Despite the extensive study of predictors of cognitive decline in older age, a key uncertainty is how much these predictors explain both the intercept and age- and non-age-related change in cognitive ...functioning (CF). We examined the contribution of a broad range of life course determinants to CF trajectories. Data came from 7,068 participants in the 1996-2016 Health and Retirement Study. CF was measured as a summary score on a 27-point cognitive battery of items. We estimated multilevel growth curve models to examine the CF trajectories in individuals ages 54-85. We found that the variation in CF level at age 54 was three times as much as the variation in age slope. All the observed individual predictors explained 38% of the variation in CF at age 54. Personal education was the most important predictor (25%), followed by race, household wealth and income, parental education, occupation, and depression. The contributions of activity limitations, chronic diseases, health behaviors (obesity, smoking, vigorous activity), childhood conditions (childhood health, nutrition, financial situation), gender, marital status, and religion were rather small (<5%). Even though the age slope varied with many adulthood factors, they only explained 5.6% of the between-person variation in age slope. Moreover, age explained 23% of within-person variation in CF from age 54 to 85. The rest non-age-related within-person variation could not be explained by the observed time-varying factors. These findings suggest that future research is urgently needed to discover the main determinants of the slope of cognitive decline to slow down the progression of cognitive impairment and dementia.
In this paper, we introduce Sonar image Augmentation with Cut and Paste based DataBank for semantic segmentation (SACuP), a novel data augmentation framework specifically designed for sonar imagery. ...Unlike traditional methods that often overlook the distinctive traits of sonar images, SACuP effectively harnesses these unique characteristics, including shadows and noise. SACuP operates on an object-unit level, differentiating it from conventional augmentation methods applied to entire images or object groups. Improving semantic segmentation performance while carefully preserving the unique properties of acoustic images is differentiated from others. Importantly, this augmentation process requires no additional manual work, as it leverages existing images and masks seamlessly. Our extensive evaluations contrasting SACuP against established augmentation methods unveil its superior performance, registering an impressive 1.10% gain in mean intersection over union (mIoU) over the baseline. Furthermore, our ablation study elucidates the nuanced contributions of individual and combined augmentation methods, such as cut and paste, brightness adjustment, and shadow generation, to model enhancement. We anticipate SACuP’s versatility in augmenting scarce sonar data across a spectrum of tasks, particularly within the domain of semantic segmentation. Its potential extends to bolstering the effectiveness of underwater exploration by providing high-quality sonar data for training machine learning models.
Although respiratory syncytial virus (RSV) immunoprophylaxis is recommended for high-risk infants, the American Academy of Pediatrics (AAP) recommends against immunoprophylaxis in the same season ...following a breakthrough hospitalization due to limited risk for a second hospitalization. Evidence in support of this recommendation is limited. We estimated population-based re-infection rates from 2011-2019 in children <5 years since RSV risk remains relatively high in this age group.
Using claims data from private insurance enrollees, we established cohorts of children <5 years who were followed to ascertain annual (July 1-June 30) and seasonal (November 1- February 28/29) RSV recurrence estimates. Unique RSV episodes included inpatient encounters with RSV diagnosis ≥30 days apart, and outpatient encounters ≥30 days apart from each other as well as from inpatient encounters. The risk of annual and seasonal re-infection was calculated as the proportion of children with a subsequent RSV episode in the same RSV year/season.
Over the 8 assessed seasons/years (N = 6,705,979) and across all age groups annual inpatient and outpatient infection rates were 0.14% and 1.29%, respectively. Among children with a first infection, annual inpatient and outpatient re-infection rates were 0.25% (95% confidence interval (CI) = 0.22-0.28) and 3.44% (95% CI = 3.33-3.56), respectively. Both infection and re-infection rates declined with age.
While medically-attended re-infections contributed numerically only a fraction of the total RSV infections, re-infections among those with previous infection in the same season were of similar magnitude as the general infection risk, suggesting that a previous infection may not attenuate the risk for a re-infection.
The COVID-19 pandemic increased the burden due to school closures and stay-at-home orders, disrupting the community energy balance. This study examines rising obesity trends among Korean adolescents ...during school closures, focusing on gender differences and immigrant-origin youths – those of foreign descent or with at least one foreign-born parent. We analysed data from the Korea Youth Risk Behavior Web-based Survey (KYRBS) (N = 539,187). The study aims to assess BMI trends between 2013 and 2022, examine the impact of school closures, and explore differential obesity risks among immigrant-origin youths by gender. Regression models with interaction terms were used to analyse BMI trends and pandemic effects on immigrant-origin youths compared to non-immigrant-origin youths, with gender subgroup analyses. Results show increased BMI for all adolescents, with a notable rise and higher overweight risks in immigrant-origin male adolescents during COVID-19. These findings highlight the need for gender-specific interventions in schools for immigrant-origin youths.
High-quality, Cd-free InP quantum dots (QDs) have been conventionally synthesized by exclusively selecting tris(trimethylsilyl)phosphine (P(TMS)
3
) as a phosphorus (P) precursor, which is ...problematic from the standpoint of green and economic chemistry. Thus, other synthetic chemistries adopting alternative P sources to P(TMS)
3
have been introduced, however, they could not guarantee the production of satisfactorily fluorescence-efficient, color-pure InP QDs. In this study, the unprecedented controlled synthesis of a series of band-gap-tuned InP QDs is demonstrated through a hot-injection of a far safer and cheaper tris(dimethylamino)phosphine in the presence of a key coordinating solvent of oleylamine that enables successful QD nucleation/growth. Effects of the co-existence of Zn additive, the core growth temperature, and the amount of P source injected on the growth behaviors of InP QD are investigated. After ZnS overcoating by a successive injection of 1-dodecanethiol only, high-fluorescence-quality, green-to-red color emission-tunable core/shell QDs of InP/ZnS are obtained. The fluorescent characteristics of different color-emitting QDs desirably exhibit little fluctuations in quantum yield and emission bandwidth, specifically ranging 51–53 % and 60–64 nm, respectively. Lastly, the utility of the introduction of a secondary shelling process in rendering the QDs are more bright, photostable is also proved.
RSV-incidence estimates obtained from routinely-collected healthcare data (e.g., MarketScan) are commonly adjusted for under-reporting using test positivity reported in national Surveillance Systems ...(NREVSS). However, NREVSS lacks detail on patient-level characteristics and the validity of applying a single positivity estimate across diverse patient groups is uncertain. We aimed to describe testing practices and test positivity across subgroups of private health insurance enrollees in the US and illustrate the possible magnitude of misclassification when using NREVSS to correct for RSV under ascertainment. Using billing records, we determined distributions of RSV-test claims and test positivity among a national sample of private insurance enrollees. Tests were considered positive if they coincided with an RSV-diagnosis. We illustrated the influence of positivity variation across sub-populations when accounting for untested acute respiratory infections. Most tests were for children (age 0-4: 65.8%) and outpatient encounters (78.3%). Test positivity varied across age (0-4: 19.8%, 5-17: 1.8%, adults: 0.7%), regions (7.6-16.1%), settings (inpatient 4.7%, outpatient 14.2%), and test indication (5.0-35.9%). When compared to age, setting or indication-specific positivity, bias due to using NREVSS positivity to correct for untested ARIs ranged from - 76% to 3556%. RSV-test positivity depends on the characteristics of patients for whom those tests were ordered. NREVSS-based correction for RSV-under-ascertainment underestimates the true incidence among children and overestimate rates among adults. Demographic-specific detail on testing practice and positivity can improve the accuracy of RSV-incidence estimates.
Despite the significant scientific advancement in deciphering the "deaths of despair" narrative, most relevant studies have focused on drug-, alcohol-, and suicide-related (DAS) deaths. This study ...directly investigated despair as a determinant of death and the temporal variation and racial heterogeneity among individuals. We used psychological distress (PD) as a proxy for despair and drew data from the US National Health Interview Survey-Linked Mortality Files 1997 to 2014, CDC (Centers for Disease Control and Prevention) Multiple Cause of Death database 1997 to 2014, CDC bridged-race population files 1997 to 2014, Current Population Survey 1997 to 1999, and the American Community Survey 2000 to 2014. We used Cox proportional hazards models to estimate mortality hazard ratios of PD and compared age-standardized PD- and DAS-related mortality rates by race/ethnicity and over time. We found that while Whites had a lower prevalence of PD than Blacks and Hispanics throughout the whole period, they underwent distinctive increases in PD-related death and have had a higher PD-related mortality rate than Blacks and Hispanics since the early 2000s. This was predominantly due to Whites' relatively high and increasing vulnerability to PD less the prevalence of PD. Furthermore, PD induced a more pervasive mortality consequence than DAS combined for Whites and Blacks. In addition, PD- and DAS-related deaths displayed a concordant trend among Whites but divergent patterns for Blacks and Hispanics. These findings suggest that 1) DAS-related deaths underestimated the mortality consequence of despair for Whites and Blacks but overestimated it for Hispanics; and 2) despair partially contributed to the DAS trend among Whites but probably not for Blacks and Hispanics.
Schwann cells (SCs), which produce neurotropic factors and adhesive molecules, have been reported previously to contribute to structural support and guidance during axonal regeneration; therefore, ...they are potentially a crucial target in the restoration of injured nervous tissues. Autologous SC transplantation has been performed and has shown promising clinical results for treating nerve injuries and donor site morbidity, and insufficient production of the cells have been considered as a major issue. Here, we performed differentiation of tonsil-derived mesenchymal stem cells (T-MSCs) into SC-like cells (T-MSC-SCs), to evaluate T-MSC-SCs as an alternative to SCs. Using SC markers such as
,
,
,
,
, and
during quantitative real-time PCR we detected the upregulation of
,
, and
and the downregulation of
and
at the fully differentiated stage. Furthermore, we found myelination of axons when differentiated SCs were cocultured with mouse dorsal root ganglion neurons. The application of T-MSC-SCs to a mouse model of sciatic nerve injury produced marked improvements in gait and promoted regeneration of damaged nerves. Thus, the transplantation of human T-MSCs might be suitable for assisting in peripheral nerve regeneration.
PURPOSE.The development of risk models for 16 preventable adverse drug events (pADEs) and their aggregation into the final complexity score (C-score) are described.
METHODS.Using data from 2 tertiary ...care facilities, logistic regression models were constructed for the first 5 hospital days that admissions were at risk for each of 16 pADEs. The best model for each pADE was validated in 100 bootstrap samples. The C-score was then aggregated and predicted individual pADE risk as the probability to develop at least 1 pADE. Using the 100 bootstrap samples for each pADE, 100 C-scores for validation were generated.
RESULTS.We utilized electronic health records (EHR) data from 65,518 admissions to UF Health Shands and 18,269 admissions to UF Health Jacksonville to develop risk models for 16 pADEs. Most models had very strong discriminant validity (C-statistic > 0.8), with the highest predicted decile representing about half of manifest pADEs. Among admissions in the highest C-score decile, about two thirds experienced at least 1 pADE (C-statistic, 0.838; 95% confidence interval, 0.838–0.839). C-score precision, defined as the percentage of patients consistently (i.e., at least 95 of 100 samples) ranked in the 90th percentile, was 80–84%.
CONCLUSION.The C-score was developed and validated for the identification of hospitalized patients at highest risk for pADEs. Aggregation of individual prediction models into a single score reduced its predictive power for most pADEs, compared with the individual risk models, but concentrated in the highest C-score decile a patient group more than two thirds of whom experienced at least 1 pADE.
While other countries have experienced a gradual decline in CBR since the 1990s, South Korea has shown a rapid decline and now has one of the lowest rates in the world. To identify what drives the ...decline of CBR, we apply a decomposition developed by Das Gupta (1993) to Korean registry data (KOSIS) and decompose CBR from 1990 to 2015 into four demographic factors: (1) the proportion of women of reproductive age, (2) the age structure of women of reproductive age, (3) the proportion married among women at each age group, and (4) the marital birth rate at each age group. The results show that the proportion of married among women is the main contributor to the decrease in CBR; a decline in the marriage rate is largely responsible for the low birth rate. The proportion of women of reproductive age and age structure of women of reproductive age are other factors lowering the CBR. Meanwhile, the marital birth rate contributes to an increase in CBR. Although some of the increases produced by marital birth rates could be an artifact of timing changes, the impact reflects the patterns of postponing marriage, which leads to more rapid births after marriage. This study uncovers important demographic factors like decreasing proportion married, the shrinking population in reproductive ages, and ageing among Korean women that drive the decline of CBR.
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