A significant number of patients develop cognitive impairment that persists for months following coronary artery bypass grafting (CABG) surgery. Our objectives were to identify patient-related risk ...factors, processes of care, and the occurrence of any perioperative complications associated with cognitive decline.
Nine hundred thirty-nine patients enrolled in the Processes, Structures, and Outcomes of Care in Cardiac Surgery study undergoing CABG-only surgery at 14 Veterans Administration medical centers between 1992 and 1996 completed a short battery of cognitive tests at baseline and 6-months post-CABG. The composite cognitive score was based on the sum of errors for each individual item in the battery. Multiple linear regression analyses were used to identify independent predictors of the 6-month composite cognitive score.
In multivariable analyses, patient characteristics associated with cognitive decline included cerebrovascular disease (
p = 0.009), peripheral vascular disease (
p = 0.007), history of chronic disabling neurologic illness (
p = 0.016), and living alone (
p = 0.049), while the number of years of education (
p = 0.001) was inversely related to cognitive decline. After adjustment for baseline patient risk factors, the presence of any postoperative complication(s) (
p = 0.001) was also associated with cognitive decline while cardiopulmonary bypass time (
p = 0.008) was inversely related to cognitive decline.
Patients with noncoronary manifestations of atherosclerosis, chronic disabling neurologic illness, or limited social support are at risk for cognitive decline after CABG surgery. In contrast, more years of education were associated with less cognitive decline. Preoperative assessment of risk factors identified in this study may be useful when counseling patients about the risk for cognitive decline following CABG surgery.
In this paper we consider the quantization of open strings ending on D-branes with a background
B field. We find that space-time coordinates of the open string end-points become noncommutative, and ...correspondingly the D-brane world-volume also becomes non-commutative. This provides a string theory derivation and generalization of the non-commutativity obtained previously in the M(atrix) model compactification. For D
p-branes with
p ⩾ 2 our results are new and agree with that of M(atrix) theory for the case of
A = 0 (where
A is the world-volume gauge field) if the
T-duality radii are used.
Objective: Adherence to anti-platelet medications is critical following coronary stenting, but prior studies indicate that clinician assessment and patient self-assessment of adherence are poorly ...correlated with future medication-taking behavior. We therefore sought to determine if integrated pharmacy data can be used to identify patients at high risk of non-adherence after percutaneous coronary interventions (PCI). Methods: Using Veteran Affairs (VA) Clinical Assessment, Reporting, and Tracking (CART) data linked with pharmacy records, we assessed adherence to cardiovascular medications from 2012 to 2018. Adherence was defined as the proportion of days covered (PDC) greater than or equal to 0.80. We assessed the association of pre-PCI adherence with post-PCI adherence to P2Y.sub.12 inhibitors and clinical outcomes using logistic regression and Cox proportional hazard models, respectively. Results: Among 56,357 patients, 66.0% filled at least 1 cardiovascular medication within VA for the year prior to PCI and were evaluable for adherence. Pre-PCI non-adherence was 20.7%, and non-adherent patients were more likely to be younger and present non-electively. Non-adherent patients were less likely to adhere to P2Y.sub.12 inhibitor therapy after PCI (Adjusted OR 0.45 C.I. 0.41-0.46), compared with adherent patients, and had a higher adjusted risk of mortality (HR 1.17 C.I. 1.03-1.33). Conclusion: Adherence to cardiovascular medications prior to PCI can be assessed for most patients using pharmacy data, and past adherence is associated with future adherence and mortality after PCI. Use of integrated pharmacy data to identify high-risk patients could improve outcomes and cost-effectiveness of adherence interventions. Plain Language Summary: Why was the study done?: Non-adherence to anti-platelet medications is common following coronary stenting procedures and is associated with worse outcomes, but predicting non-adherence is challenging. What did the researchers do and find?: The researchers examined pharmacy fill-based adherence assessments before and after stenting procedures. Pharmacy data can provide adherence estimates for most patients receiving percutaneous coronary intervention, and these estimates are associated with downstream medication-taking behavior and clinical outcomes. What do the results mean?: Health systems should seek to integrate pharmacy-based adherence estimates into routine care for patients with cardiovascular disease. Identification and targeting of patients at high-risk for non-adherence may improve the impact and cost-effectiveness of future research and health policy interventions aimed at improving adherence. Keywords: percutaneous coronary intervention, medication adherence
We derive noncommutative multiparticle quantum mechanics from noncommutative quantum field theory in the nonrelativistic limit. Particles of opposite charges are found to have opposite ...noncommutativity. As a result, there is no noncommutative correction to the hydrogen atom spectrum at the tree level. We also comment on the obstacles to take noncommutative phenomenology seriously and propose a way to construct noncommutative SU(5) grand unified theory.
In a previous paper we provided a consistent quantization of open strings ending on D-branes with a background
B field. In this letter, we show that the same result can also be obtained using the ...more traditional method of Dirac's constrained quantization. We also extend the discussion to the fermionic sector.
Matrix descriptions of even-dimensional fuzzy spherical branes
S
2
k
in Matrix Theory and other contexts in type II superstring theory reveal, in the large N limit, higher-dimensional geometries
SO(2
...k+1)/
U(
k), which have an interesting spectrum of
SO(2
k+1) harmonics and can be up to 20-dimensional, while the spheres are restricted to be of dimension less than 10. In the case
k=2, the matrix description has two dual field theory formulations. One involves a field theory living on the non-commutative coset
SO(5)/
U(2) which is a fuzzy
S
2 fibre bundle over a fuzzy
S
4. In the other, there is a
U(
n) gauge theory on a fuzzy
S
4 with
O(n
3)
instantons. The two descriptions can be related by exploiting the usual relation between the fuzzy two-sphere and
U(
n) Lie algebra. We discuss the analogous phenomena in the higher-dimensional cases, developing a relation between fuzzy
SO(2
k)/
U(
k) cosets and unitary Lie algebras.
We study the implication of decoupling zero-norm states in the high-energy limit, for the 26-dimensional bosonic open string theory. Infinitely many linear relations among 4-point functions are ...derived algebraically, and their unique solution is found. Equivalent results are also obtained by taking the high-energy limit of Virasoro constraints, and as an independent check, we compute all 4-point functions of 3 tachyons and an arbitrary massive state by saddle-point approximation.
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