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BACKGROUND: Inhibiting the development and progression of diabetic kidney disease (DKD) is an important issue, but the renoprotective effect of metformin is still controversial. AIMS: To assess the renoprotective effect of metformin in patients with type 2 diabetes. METHODS: This retrospective observational multicenter cohort study included 316,693 patients with type 2 diabetes from seven hospital. After age, gender, medical year, baseline estimated glomerular filtration rate (eGFR), urine protein (dipstick), glycated hemoglobin (HbA1C) and propensity score matching; a total of 13,096 metformin and 13,096 non-metformin patients were included. The main results were doubling of serum creatinine, eGFR ≤ 15 mL/min/1.73 m2 and end stage kidney disease (ESKD). RESULTS: After conducting a multivariable logistic regression analysis on the variables, the metformin group was revealed to have better renal outcomes than non-metformin group, including a lower incidence of doubling of serum creatinine (hazard ratio [HR], 0.71; 95% CI, 0.65-0.77), eGFR ≤ 15 mL/min/1.73 m2 (HR 0.61; 95% CI 0.53-0.71), and ESKD (HR 0.55; 95% CI 0.47-0.66). The subgroup analyses revealed a consistent renoprotective effect across patients with various renal functions. Furthermore, when considering factors such as age, sex, comorbidities, and medications in subgroup analyses, it consistently showed that the metformin group experienced a slower deterioration in renal function across nearly all patient subgroups. CONCLUSIONS: Metformin decreased the risk of renal function deterioration.
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Whereas the effects of emotional intensity (the perceived strength of an item's valence or arousal) have long been studied in true- and false-memory research, emotional ambiguity (the uncertainty that attaches to perceived emotional intensity) has only been studied recently. Available evidence suggests that emotional ambiguity has reliable effects on true memory that are distinct from those of emotional intensity. However, those findings are mostly restricted to recall, and the effects of emotional ambiguity on false memory remain unexplored. The current study addressed both limitations by measuring the effects of emotional ambiguity and emotional intensity on true and false recognition. In two experiments, we manipulated valence ambiguity and valence intensity (Experiment 1) and arousal ambiguity and arousal intensity (Experiment 2) of Deese/Roediger/McDermott lists. Multiple linear regression analyses were conducted for Experiment 1, Experiment 2, and the combined data of the experiments to separate the effects of emotional ambiguity and emotional intensity. Our results showed that both valence ambiguity and arousal ambiguity improved true recognition, and the effects of valence ambiguity remained robust even when controlling for valence intensity, arousal intensity, and arousal ambiguity. More importantly, for both valence and arousal, there was an interaction between ambiguity and intensity in false memory. Specifically, we found that valence ambiguity increased false recognition with positive valence, while arousal ambiguity amplified the effect of arousal intensity on false recognition. Our results are discussed in the context of the emotional ambiguity hypothesis and fuzzy-trace theory.
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A distinction has recently been drawn between surface distortions and deep distortions in false memory, where the former are conventional errors of commission and the latter are illogical relations among multiple memories of items. The deep distortions that have been studied to date are violations of the logical rules that govern incompatibility relations, such as additivity and countable additivity. Because that work is confined to laboratory word-list tasks, it is subject to the ecological validity criticism that memory for everyday facts may not exhibit such phenomena. We report evidence that memory for everyday facts displays the same deep distortions as laboratory tasks. We developed a version of the conjoint-recognition paradigm that measures memory for incompatible general knowledge facts, similar to those found on the quiz program Jeopardy! In experiments with university participants, four deep distortions were detected (violations of the additivity, countable additivity, universal set, and compensation rules), with participants consistently remembering more than what is logically possible. The distortions were more robust than in laboratory experiments, and memories of incompatible facts (e.g., Jupiter and Saturn cannot both be the largest planet in the solar system) did not suppress each other. These patterns were replicated in subsequent experiments with older and more diverse participant samples. Consistent with the notion that deep distortions are by-products of gist memory, conjoint-recognition modeling analyses revealed that memory for everyday facts was even more reliant on gist than memory for word lists, and that verbatim memory was near-floor. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Memória , Reconhecimento Psicológico , Humanos , Rememoração MentalRESUMO
Judgments of learning (JOLs) reactivity refers to the finding that the mere solicitation of JOLs modifies subsequent memory performance. One theoretical explanation is the item-specific processing hypothesis, which posits that item-level JOLs redound to the benefit of later memory performance because they enhance item-specific processing. The current study was designed to test this account. We factorially manipulated the organization (blocked vs. randomized) of categorized lists and JOL condition (item-JOLs, list-JOLs, no-JOLs) between participants, and fit the dual-retrieval model to free recall data to pinpoint the underlying memory processes that were affected by JOL solicitation. Our results showed that item-level JOLs produced positive reactivity for randomized but not for blocked categorized lists. Moreover, we found that the positive JOL reactivity for randomized categorized lists was tied to a familiarity judgment process that is associated with gist processing, rather than to item-specific recollective processes. Thus, our results pose a challenge to the item-specific processing explanation of JOL reactivity. We argue that JOL reactivity is not restricted to item-specific processing; instead, whether JOLs predominantly engage participants with item-specific or relational processing depends on the interaction between learning stimuli and JOLs.
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BACKGROUND: Periodontal disease during pregnancy affects maternal oral health and increases the risk of adverse pregnancy outcomes. However, studies on the risk factors for periodontal disease and its impact on oral health-related quality of life in pregnant women in Taiwan are lacking. This present study aimed to identify the risk factors associated with periodontal disease during pregnancy and examine the relationship of periodontal disease with oral health-related quality of life among pregnant women. METHODS: This study was conducted in a large medical centre in northern Taiwan. Eighty-four participants completed a periodontal examination by dentists as well as structured questionnaires, including the Oral Health Impact Profile-14, demographics, obstetric history, dietary habits, and oral hygiene behaviours. Multivariate logistic regression was used to determine the risk factors associated with periodontal disease and a t-test was used to compare the difference in oral health-related quality of life between pregnant women with and without periodontal disease. RESULTS: Fifty participants (59.5%) had periodontal diseases. Risk factors for periodontal disease included eating out for lunch, consuming beverages, brushing less than three times per day, and not receiving regular professional dental cleanings. The oral health-related quality of life was significantly poorer in pregnant women with periodontal disease than in those without. CONCLUSIONS: The risk factors for periodontal disease, including eating out for lunch, drinking beverages, brushing teeth less, and not regular dental cleaning, provide convincing evidence for pregnant women to maintain good oral hygiene to prevent periodontal disease and improve oral health-related quality of life.
Pregnancy can cause poor mouth health. Expectant mothers with gum disease might face problems such as low birth weight and premature birth. This study found that certain factors can worsen gum disease during pregnancy. These include eating out for lunch, drinking sugary or acidic drinks, brushing their teeth less than three daily, and skipping regular teeth cleaning by a dentist. Pregnant women with gum disease also reported a lower quality of life related to oral health compared to those without it. Healthcare providers should educate pregnant women about oral health maintenance. Emphasize the importance of professional dental cleanings every three months, frequent tooth brushing, avoiding sugary and acidic drinks, and reducing eating out for lunch. Future research should explore additional ways to support pregnant women in this regard.
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Doenças Periodontais , Gestantes , Feminino , Humanos , Gravidez , Doenças Periodontais/complicações , Resultado da Gravidez , Qualidade de Vida , Fatores de Risco , Complicações na GravidezRESUMO
Word frequency (WF) is a strong predictor of lexical behavior. However, much research has shown that measures of contextual and semantic diversity offer a better account of lexical behaviors than WF (Adelman et al., 2006; Jones et al., 2012). In contrast to these previous studies, Chapman and Martin (see record 2022-14138-001) recently demonstrated that WF seems to account for distinct and greater levels of variance than measures of contextual and semantic diversity across a variety of datatypes. However, there are two limitations to these findings. The first is that Chapman and Martin (2022) compared variables derived from different corpora, which makes any conclusion about the theoretical advantage of one metric over another confounded, as it could be the construction of one corpus that provides the advantage and not the underlying theoretical construct. Second, they did not consider recent developments in the semantic distinctiveness model (SDM; Johns, 2021a; Johns et al., 2020; Johns & Jones, 2022). The current paper addressed the second limitation. Consistent with Chapman and Martin (2022), our results showed that the earliest versions of the SDM were less predictive of lexical data relative to WF when derived from a different corpus. However, the later versions of the SDM accounted for substantially more unique variance than WF in lexical decision and naming data. The results suggest that context-based accounts provide a better explanation of lexical organization than repetition-based accounts. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Idioma , SemânticaRESUMO
When examining memory effects of semantic attributes, it is common practice to manipulate normed mean (M) ratings of the attributes (i.e., attribute intensity) in learning materials. Meanwhile, the standard deviations (SDs) of attribute ratings (i.e., attribute ambiguity) are usually treated as indexes of measurement error. However, some recent research found that recall accuracy varied as a function of both the intensity and ambiguity of semantic attributes such as valence, categorization, concreteness, and meaningfulness. These findings challenged the traditional interpretation of attribute rating SDs as noise indexes. In the current study, we examined the recognition effects of ambiguity, intensity, and Ambiguity × Intensity interactions for 21 attributes using mega study data for over 5,000 words. Our results showed that attribute ambiguity had reliable recognition effects beyond those of attribute intensity, and that it sometimes explained more unique variance in recognition than attribute intensity. Thus, we concluded that attribute ambiguity is a distinct psychological dimension of semantic attributes, which is processed separately from attribute intensity during encoding. Two theoretical hypotheses had been proposed for the memory effects of attribute ambiguity. We discuss the implications of our findings for the two theoretical hypotheses about how attribute ambiguity influences episodic memory.
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Reconhecimento Psicológico , Semântica , Humanos , Rememoração MentalRESUMO
Parkinson's disease (PD) is a neurodegenerative disease characterized by motor deficits and marked neuroinflammation in various brain regions. The pathophysiology of PD is complex and mounting evidence has suggested an association with the dysregulation of microRNAs (miRNAs) and gut dysbiosis. Using a rotenone-induced PD mouse model, we observed that administration of Lactobacillus plantarum PS128 (PS128) significantly improved motor deficits in PD-like mice, accompanied by an increased level of dopamine, reduced dopaminergic neuron loss, reduced microglial activation, reduced levels of inflammatory factors, and enhanced expression of neurotrophic factor in the brain. Notably, the inflammation-related expression of miR-155-5p was significantly upregulated in the proximal colon, midbrain, and striatum of PD-like mice. PS128 reduced the level of miR-155-5p, whereas it increased the expression of suppressor of cytokine signaling 1 (SOCS1), a direct target of miR-155-5p and a critical inhibitor of the inflammatory response in the brain. Alteration of the fecal microbiota in PD-like mice was partially restored by PS128 administration. Among them, Bifidobacterium, Ruminiclostridium_6, Bacteroides, and Alistipes were statistically correlated with the improvement of rotenone-induced motor deficits and the expression of miR-155-5p and SOCS1. Our findings suggested that PS128 ameliorates motor deficits and exerts neuroprotective effects by regulating the gut microbiota and miR-155-5p/SOCS1 pathway in rotenone-induced PD-like mice.
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Microbioma Gastrointestinal , Lactobacillus plantarum , MicroRNAs , Doenças Neurodegenerativas , Fármacos Neuroprotetores , Doença de Parkinson , Camundongos , Animais , Doença de Parkinson/metabolismo , MicroRNAs/genética , MicroRNAs/metabolismo , Fármacos Neuroprotetores/farmacologia , Fármacos Neuroprotetores/uso terapêutico , Lactobacillus plantarum/metabolismo , Rotenona , Modelos Animais de Doenças , Camundongos Endogâmicos C57BLRESUMO
BACKGROUND This study from a single center in Taiwan aimed to evaluate the impact of remote patient monitoring (RPM) using the Sharesource connectivity platform on adherence to automated peritoneal dialysis (APD) in 51 patients. MATERIAL AND METHODS We analyzed data on 51 patients with end-stage renal disease (ESRD) under APD. They were treated with a traditional APD machine HomeChoice (phase 1), changed to new APD machine HomeChoice Claria for 12 weeks (phase 2), then connected to the Sharesource platform for another 12 weeks (phase 3), and were followed up for 1 year. The non-adherence rate was compared between the 3 phases. The secondary outcomes included peritonitis rate, hospitalization rate, and hospitalization days, 1 year before and after receiving a new APD machine. Patients were subdivided into good and poor adherence (>1 episode of non-adherence in phase 1) groups for further analysis. RESULTS The average non-adherence rates were 10.5%, 5.1%, and 4.9% in phases 1, 2, and 3, respectively, although differences were not significant. Serum potassium (P<0.0001) and C-reactive protein (CRP) (P=0.026) levels significantly decreased in phase 3. The 1-year peritonitis rate, hospitalization rate, and number of days of hospitalization showed no significant changes. Subgroup analysis revealed that the non-adherence rate in the poor adherence group decreased from 48.4% in phase 1 to 14.2% and 12.4% in phases 2 and 3, respectively (P=0.007). CONCLUSIONS Remoting monitoring using the Sharesource connectivity platform increased dialysis adherence in APD treatment, especially in patients with poor adherence. Serum potassium level and inflammation status were also improved by this system.
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Falência Renal Crônica , Diálise Peritoneal Ambulatorial Contínua , Diálise Peritoneal , Peritonite , Humanos , Diálise Peritoneal Ambulatorial Contínua/efeitos adversos , Diálise Peritoneal Ambulatorial Contínua/métodos , Diálise Peritoneal/métodos , Falência Renal Crônica/terapia , PotássioRESUMO
The font size effect refers to the metacognitive illusion that larger fonts lead to higher judgments of learning (JOLs) but not better recall. Prior studies demonstrated robust JOL effects of font size under conditions of intra-item relation (i.e., cue-target relatedness within a word pair), even though intra-item relation is a more diagnostic cue than font size. However, it remains an open question whether the JOL effects of font size persist under conditions of inter-item relation (i.e., relations across items on a single-word list). In the current study, we examined the JOL and recall effects of font size when font size and inter-item relation were factorially manipulated in three JOL-recall experiments. Additionally, to manipulate the salience of inter-item relation, we presented related and unrelated lists in a blocked manner in Experiment 1 but in a mixed manner in Experiments 2 and 3. Our results showed that the JOL effects of font size are moderated or eliminated when inter-item relation is manipulated simultaneously with font size. Moreover, the smaller font led to better recall for related lists but not for unrelated lists across all three experiments. Therefore, our results demonstrate that individual cues may not be integrated with equal weight, and there can be a trade-off between item-specific and relational processing during the JOL process. Additionally, highlighting key information with larger fonts may not be optimal with related items.
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Ilusões , Metacognição , Humanos , Rememoração Mental , Sinais (Psicologia) , JulgamentoRESUMO
Patients with end-stage renal disease (ESRD) are at a higher mortality risk compared with the general population. Previous studies have described a relationship between mortality and patients with ESRD, but the data on standardized mortality ratio (SMR) corresponding to different causes of death in patients undergoing hemodialysis (HD) and peritoneal dialysis (PD) are limited. This study was designed as a nationwide population-based retrospective cohort study. Incident dialysis patients between January 2000 and December 2015 in Taiwan were included. Using data acquired from the Taiwan Death Registry, SMR values were calculated and compared with the overall survival. The results showed there were a total of 128,966 patients enrolled, including 117,376 incident HD patients and 11,590 incident PD patients. It was found that 75,297 patients (58.4%) died during the period of 2000-2017. The overall SMR was 5.21. The neoplasms SMR was 2.11; the endocrine, nutritional, metabolic, and immunity disorders SMR was 13.53; the circulatory system SMR was 4.31; the respiratory system SMR was 2.59; the digestive system SMR was 6.1; and the genitourinary system SMR was 27.22. Therefore, more attention should be paid to these diseases in clinical care.
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Falência Renal Crônica , Diálise Peritoneal , Humanos , Estudos Retrospectivos , Estudos de Coortes , Diálise Renal , Falência Renal Crônica/epidemiologia , Falência Renal Crônica/terapiaRESUMO
AIM: Gestational diabetes mellitus (GDM) has become the most common complication in women during pregnancy in Taiwan. Since several clinical trials have demonstrated benefits of aggressive treatment, which rely heavily on self-management. The present study was conducted to explore the self-management experience of women with first-time diagnosed GDM. DESIGN: A qualitative descriptive approach was applied to conduct this study. METHODS: Purposive sampling was used to recruit patients with first-time diagnosed GDM from the maternity outpatient clinics of medical centre in Taiwan. A total of three focus groups interviews with 22 women were conducted to collect the data. Content analysis was applied to analyse the data. RESULTS: Four themes were identified: (1) unexpectedly having a high-risk pregnancy, (2) different perceptions for self-management, (3) implementation predicament of self-management and (4) maternal duty to ensure the safety of mother and child.
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Diabetes Gestacional , Autogestão , Criança , Gravidez , Feminino , Humanos , Diabetes Gestacional/diagnóstico , Diabetes Gestacional/terapia , Grupos Focais , Pesquisa Qualitativa , Gravidez de Alto RiscoRESUMO
In patients with chronic hemodialysis (HD), both abnormal thrombotic and bleeding events are commonly observed. Uremic platelet dysfunction is one of the important attributing factors. Moreover, HD may also result in aggregation dysfunction of platelets during the therapeutic procedure. However, how the HD process affects platelet and coagulation function is unknown and dialyzer membrane flux could have an impact on it. We aimed to compare the impacts of low-flux and high-flux HD on the platelet function of patients undergoing chronic HD. This was a cross-sectional study conducted in the HD unit of E-Da hospital in Taiwan. A total of 78 patients with maintenance HD three times per week for more than one year, including 40 with high- and 38 with low-flux hemodialysis, were recruited. Their platelet functions were evaluated using an in vitro platelet function analyzer (PFA-100) before and after the HD session. Of the 78 patients undergoing HD, 60 (76%) had prolonged pre-dialysis collagen/epinephrine (CEPI) and collagen/adenosine diphosphate closure times. Those receiving low-flux dialyzer had a significant increase in CEPI closure time (pre-dialysis 212.3â ±â 62.1 seconds. post-dialysis 241.5â ±â 64.3 seconds, Pâ =â .01), but not collagen/adenosine diphosphate closure time, after HD. After adjusting confounding factors, only the low-flux dialyzer demonstrated an independent association with the prolonged CEPI closure time after HD therapy (odds ratioâ =â 23.31, 95% CI: 1.94-280.61, Pâ =â .01). We observed that impaired platelet aggregation is prevalent in patients undergoing chronic HD. Therefore, the use of low-flux dialyzers may further worsen platelet aggregation after dialysis. Patients with uremic bleeding diathesis should take precautions. We suggest that further studies using flow cytometry should be conducted to explore the mechanism of dialysis flux and platelet activity during HD.
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Agregação Plaquetária , Diálise Renal , Humanos , Diálise , Estudos Transversais , Diálise Renal/efeitos adversos , Diálise Renal/métodos , Difosfato de AdenosinaRESUMO
This study observed the antibody response and adverse events of AZD1222 (Oxford/AstraZeneca) vaccination in dialysis patients. A prospective cohort study was conducted in E-Da Healthcare Group hospitals between 1 July and 30 November 2021. Patients receiving hemodialysis (HD, n = 204) or peritoneal dialysis (PD, n = 116) were enrolled alongside healthy subjects (control, n = 34). Anti-SARS-CoV-2 S1 RBD IgG antibodies were measured before the first vaccination (T0), four to six weeks afterwards (T1), one week before the second dose (T2), and four to six weeks afterwards (T3). Adverse events were recorded one week after each dose. The positive IgG rates in the HD (T1: 72%; T2: 62%) and PD (T1: 69%; T2: 70%) groups were lower than the control group (T1: 97%; T2: 91%), with lower median antibody titers. At T3, the positive antibody response rates (HD: 94%; PD: 93%; control: 100%) and titers were similar. Titers were higher after the second dose in all groups. Adverse events were more severe after the first dose and less common with HD than PD or controls. Dialysis patients exhibited lower antibody responses than controls after the first dose of the AZD1222 vaccine but achieved similar responses after consecutive vaccination. Age, health status, two vaccine doses, and alcohol consumption may influence antibody levels.
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INTRODUCTION: We studied the ability of latent factor scores to predict conversion from mild cognitive impairment (MCI) to Alzheimer's disease (AD) and investigated whether multimodal factor scores improve predictive power, relative to single-modal factor scores. METHOD: We conducted exploratory factor analyses (EFAs) and confirmatory factor analyses (CFAs) of the baseline data of MCI subjects in the Alzheimer's Disease Neuroimaging Initiative (ADNI) to generate factor scores for three data modalities: neuropsychological (NP), magnetic resonance imaging (MRI), and cerebrospinal fluid (CSF). Factor scores from single or multiple modalities were entered in logistic regression models to predict MCI to AD conversion for 160 ADNI subjects over a 2-year interval. RESULTS: NP factors attained an area under the curve (AUC) of .80, with a sensitivity of .66 and a specificity of .77. MRI factors reached a comparable level of performance (AUC = .80, sensitivity = .66, specificity = .78), whereas CSF factors produced weaker prediction (AUC = .70, sensitivity = .56, specificity = .79). Combining NP factors with MRI or CSF factors produced better prediction than either MRI or CSF factors alone. Similarly, adding MRI factors to NP or CSF factors produced improvements in prediction relative to NP or CSF factors alone. However, adding CSF factors to either NP or MRI factors produced no improvement in prediction. CONCLUSIONS: Latent factor scores provided good accuracy for predicting MCI to AD conversion. Adding NP or MRI factors to factors from other modalities enhanced predictive power but adding CSF factors did not.
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Doença de Alzheimer , Disfunção Cognitiva , Doença de Alzheimer/diagnóstico , Doença de Alzheimer/diagnóstico por imagem , Biomarcadores/líquido cefalorraquidiano , Disfunção Cognitiva/diagnóstico por imagem , Disfunção Cognitiva/etiologia , Progressão da Doença , Humanos , Imageamento por Ressonância Magnética/métodos , NeuroimagemRESUMO
Peritoneal fibrosis is an important complication of peritoneal dialysis (PD). To investigate and address this problem, an appropriate animal model of PD is required. The present protocol establishes a chlorhexidine gluconate (CG) induced peritoneal fibrosis model that mimics the condition of a patient with PD. Peritoneal fibrosis was induced by intraperitoneal injection of 0.1% of CG in 15% ethanol for 3 weeks (administered every other day), for a total of nine times in male C57BL/6 mice. Peritoneal functional tests were then performed on day 22. After the mice were sacrificed, the parietal peritoneum of the abdominal wall and the visceral peritoneum of the liver were harvested. They were thicker and more fibrotic when analyzed microscopically after Masson's trichrome staining. The ultrafiltration rate decreased, and glucose mass transport indicated a CG-induced increase in peritoneal permeability. The PD model thus established may have applications in improving PD technology, dialysis efficacy, and prolonging patient survival.
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Clorexidina/efeitos adversos , Fibrose Peritoneal , Peritônio , Animais , Clorexidina/administração & dosagem , Clorexidina/análogos & derivados , Modelos Animais de Doenças , Humanos , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Fibrose Peritoneal/induzido quimicamente , Fibrose Peritoneal/patologia , Peritônio/patologia , Diálise Renal/efeitos adversosRESUMO
The font size effect is a metamemory illusion in which larger-font items produce higher judgments of learning (JOLs) but not better memory, relative to smaller-font items. We conducted meta-analyses to determine what is currently known about how font size affects JOLs and memory accuracy. In addition, we implemented both univariate and multivariate meta-regressions to isolate the moderators of JOL effects and memory effects. The results revealed a small-to-moderate effect of font size on JOLs. There was also a small but significant effect of font size on memory. This suggests that JOLs and memory accuracy both increase with font size, rather than being completely dissociated. Moreover, JOL-memory dissociation only occurred when font size ranged between very small and intermediate. Our working explanation is that the memory effects of font size are tied to (dis)fluency, but its JOL effects are not. Some boundary conditions were identified for font size effects on both JOLs and memory. Specifically, larger font sizes only reliably increased both JOLs and memory accuracy (a) when font sizes ranged from intermediate to very large, (b) when study materials were unrelated word lists, (c) when JOLs were solicited immediately after encoding, and (d) when study time was relatively brief. Supplementary Information: The online version contains supplementary material available at 10.1007/s11409-021-09287-3.
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BACKGROUND: The Taiwanese government launched a universal pay-for-performance (P4P) program in 2006 to promote multidisciplinary care for patients with stage 3b-5 chronic kidney disease (CKD). This study aimed to understand the enrollments, care processes, and outcomes of the P4P program between 2010 and 2018. METHODS: We conducted a population-based study using the Taiwan National Health Insurance Research Data. We divided the incident dialysis population into joining and not joining P4P groups based on whether patients had joined the pre-ESRD program before dialysis or not. Trends in the medications prescribed, anemia correction, vascular access preparation before dialysis initiation, and cumulative survival rate were compared. RESULTS: The program included more than 100,000 patients with late-stage CKD. Enrollment increased by almost 100% from 2010 to 2018, with increases seen in those over 75 years old (127.5%), male (96.7%), and earlier CKD stages (≥35% stage 3b in 2018). Females were more likely to stay being enrolled. The joining P4P group was prescribed more appropriate medications, such as erythropoietin-stimulating agents and statins. However, a high number of patients were still prescribed metformin (≥40%) and non-steroidal anti-inflammatory drugs (≥20%). Compared to the not joining P4P group, the patients in the P4P group had better anemia management, dialysis preparation, and post-dialysis survival. CONCLUSION: The patients in the joining P4P program group were delivered more appropriate CKD care and were associated with better survival outcomes. Polices and action plans are needed to extend the coverage of and enrollment in the P4P program.
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Falência Renal Crônica , Reembolso de Incentivo , Idoso , Feminino , Humanos , Falência Renal Crônica/epidemiologia , Falência Renal Crônica/terapia , Masculino , Programas Nacionais de Saúde , Diálise Renal , Taiwan/epidemiologiaRESUMO
Lacticaseibacillus paracasei strain PS23 (PS23) exhibits some probiotic properties. In this study, a genomic analysis of PS23 revealed no genes related to virulence or antibiotic resistance. Moreover, ornithine decarboxylase activity was not detected in vitro. In addition, PS23 was sensitive to the tested antibiotics. Genotoxicity tests for PS23 including the Ames test and chromosomal aberrations in vitro using Chinese hamster ovary cells and micronuclei in immature erythrocytes of ICR mice were all negative. Moreover, following a 28-day study involving repeated oral dose toxicity tests (40, 400, and 4000 mg/kg equal 1.28 × 1010, 1.28 × 1011, and 1.28 × 1012 CFU/kg body weight, respectively) using an ICR mouse model, no adverse effects were observed from any doses. In addition, supplementation with live or heat-killed PS23 ameliorates DSS-induced colonic inflammation in mice. Our findings suggest that PS23 is safe and has anti-inflammatory effects and may therefore have therapeutic implications.
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Lacticaseibacillus paracasei , Cricetinae , Camundongos , Animais , Lacticaseibacillus , Células CHO , Cricetulus , Camundongos Endogâmicos ICR , Anti-Inflamatórios/farmacologia , Anti-Inflamatórios/uso terapêuticoRESUMO
The conjoint-recognition model (CRM) implements fuzzy-trace theory's opponent process conception of false memory. Within the family of measurement models that separate the memory effects of recollection and familiarity, CRM is the only one that accomplishes this for false as well as true memory. We assembled a corpus of 537 sets of conjoint-recognition data, with estimates of CRM's parameters plus goodness-of-fit statistics being available for all the data sets. This corpus was used to conduct a meta-analysis of CRM's underlying process assumptions by pitting two theoretical interpretations of the model against each other: (a) the original interpretation, which assumes that its retrieval parameters tap a single recollection process (verbatim retrieval) and a single familiarity process (gist retrieval), and (b) the dual-recollection interpretation, which assumes that its parameters also tap a second recollection process (context retrieval). The two interpretations generate a series of differential predictions that fall into three groups-namely, predictions about invariant relations among parameters, about the structure of CRM's parameter space, and about the location of individual parameters within the space. When these predictions were evaluated with the corpus, the results converged on the dual-recollection interpretation. The results also resolved a long-standing uncertainty about whether the familiarity process for true memory is semantically or perceptually driven. (PsycInfo Database Record (c) 2022 APA, all rights reserved).