Assessing the district-level flood vulnerability in Bihar, eastern India: an integrated socioeconomic and environmental approach.

States of India like Bihar, Uttar Pradesh, and West Bengal along the Ganga River, endure natural disasters periodically, resulting in repeated trends of economic loss and damages. Especially, most of the districts of Bihar, India, are prone to floods. Based on this background, this study aims to assess the flood vulnerabilities across districts of Bihar, India, employing data from the Central Water Commission from 1953 to 2020. Further, we explore trends and patterns of loss and damage due to flood risks in Bihar. Using the flood vulnerability integrated method and the principal component analysis, the index is constructed by incorporating the three major indicators: exposure, sensitivity, and adaptive capacity. This study is unique, and advances from previous studies in using a greater number of variables in exposure indicator. The proxy variable for each indicator is identified through both inductive and deductive approaches, and the composite index is constructed using all three indicators. Also, we identify the districts with high level of education and per capita income are less likely to expose flood vulnerability. The comparison of the districts reflects wide range of variation in terms of flood vulnerability as per their adaptive capacity and sensitivity. Specifically, these findings align with Target Sustainable Development Goal 11.5. This study addresses the policy for disaster prevention, risk reduction, and mitigation measures, as well as the enhancement of the capability of adaptation to floods by the affected community.

Spatial correlation of left atrial low voltage substrate in sinus rhythm versus atrial fibrillation: The rhythm specificity of atrial low voltage substrate.

INTRODUCTION: Improved sinus rhythm (SR) maintenance rates have been achieved in patients with persistent atrial fibrillation (AF) undergoing pulmonary vein isolation plus additional ablation of low voltage substrate (LVS) during SR. However, voltage mapping during SR may be hindered in persistent and long-persistent AF patients by immediate AF recurrence after electrical cardioversion. We assess correlations between LVS extent and location during SR and AF, aiming to identify regional voltage thresholds for rhythm-independent delineation/detection of LVS areas. (1) Identification of voltage dissimilarities between mapping in SR and AF. (2) Identification of regional voltage thresholds that improve cross-rhythm substrate detection. (3) Comparison of LVS between SR and native versus induced AF. METHODS: Forty-one ablation-naive persistent AF patients underwent high-definition (1 mm electrodes; >1200 left atrial (LA) mapping sites per rhythm) voltage mapping in SR and AF. Global and regional voltage thresholds in AF were identified which best match LVS < 0.5 mV and <1.0 mV in SR. Additionally, the correlation between SR-LVS with induced versus native AF-LVS was assessed. RESULTS: Substantial voltage differences (median: 0.52, interquartile range: 0.33-0.69, maximum: 1.19 mV) with a predominance of the posterior/inferior LA wall exist between the rhythms. An AF threshold of 0.34 mV for the entire left atrium provides an accuracy, sensitivity and specificity of 69%, 67%, and 69% to identify SR-LVS < 0.5 mV, respectively. Lower thresholds for the posterior wall (0.27 mV) and inferior wall (0.3 mV) result in higher spatial concordance to SR-LVS (4% and 7% increase). Concordance with SR-LVS was higher for induced AF compared to native AF (area under the curve[AUC]: 0.80 vs. 0.73). AF-LVS < 0.5 mV corresponds to SR-LVS < 0.97 mV (AUC: 0.73). CONCLUSION: Although the proposed region-specific voltage thresholds during AF improve the consistency of LVS identification as determined during SR, the concordance in LVS between SR and AF remains moderate, with larger LVS detection during AF. Voltage-based substrate ablation should preferentially be performed during SR to limit the amount of ablated atrial myocardium.

The anterior center edge angle has limited ability to predict three-dimensional coverage of the femoral head in patients with developmental dysplasia of the hip undergoing curved periacetabular osteotomy.

INTRODUCTION: Femoral head coverage in patients with hip dysplasia (DDH) is typically quantified using 2D measurements of the lateral center edge angle (LCEA) and anterior center edge angle (ACEA). However, as the morphology of DDH is complex and varies between patients, 2D measurements may not predict the true 3D femoral head coverage. Herein, 2D and 3D coverage were quantified before and after curved periacetabular osteotomy (CPO) and their relationships were assessed. MATERIALS AND METHODS: Forty-three hips that underwent CPO for DDH were analyzed. For 2D evaluation, LCEA was quantified from X-rays and CT images. The ACEA was measured from CT images (CT-ACEA) and digitally reconstructed radiographs generated from CT images (DRR-ACEA). Three-dimensional coverage was quantified from CT reconstructions of the hip and evaluated in the anterior, superior, posterior, and inferior regions of the femoral head. Two-dimensional measurements were correlated to 3D coverage to assess their relationships. RESULTS: The median preoperative 3D percent coverage was 17.7, 36.1, 56.1, and 14.6% for the anterior, superior, posterior, and inferior region, respectively. After CPO, all LCEAs and ACEAs increased significantly (all p < 0.001). For the 3D coverage, anterior and superior coverage significantly increased while the posterior and inferior coverage decreased (all p < 0.001). Moderate to strong correlations were detected between the two LCEAs and the 3D superior coverage in both the preoperative and postoperative period. For the correlation between 3D anterior coverage, no significant correlation was found between the CT-ACEA while a moderate correlation was found between the DRR-ACEA (rs = 0.41, p = 0.023). CONCLUSIONS: Our results indicate that the LCEA can be used to predict 3D coverage in the superior region of the femoral head. However, as the CT-ACEA or DRR-ACEA had no or only moderate correlation between the 3D anterior coverage, these measurements are not recommended for evaluating/estimating the 3D anterior coverage in patients with DDH.

locStra: Fast analysis of regional/global stratification in whole-genome sequencing studies.

locStra is an R -package for the analysis of regional and global population stratification in whole-genome sequencing (WGS) studies, where regional stratification refers to the substructure defined by the loci in a particular region on the genome. Population substructure can be assessed based on the genetic covariance matrix, the genomic relationship matrix, and the unweighted/weighted genetic Jaccard similarity matrix. Using a sliding window approach, the regional similarity matrices are compared with the global ones, based on user-defined window sizes and metrics, for example, the correlation between regional and global eigenvectors. An algorithm for the specification of the window size is provided. As the implementation fully exploits sparse matrix algebra and is written in C++, the analysis is highly efficient. Even on single cores, for realistic study sizes (several thousand subjects, several million rare variants per subject), the runtime for the genome-wide computation of all regional similarity matrices does typically not exceed one hour, enabling an unprecedented investigation of regional stratification across the entire genome. The package is applied to three WGS studies, illustrating the varying patterns of regional substructure across the genome and its beneficial effects on association testing.

Regional Analysis of Liver Surface Nodularity in a Single Axial MR Image for Staging Liver Fibrosis.

BACKGROUND: The assessment of liver surface nodularity (LSN) for staging hepatic fibrosis is restricted in clinical practice because it requires customized software and time-consuming procedures. A simplified method to estimate LSN score may be useful in the clinic. PURPOSE: To evaluate the regional analysis of LSN and processing time in a single axial liver MR image for staging liver fibrosis. STUDY TYPE: Retrospective. POPULATION: A total of 210 subjects, a multicenter study. FIELD STRENGTH/SEQUENCE: A 3 T/noncontrast gradient echo T1WI. ASSESSMENT: Subjects were divided into five fibrosis groups (F0  = 29; F1  = 20; F2  = 32; F3  = 50; F4  = 79) based on the METAVIR fibrosis scoring system. The mean LSN (on three slices) and regional LSN (on one slice) measurements, and the processing times, are compared. The regional LSN scores in five regions-of-interests (ROI1-5 ) were analyzed in a single axial MRI at the level of the hilum by two independent observers. STATISTICAL TESTS: Regional variations in LSN scores were compared using ANOVA with Tukey test. Agreement between the mean and regional LSN measurements was evaluated using Pearson correlation coefficients (r) and Bland-Altman plots. The diagnostic performance of mean and regional LSN scores according to fibrosis stage was evaluated with the AUROC. A P value < 0.05 was considered statistically significant. RESULTS: Total processing time for a regional LSN measurement (3.6 min) was 75.5% less than that for mean LSN measurement (14.7 min). Mean LSN scores and all five regional LSN scores showed significant differences between fibrosis groups. Among regional LSN scores, ROI5 showed the highest AUROC (0.871 at cut-off 1.12) for discriminating F0-2 vs. F3-4 and the best correlation with mean LSN score (r = 0.800, -0.07 limit of agreement). CONCLUSION: Quantitative regional LSN measurement in a single axial MR image reduces processing time. Regional ROI5 LSN score might be useful for clinical decision-making and for distinguishing the difference between early fibrosis (F0-2 ) and advanced fibrosis (F3-4 ) in the liver. EVIDENCE LEVEL: 3 TECHNICAL EFFICACY: Stage 2.

Natural and anthropogenic controls on lake water-level decline and evaporation-to-inflow ratio in the conterminous United States.

Lake water levels are integral to lake function, but hydrologic changes from land and water management may alter lake fluctuations beyond natural ranges. We constructed a conceptual model of multifaceted drivers of lake water-levels and evaporation-to-inflow ratio (Evap:Inflow). Using a structural equation modeling framework, we tested our model on 1) a national subset of lakes in the conterminous United States with minimal water management to describe natural drivers of lake hydrology and 2) five ecoregional subsets of lakes to explore regional variation in water management effects. Our model fit the national and ecoregional datasets and explained up to 47% of variation in Evap:Inflow, 38% of vertical water-level decline, and 79% of horizontal water-level decline (littoral exposure). For lakes with minimal water management, Evap:Inflow was related to lake depth (ß = -0.31) and surface inflow (ß = -0.44); vertical decline was related to annual climate (e.g., precipitation ß = -0.18) and water management (ß = -0.21); and horizontal decline was largely related to vertical decline (ß = 0.73) and lake morphometry (e.g., depth ß = -0.18). Anthropogenic effects varied by ecoregion and likely reflect differences in regional water management and climate. In the West, water management indicators were related to greater vertical decline (ß = 0.38), whereas in the Midwest, these indicators were related to more stable and full lake levels (ß = -0.22) even during drought conditions. National analyses show how human water use interacts with regional climate resulting in contrasting impacts to lake hydrologic variation in the US.

Regional variation in coronary angiography rates: the association with supply factors and the role of indication: a spatial analysis.

BACKGROUND: Coronary angiographies (CAs) are among the most common diagnostic procedures carried out in German hospitals, and substantial regional differences in their frequency of use have been documented. Given the heterogeneity with regard to the expected benefits and the varying scope for discretion depending on the indication for the procedure, we hypothesized that the observed variation and the association of need and supply factors differs by indication for CA. METHODS: We investigated the correlation between supply factors and the regional rates of CAs in Germany while controlling for need using spatial-autoregressive error models (SARE) and spatial cross-regressive models with autoregressive errors (SCRARE). The overall rates of CAs and the rates in specific patient subgroups, namely, patients with and without myocardial infarction (MI), were calculated based on a comprehensive set of nationwide routine data from three statutory health insurances at the district level. RESULTS: Although little variation was found in cases with MI, considerable variation was seen in the overall cases and cases without MI. The SARE models revealed a positive association between the number of hospitals with a cardiac catheterization laboratory per 10,000 population and the rates of overall cases and cases without MI, whereas no such relationship existed in cases with MI. Additionally, an association between regional deprivation and the rates of CAs was found in cases with MI, but no such association was seen in cases without MI. CONCLUSIONS: The results supported the hypothesis that the relative association of need and supply factors differed by the indication for CA. Although the regional differences in the frequency of use of CAs can only be explained in part by the factors examined in our study, it offers insight into patient access to and the provision of CA services and can provide a platform for further local research.

[Relevance of health geographic research for dermatology]. / Bedeutung der gesundheitsgeografischen Forschung für die Dermatologie.

The association between geographic and medical aspects is a well-known phenomenon, which also occurs in dermatological research. This article reviews the field of health geography, the history of the association between spatial location and health, and focuses on current areas of research. Research focusing on explaining regional variations in health refer to individual aspects and needs, population factors, environmental factors, and health care delivery structures in specific regions, as well as the interaction between them. Regional healthcare research is primarily concerned with access to health services and on the utilisation of those services. Methodologically, the analysis of geodata and the application of geographic information systems (GIS) and spatial modelling play a major role in this field. Dermatological research and dermatological practice can benefit from the findings of the regional analysis of access, utilisation, and variations in order to obtain a more detailed picture of care and thus to optimise care.

The potential effects of the COVID-19 pandemic on learnings.

In this paper, we use a new database for Mexico to model the possible long-run effects of the pandemic on learning. First, based on the framework of Neidhöffer et al. (2021), we estimate the loss of schooling due to the transition from in-person to remote learning using data from the National Survey on Social Mobility (ESRU-EMOVI-2017), census data, and national statistics of COVID-19 incidence. In this estimation, we account for the attenuation capacity of households by econsidering the parental educational attainment and the economic resources available to the household in the calculation of the short-run cost. Secondly, we estimate the potential long-run consequences of this shock through a calibrated learning profile for five Mexican regions following Kaffenberger and Pritchett (2020a, 2020b). Assuming the distance learning policy adopted by the Mexican government is entirely effective, our results indicate that a learning loss equivalent to the learning during a third of a school year in the short run translates into a learning loss equivalent to an entire school year further up the educational career of students. On the other hand, if the policy was ineffective, the short-run loss increases to an entire school year and becomes a loss of two years of learning in the long run. Our results suggest substantial variation at the regional level, with the most affected region, the South experiencing a loss thrice as large as that of the least affected region, the Centre region.

A mixed-effect model approach for assessing land-based mitigation in integrated assessment models: A regional perspective.

Given the prospects of low short-term emissions reduction, carbon removals (CDRs) are expected to play an important role in achieving ambitious mitigation targets in future scenarios of integrated assessment models (IAMs), particularly Bioenergy with Carbon Capture and Storage (BECCS). In this paper, we explore the IAMC 1.5℃ database to depict the characteristics of the two main CDR options present in mitigation scenarios: BECCS and afforestation/reforestation. We apply a linear mixed-effect model to capture the specific regional and cross-IAM effects. Results reveal that the distribution of BECCS and afforestation deployment differs across IAMs and regions and, to a second extent, time. BECCS is preferred in the scenarios not for its ability to expand energy use but actually because it appears as an alternative to afforestation, which is associated with a decrease in energy use. However, the regional distribution of CDR deployment does not show a common pattern across scenarios and IAMs. Therefore, a more comprehensive investigation is needed before it can support policy proposals.

An iPPG-Based Device for Pervasive Monitoring of Multi-Dimensional Cardiovascular Hemodynamics.

Hemodynamic activities, as an essential measure of physiological and psychological characteristics, can be used for cardiovascular and cerebrovascular disease detection. Photoplethysmography imaging (iPPG) can be applied for such purposes with non-contact advances, however, most cardiovascular hemodynamics of iPPG systems are developed for laboratory research, which limits the application in pervasive healthcare. In this study, a video-based facial iPPG detecting equipment was devised to provide multi-dimensional spatiotemporal hemodynamic pulsations for applications with high portability and self-monitoring requirements. A series of algorithms have also been developed for physiological indices such as heart rate and breath rate extraction, facial region analysis, and visualization of hemodynamic pulsation distribution. Results showed that the new device can provide a reliable measurement of a rich range of cardiovascular hemodynamics. Combined with the advanced computing techniques, the new non-contact iPPG system provides a promising solution for user-friendly pervasive healthcare.

Regional variation of lower limb major amputations on different geographic scales - a Hungarian nationwide study over 13 years.

Background: The incidence of lower limb major amputations is an important healthcare quality indicator, as it reflects all efforts aimed to prevent limb loss. Analysis of within-country regional variations in incidence may reveal the sources of disparities in care. Materials and methods: Based on the data of the Hungarian healthcare beneficiary population from 2004 to 2016, the incidence of lower limb major amputations and its spatial variations was determined regionally on four levels of geographic resolution. Variability and autocorrelation were quantified on different resolutions. Results: A total of 56,468 lower limb major amputation procedures were identified in 49,528 patients over the observation period. Marked regional variations were detected at all geographic scale levels. In the case of county-level and local administrative level, the systematic component of variation was 0.03 and 0.09, respectively. Only half of the variation at local administrative level was explained by county. Conclusions: Lower limb major amputations show marked regional variations on the different geographic levels of resolution. The more granular the assessment, the higher the regional variation was. Assumingly, this observation is partially a mathematical necessity but may also be related to the different characteristics of care at a given level of spatial aggregation. The decomposition of the variance of amputation rates indicates that the potential explanatory factors contributing to spatial variability are multiple and may be interpreted on different levels of geographic resolution. Addressing the unwarranted variations and resolving the issues that contribute to high lower limb major amputation rates needs further explorative analysis.

Regional variation in endovascular treatment rate and in-hospital mortality of abdominal aortic aneurysms in Germany.

Background: Abdominal aortic aneurysms (AAA) can be treated by either open surgery (OAR) or endovascular aortic repair (EVAR). The aim of this study was to analyze regional variations in application of (EVAR) and in-hospital mortality after intact AAA (iAAA) repair. Methods: Using data provided by the German Federal Statistical Office, a nationwide analysis for 2012 to 2014 was conducted. Patients with a diagnosis of iAAA (I71.4) and corresponding procedure codes for OAR (5-384.5/7) or EVAR (5-38a.1) were included. Odds ratios (ORs) for use of EVAR (proportion of EVAR among total EVAR + OAR cases) and mortality were calculated for all regions in Germany. ORs for EVAR use were adjusted for age, sex, and risk (Elixhauser score). ORs for mortality were additionally adjusted for type of procedure (OAR/EVAR). Results: Finally, 31,757 procedures for iAAA were included. Median age of all patients was 73 years (interquartile range 67-78 years) and 87.1 % were male. The mean proportion of EVAR procedures was 72.6 %; however, the application of EVAR for repair of iAAA varied widely depending on region. The lowest unadjusted regional rate of EVAR use was 48.8 %, while the highest was 92.5 %. After adjustment, the lowest regional OR for EVAR use (compared to the nationwide mean) was 0.23 (95 % confidence interval [0.15-0.36]), the highest 5.93 [1.79-19.65]. Overall in-hospital mortality was 2.9 % (OAR 6.2 %; EVAR 1.7 %). The adjusted regional OR for mortality ranged from 0.31 [0.07-1.42] to 4.98 [2.08-11.93]. Conclusions: This study reveals variations in use of EVAR and in-hospital mortality for iAAA treatment in Germany. This may imply that selection of treatment might not only be influenced by patient characteristics, but also by regional location. These results need to be taken into account when discussing centralization of AAA treatment in Germany.

Regional variations in trajectories of long-term readmission rates among patients in England with heart failure.

BACKGROUND: We aimed to compare the characteristics and types of heart failure (HF) patients termed "high-impact users", with high long-term readmission rates, in different regions in England. This will allow clinical factors to be identified in areas with potentially poor quality of care. METHODS: Patients with a primary diagnosis of heart failure (HF) in the period 2008-2009 were identified using nationally representative primary care data linked to national hospital data and followed up for 5 years. Group-based trajectory models and sequence analysis were applied to their readmissions. RESULTS: In each of the 8 NHS England regions, multiple discrete groups were identified. All the regions had high-impact users. The group with an initially high readmission rate followed by a rapid decline in the rate ranged from 2.5 to 11.3% across the regions. The group with constantly high readmission rate compared with other groups ranged from 1.9 to 12.1%. Covariates that were commonly found to have an association with high-impact users among most of the regions were chronic respiratory disease, chronic renal disease, stroke, anaemia, mood disorder, and cardiac arrhythmia. Respiratory tract infection, urinary infection, cardiopulmonary signs and symptoms and exacerbation of heart failure were common causes in the sequences of readmissions among high-impact users in all regions. CONCLUSION: There is regional variation in England in readmission and mortality rates and in the proportions of HF patients who are high-impact users.

A systems dynamics approach for supporting regional decisions on the energetic use of regional biomass residues.

This article presents the definition, building, calibration and application of a system dynamics simulation model to quantify the present and future comparative advantages and disadvantages of using forest and agricultural residual biomass for energetic purpose through different processes and technologies, on a regional basis. A dynamic structure of the agricultural and forestry biomass process activities (i.e. production, transport, conversion and consumption) based on regional time-series data was built, implemented into and calibrated within a dynamic simulation tool (Vensim software) within a Hungarian county. Besides the agriculture and forestry sectors, the model includes data about demography, economy, environment and land use, among others. For carrying out the assessment, realistic scenarios of future biomass processes and of biomass use were formulated, characterised by quantitative sustainable development indicators and simulated within the dynamic model. The results prove that the introduced model supports decision making of biomass utilisation in a regional scale, through comparing and analysing quantitative changes of economic, social and environment indicators, which characterise a sustainable regional development. The model therefore allows analyses and evaluation of not only partial prosperous or adverse characteristics of biomass processes and use, but also to relate regional components and their development over time. The developed dynamic tool is therefore a powerful method to model complex systems, such as a regional energy system, considering the framework of the regional preferences stated by the regional stakeholders. It can thus provide useful decision support, especially when used as a priority-based screening of potential regional development programmes in the energy field.

The role of drought on wheat yield interannual variability in the Iberian Peninsula from 1929 to 2012.

The production of wheat in the Iberian Peninsula is strongly affected by climate conditions being particularly vulnerable to interannual changes in precipitation and long-term trends of both rainfall and evapotranspiration. Recent trends in precipitation and temperature point to an increase in dryness in this territory, thus highlighting the need to understand the dependence of wheat yield on climate conditions. The present work aims at studying the relation between wheat yields and drought events in the Iberian Peninsula, using a multiscalar drought index, the standardized precipitation evapotranspiration index (SPEI), at various timescales. The effects of the occurrence of dry episodes on wheat yields were analyzed, on regional spatial scale for two subperiods (1929-1985 and 1986-2012). The results show that in western areas, wheat yield is positively affected by dryer conditions, whereas the opposite happens in eastern areas. The winter months have a bigger influence in the west while the east is more dependent on the spring and summer months. Moreover, in the period of 1986-2012, the simultaneous occurrence of low-yield anomalies and dry events reaches values close to 100 % over many provinces. Results suggest that May and June have a strong control on wheat yield, namely, for longer timescales (9 to 12 months). A shift in the dependence of wheat yields on climatic droughts is evidenced by the increase in the area with positive correlation and the decrease in area with negative correlation between wheat yields and SPEI, probably due to the increase of dry events.

[Applicability of hospital reports submitted for reimbursement purposes for epidemiological studies based on the example of ischemic cerebrovascular diseases]. / A kórházi adatlapok jelentéseinek alkalmazhatósága epidemiológiai elemzésekre az ischaemiás cerebrovascularis betegségek példája alapján.

INTRODUCTION: In single-payer health care financing systems data extracted from hospital report forms submitted for reimbursement purposes may be used for epidemiological investigations. AIM: Based on data submitted by 14 neurological wards in Central Hungary the authors examined the reliability of these reports. METHOD: Analyses were performed for the 3-digit codes of the 10th version of the International Classification of Diseases for cerebral infarcts (ICD-10 I63+I64) reported for the National Health Insurance Fund. RESULTS: The number of cases in individual hospitals changed between a decrease by 35% and an increase by 73% from the first to the second half of the year 2012, reflecting changes in the size of the catchment area of the hospitals in July 2012. Of those with an ICD-10 I63 or I64 discharge diagnosis 54-84% had acute stroke. Neurological wards cared for 34-98% of all stroke patients. The diagnoses submitted for reimbursement purposes corresponded in over 99% to the diagnoses in the hospital discharge reports. Inaccuracies occurred in a larger proportion (about 20%) in coding the DRG financing categories. CONCLUSIONS: Databases created from hospital reports submitted for reimbursement purposes can be used reliably in Hungary for stroke epidemiological studies.

Regional analysis of drought and heat impacts on forests: current and future science directions.

Accurate assessments of forest response to current and future climate and human actions are needed at regional scales. Predicting future impacts on forests will require improved analysis of species-level adaptation, resilience, and vulnerability to mortality. Land system models can be enhanced by creating trait-based groupings of species that better represent climate sensitivity, such as risk of hydraulic failure from drought. This emphasizes the need for more coordinated in situ and remote sensing observations to track changes in ecosystem function, and to improve model inputs, spatio-temporal diagnosis, and predictions of future conditions, including implications of actions to mitigate climate change.

Evaluation of P300 components for emotion-loaded visual event-related potential in elderly subjects, including those with dementia.

AIM: In the present study, the P300 component of the emotion-loaded visual event-related potential in response to photographs of babies crying or smiling was measured to evaluate cognitive function in elderly subjects, including those with dementia. METHODS: The subjects were 48 elderly people who consulted a memory disorder clinic. The visual event-related potential was measured using oddball tasks. Brain waves were recorded from four sites. We analyzed the P300 amplitude and latency. Subjects were divided into three groups (the dementia with Alzheimer's disease group [ADG]; the intermediate group [MG], and the healthy group [HG]) based on the Revised Hasegawa Dementia Scale, Mini-mental State Examination scores and the Clinical Dementia Rating. RESULTS: For all subjects, there was a significant positive correlation between P300 latency and Z-score of voxel-based specific regional analysis for Alzheimer's disease for crying or smiling faces. There was a negative correlation between P300 amplitude and Z-score for the crying face. MG subjects were divided into two groups (high risk: HRMG, low risk: LRMG) based on Z-scores (HRMG ≥ 2.0). The P300 amplitude of ADG was significantly smaller than that of HG, and the P300 latency of ADG was significantly longer than those of other groups for crying or smiling faces. The P300 latency of HRMG was significantly longer than that of LRMG for the smiling face. Furthermore, the P300 latency for the crying face was significantly shorter than that for the smiling face in HG and ADG. CONCLUSION: These findings suggest that analysis of P300 components of the emotion-loaded visual event-related potential may be a useful neuropsychological index for the diagnosis of Alzheimer's disease and high-risk subjects.

Disparities in Bariatric Surgery Outcomes: A Regional Analysis.

PURPOSE: The success of metabolic and bariatric surgery (MBS) is impacted by significant pre-surgical attrition rates and poor postoperative follow-up. This study focused on geographic variations in attrition rates and surgical outcomes for MBS practice for which the patient population is drawn from nine Chicago neighborhoods, to examine whether suboptimal weight loss or reduced adherence to the program varied across neighborhoods. METHODS: Patients who presented for their initial MBS consultation at the University of Illinois (UI) Health's program between January 2019 and December 2020 were identified from electronic medical records. Demographic and medical information was extracted, along with postoperative weight at 3, 6, and 12 months after surgery. The Chicago area was divided into nine geographic regions. The outcomes of interest were preoperative attrition rate, postoperative compliance to follow-up appointments, and postoperative weight loss for each group and by residential neighborhood. RESULTS: A total of 1202 patients were included in this analysis, of whom 423 (35%) underwent surgery and 780 did not, representing a pre-surgical attrition rate of 64.9%. Age, sex, and race/ethnic distribution varied markedly across geographic regions. Postoperative weight loss varied significantly in neighborhoods with higher proportions of residents from racial/ethnic minority backgrounds. Preoperative attrition and postoperative compliance did not differ across geographic regions. CONCLUSION: Patients' residential neighborhoods may influence weight loss after MBS. Preoperative and postoperative compliance did not vary by residential neighborhood.