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Specifically, whereas higher numerate participants’ experienced difficulty and satisfaction were relatively stable between the two choice conditions, lower numerate participants experienced more difficulty and dissatisfaction in the hyperchoice condition than in the simple-choice condition. Additionally, compared to younger adults, older adults reported greater decision difficulty and lower decision satisfaction, regardless of choice condition. The study supported the notion that the specific effect of hyperchoice was moderated by individual factors. The study implied merchants should adopt strategies to ease decision experience and advocated for numeracy education.Clinical studies with time-to-event outcomes often collect measurements of a large number of time-varying covariates over time (e.g., clinical assessments or neuroimaging biomarkers) to build time-sensitive prognostic model. An emerging challenge is that due to resource-intensive or invasive (e.g., lumbar puncture) data collection process, biomarkers may be measured infrequently and thus not available at every observed event time point. Lever-aging all available, infrequently measured time-varying biomarkers to improve prognostic model of event occurrence is an important and challenging problem. In this paper, we propose a kernel-smoothing based approach to borrow information across subjects to remedy infrequent and unbalanced biomarker measurements under a time-varying hazards model. A penalized pseudo-likelihood function is proposed for estimation, and an efficient augmented penalization minimization algorithm related to the alternating direction method of multipliers (ADMM) is adopted for computation. Under some regularity conditions to carefully control approximation bias and stochastic variability, we show that even in the presence of ultra-high dimensionality, the proposed method selects important biomarkers with high probability. Through extensive simulation studies, we demonstrate superior performance in terms of estimation and selection performance compared to alternative methods. Finally, we apply the proposed method to analyze a recently completed real world study to model time to disease conversion using longitudinal, whole brain structural magnetic resonance imaging (MRI) biomarkers, and show a substantial improvement in performance over current standards including using baseline measures only.

Interactions between endothelial cells and vascular smooth muscle cells (VSMCs) through the Notch signal pathway causing diabetic microvasculopathy have been reported.

The purpose of this study was to investigate whether the effect of high glucose on VSMCs through the Notch-2 signaling pathway could induce extracellular matrix (ECM) accumulation, VSMC proliferation and migration and thus directly mediate diabetic macrovasculopathy.

Rat smooth muscle cells (SV40LT-SMC Clone HEP-SA cells) were cultured in different concentrations of D-glucose to evaluate the impact of high glucose on ECM accumulation including fibronectin and collagen I measured by Western blot analysis, and on VSMC proliferation and migration evaluated by MTT assay and wound healing assay. The expression of Notch-2 intra-cellular domain (Notch-2 ICD) protein was also checked in high glucose-stressed VSMCs. N-[N-(3,5-difluorophenacetyl)-l-alanyl]-S-phenylglycine t-butyl ester (DAPT), an inhibitor of γ-secretase, was used to modulate the Nllagen I expressions secreted by VSMCs, and reduced the proliferation and migration of VSMCs under high glucose stress. Inhibition of Notch-2 signaling represents a promising target for treating diabetic macrovasculopathy.

Endovascular therapy with ultrasound-assisted catheter-directed thrombolysis (UACDT) theoretically provides higher efficacy while reducing the bleeding risk compared with conventional systemic thrombolysis. click here The clinical outcomes of UACDT in treating intermediate-to-high-risk pulmonary embolism (PE) are lacking in an Asian population.

Forty-two patients who presented with intermediate-to-high-risk PE received UACDT. The patients were divided into two groups based on the incidence of procedure-related bleeding events, and baseline demographics were compared between the two groups. A paired-Student’s t test was conducted to evaluate the efficacy of UACDT. Univariate and multivariate logistic regression analyses were conducted to identify independent risk factors for significant bleeding events.

The average age was 58.93 ± 20.48 years, and 33.33% of the study participants were male. A total of 85.7% of the participants had intermediate-risk PE. Compared with pre-intervention pulmonary artery pressure, the mian population. The lowest fibrinogen level during thrombolysis was an independent risk factor associated with procedure-related bleeding events.

Hyperuricemia (HUA) induces inflammation and insulin resistance and is reportedly associated with left ventricular hypertrophy (LVH) and possibly with left ventricular diastolic dysfunction (LVDD).

To investigate associations among HUA, inflammation, and insulin resistance with LVDD.

We enrolled patients with metabolic syndrome (MetS) between August 1, 2017, and December 31, 2017. All participants underwent fasting blood tests and transthoracic echocardiography. HUA was defined as an serum uric acid level ≥ 7 mg/dl in men or ≥ 6 mg/dl in women. MetS was defined as at least three of the following Taiwanese criteria central obesity, prehypertension, fasting glucose impairment, hypertriglyceridemia, and lower values of high-density lipoprotein cholesterol. LVDD was defined according to contemporary guidelines.

The study included 63 patients (60% male) with a mean age of 53 ± 14 years and body mass index (BMI) of 29.4 ± 4.0 kg/m

. Prevalence rates of HUA, LVH, LVDD were 40%, 18%, and 10%, respectively. Baseline characteristics were similar between the HUA and normouricemia groups, except that the HUA group had significantly higher serum high-sensitivity interleukin 6 and tumor necrosis factor-alpha (TNF-α) levels. LVDD occurred more frequently in the HUA group (20.0% vs. 2.6%, p = 0.032). HUA was associated with LVDD [crude odds ratio (OR) 9.25, 95% confidence interval (CI) 1.01-84.7, p = 0.049]. In multivariate analysis, the most relevant factor associated with LVDD was TNF-α after adjustments for age, male sex, and body mass index (adjusted OR for TNF-α 4.1, 95% CI 1.02-16.5, p = 0.047).

The association between HUA and LVDD partially reflected a low-grade inflammation due to elevated TNF-α rather than increased insulin resistance in MetS patients.

The association between HUA and LVDD partially reflected a low-grade inflammation due to elevated TNF-α rather than increased insulin resistance in MetS patients.