Background and purpose
No study has established a prediction dementia model in the Asian populations. This study aimed to develop a prediction model for dementia in Chinese type 2 diabetes patients.
...Methods
The retrospective cohort study included 27 540 Chinese type 2 diabetes patients (aged 50–94 years) enrolled in the Taiwan National Diabetes Care Management Program. Participants were randomly allocated into derivation and validation sets at a 2:1 ratio. Cox proportional hazards regression models were used to identify risk factors for dementia in the derivation set. Steps proposed by the Framingham Heart Study were used to establish a prediction model with a scoring system.
Results
The average follow‐up was 8.09 years, with a total of 853 incident dementia cases in the derivation set. The dementia risk score summed up the individual scores (from 0 to 20). The areas under the curve of 3‐, 5‐ and 10‐year dementia risks were 0.82, 0.79 and 0.76 in the derivation set and 0.84, 0.80 and 0.75 in the validation set, respectively.
Conclusions
The proposed score system is the first dementia risk prediction model for Chinese type 2 diabetes patients in Taiwan.
1ES 1927+654 is a nearby active galactic nucleus (AGN) that underwent a changing-look event in early 2018, developing prominent broad Balmer lines that were absent in previous observations. We have ...followed up this object in the X-rays with an ongoing campaign that started in 2018 May and that includes 265 NICER (for a total of 678 ks) and 14 Swift/XRT (26 ks) observations, as well as three simultaneous XMM-Newton/NuSTAR (158/169 ks) exposures. In the X-rays, 1ES 1927+654 shows a behavior unlike any previously known AGN. The source is extremely variable both in spectral shape and flux and does not show any correlation between X-ray and UV flux on timescales of hours or weeks/months. After the outburst, the power-law component almost completely disappeared, and the source showed an extremely soft continuum dominated by a blackbody component. The temperature of the blackbody increases with the luminosity, going from kT∼80 eV (for a 0.3–2 keV luminosity ofL0.3−2∼1041.5erg s−1) to∼200 eV (forL0.3−2∼1044erg s−1). The spectra show evidence of ionized outflows and of a prominent feature at ∼1 keV, which can be reproduced by a broad emission line. The unique characteristics of1ES 1927+654 in the X-ray band suggest that it belongs to a new type of changing-look AGN. Future X-ray surveys might detect several more objects with similar properties.
Identifying the exact transmission route(s) of infectious diseases in indoor environments is a crucial step in developing effective intervention strategies. In this study, we proposed a comparative ...analysis approach and built a model to simulate outbreaks of 3 different in‐flight infections in a similar cabin environment, that is, influenza A H1N1, severe acute respiratory syndrome (SARS) coronavirus (CoV), and norovirus. The simulation results seemed to suggest that the close contact route was probably the most significant route (contributes 70%, 95% confidence interval CI: 67%‐72%) in the in‐flight transmission of influenza A H1N1 transmission; as a result, passengers within 2 rows of the index case had a significantly higher infection risk than others in the outbreak (relative risk RR: 13.4, 95% CI: 1.5‐121.2, P = .019). For SARS CoV, the airborne, close contact, and fomite routes contributed 21% (95% CI: 19%‐23%), 29% (95% CI: 27%‐31%), and 50% (95% CI: 48%‐53%), respectively. For norovirus, the simulation results suggested that the fomite route played the dominant role (contributes 85%, 95% CI: 83%‐87%) in most cases; as a result, passengers in aisle seats had a significantly higher infection risk than others (RR: 9.5, 95% CI: 1.2‐77.4, P = .022). This work highlighted a method for using observed outbreak data to analyze the roles of different infection transmission routes.
This study describes the development and validation of the Higher Education Student Engagement Scale (HESES). The psychometric evaluations of the scale included: (i) factor structure, (ii) internal ...consistency, and (iii) criterion validity. The HESES was developed based on our proposed five-factor model of student engagement, which was evolved from Finn and Zimmer's (In: Christenson SL, Reschly AL, Wylie C (eds) Handbook of research on student engagement. Springer, New York, 2012) student engagement model taken into account the distinctive characteristics in higher education. The five main facets of student engagement include: (1) academic engagement, (2) cognitive engagement, (3) social engagement with peers, (4) social engagement with teachers, and (5) affective engagement. The HESES was developed from the 61-item First Year Engagement Scales (FYES). For brevity, it was trimmed into a 28-item scale having regard to the content validity, factor loadings and error variances of the items. The CFA results supported the correlated five-dimensional model with all the dimensions showing high internal consistency based on Cronbach's alpha coefficients. A multi-group CFA also rendered the structure as gender invariant. Its criterion validity was evidenced by its correlations with different student learning outcomes and more importantly, its predictive power in explaining variances of GPA (15%) and satisfaction of the university experience (29%). Different from the dominant behavioral perspective of student engagement in higher education, the HESES is based on a psychological perspective, streamlining student engagement as students' level of involvement in the learning process and a multi-faceted construct with academic, cognitive, social and affective dimensions. The implications and merits of the HESES are discussed.
We report the first genome-wide association study in 1000 bipolar I patients and 1000 controls, with a replication of the top hits in another 409 cases and 1000 controls in the Han Chinese ...population. Four regions with most strongly associated single-nucleotide polymorphisms (SNPs) were detected, of which three were not found in previous GWA studies in the Caucasian populations. Among them, SNPs close to specificity protein 8 (SP8) and ST8 α-N-acetyl- neuraminide α-2,8-sialyltransferase (ST8SIA2) are associated with Bipolar I, with P-values of 4.87 × 10(-7) (rs2709736) and 6.05 × 10(-6) (rs8040009), respectively. We have also identified SNPs in potassium channel tetramerization domain containing 12 gene (KCTD12) (rs2073831, P=9.74 × 10(-6)) and in CACNB2 (Calcium channel, voltage-dependent, β-2 subunit) gene (rs11013860, P=5.15 × 10(-5)), One SNP nearby the rs1938526 SNP of ANK3 gene and another SNP nearby the SNP rs11720452 in chromosome 3 reported in previous GWA studies also showed suggestive association in this study (P=6.55 × 10(-5) and P=1.48 × 10(-5), respectively). This may suggest that there are common and population-specific susceptibility genes for bipolar I disorder.
By designing a structured gas density profile between the dual-stage gas jets to manipulate electron seeding and energy chirp reversal for compressing the energy spread, we have experimentally ...produced high-brightness high-energy electron beams from a cascaded laser wakefield accelerator with peak energies in the range of 200-600 MeV, 0.4%-1.2% rms energy spread, 10-80 pC charge, and ∼0.2 mrad rms divergence. The maximum six-dimensional brightness B_{6D,n} is estimated as ∼6.5×10^{15} A/m^{2}/0.1%, which is very close to the typical brightness of e beams from state-of-the-art linac drivers. These high-brightness high-energy e beams may lead to the realization of compact monoenergetic gamma-ray and intense coherent x-ray radiation sources.
Summary
Objectives
To review clinical evidence on the antiepileptic effects of deep brain stimulation (DBS) for drug‐resistant epilepsy, its safety, and the factors influencing individual outcomes.
...Methods
A comprehensive search of the medical literature (PubMed, Medline) was conducted to identify relevant articles investigating DBS therapy for drug‐resistant epilepsy. Reference lists of these articles were used to source further articles.
Results
Stimulation of the anterior nucleus of the thalamus (ANT) and hippocampus (HC) has been shown to decrease the frequency of refractory seizures. Half of all patients from clinical studies experienced a 46%‐90% seizure reduction with ANT‐DBS, and a 48%‐95% seizure reduction with HC‐DBS. The efficacy of stimulating other targets remains inconclusive due to lack of evidence. Approximately three‐fourths of patients receiving ANT, HC, or centromedian nucleus of the thalamus (CMT) stimulation are responders—experiencing a seizure reduction of at least 50%. The time course of clinical benefit varies dramatically, with both an initial lesional effect and ongoing stimulation effect at play. Improved quality of life and changes to cognition or mood may also occur. Side effects are similar in nature to those reported from DBS therapy for movement disorders. Several factors are potentially associated with stimulation efficacy, including an absence of structural abnormality on imaging for ANT and HC stimulation, and electrode position relative to the target. Certain seizure types or syndromes may respond more favorably to specific targets, including ANT stimulation for deep temporal or limbic seizures, and CMT stimulation for generalized seizures and Lennox‐Gastaut syndrome.
Significance
We have identified several patient, disease, and stimulation factors that potentially predict seizure outcome following DBS. More large‐scale clinical trials are needed to explore different stimulation parameters, reevaluate the indications for DBS, and identify robust predictors of patient response.
Abstract Background Our previous study results indicated that conversion from twice-daily Prograf to once-daily Advagraf associated with lower variability of tacrolimus blood trough level. Some ...factors, such as frequency of interaction by food exposure, expression of cytochrome P450 3A5 genetic polymorphism, and other interactions of unknown factors, could be the reasons for the change of variability. We aimed to clarify the impact of cytochrome P450 3A5 genetic polymorphism on the variability of tacrolimus blood trough level in Taiwanese kidney transplant recipients. Methods We collected blood samples from kidney transplant recipients to prepare DNA and then performed single-nucleotide polymorphism genotyping by using the restriction fragment length polymorphism. Results We found that 79 (52.7%) of 150 kidney transplant recipients had the low-expressive genotype (CYP3A5*3/*3), whereas the other 71 (47.3%) kidney transplant recipients had high-expressive genotype (CYP3A5*1/*1 and CYP3A5*1/*3). The prevalence of high-expressive genotype is higher than previous reports from western countries. Compared with the patients with high-expressive genotype, the average dose-normalized trough level of tacrolimus was significantly higher in patients with low-expressive genotype. Interestingly, when patients converted from twice-daily Prograf to once-daily Advagraf, the percent coefficient of variation of tacrolimus trough level was significantly decreased in patients with high-expressive genotype. Conclusion This study suggested that there is a potential benefit for kidney transplant recipients with cytochrome P450 3A5 high-expressive genotype (*1/*1 or *1/*3) to convert from Prograf to once-daily Advagraf.
The composition of asteroids and their connection to meteorites provide insight into geologic processes that occurred in the early Solar System. We present spectra of the Nightingale crater region on ...near-Earth asteroid Bennu with a distinct infrared absorption around 3.4 micrometers. Corresponding images of boulders show centimeters-thick, roughly meter-long bright veins. We interpret the veins as being composed of carbonates, similar to those found in aqueously altered carbonaceous chondrite meteorites. If the veins on Bennu are carbonates, fluid flow and hydrothermal deposition on Bennu's parent body would have occurred on kilometer scales for thousands to millions of years. This suggests large-scale, open-system hydrothermal alteration of carbonaceous asteroids in the early Solar System.
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