625–1628.
Alzheimer's disease (AD) is the commonest cause of dementia, characterized by the clinical presentation of progressive anterograde episodic memory impairment. However, atypical presentation of ...patients is increasingly recognized. These atypical AD include logopenic aphasia, behavioural variant AD, posterior cortical atrophy, and corticobasal syndrome. These atypical AD are more common in patients with young onset AD before the age of 65 years old. Since medical needs (including the behavioural and psychological symptoms of dementia) of atypical AD patients could be different from typical AD patients, it is important for clinicians to be aware of these atypical forms of AD. In addition, disease modifying treatment may be available in the future. This review aims at providing an update on various important subtypes of atypical AD including behavioural and psychological symptoms.
The ribonucleoprotein (RNP) complex is the essential transcription-replication machinery of the influenza virus. It is composed of the trimeric polymerase (PA, PB1 and PB2), nucleoprotein (NP) and ...RNA. Elucidating the molecular mechanisms of RNP assembly is central to our understanding of the control of viral transcription and replication and the dependence of these processes on the host cell. In this report, we show, by RNP reconstitution assays and co-immunoprecipitation, that the interaction between NP and polymerase is crucial for the function of the RNP. The functional association of NP and polymerase involves the C-terminal '627' domain of PB2 and it requires NP arginine-150 and either lysine-627 or arginine-630 of PB2. Using surface plasmon resonance, we demonstrate that the interaction between NP and PB2 takes place without the involvement of RNA. At 33, 37 and 41°C in mammalian cells, more positive charges at aa. 627 and 630 of PB2 lead to stronger NP-polymerase interaction, which directly correlates with the higher RNP activity. In conclusion, our study provides new information on the NP-PB2 interaction and shows that the strength of NP-polymerase interaction and the resulting RNP activity are promoted by the positive charges at aa. 627 and 630 of PB2.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Abstract
To evaluate the incremental diagnostic value of 18F-Flutemetamol PET following MRI measurements on an unselected prospective cohort collected from a memory clinic. A total of 84 participants ...was included in this study. A stepwise study design was performed including initial analysis (based on clinical assessments), interim analysis (revision of initial analysis post-MRI) and final analysis (revision of interim analysis post-18F-Flutemetamol PET). At each time of evaluation, every participant was categorized into SCD, MCI or dementia syndromal group and further into AD-related, non-AD related or non-specific type etiological subgroup. Post 18F-Flutemetamol PET, the significant changes were seen in the syndromal MCI group (57%,
p
< 0.001) involving the following etiological subgroups: AD-related MCI (57%,
p
< 0.01) and non-specific MCI (100%,
p
< 0.0001); and syndromal dementia group (61%,
p
< 0.0001) consisting of non-specific dementia subgroup (100%,
p
< 0.0001). In the binary regression model, amyloid status significantly influenced the diagnostic results of interim analysis (
p
< 0.01). 18F-Flutemetamol PET can have incremental value following MRI measurements, particularly reflected in the change of diagnosis of individuals with unclear etiology and AD-related-suspected patients due to the role in complementing AD-related pathological information.
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