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Hearing loss and cognitive decline among older adults with atrial fibrillation:the SAGE-AF study

Journal of Geriatric Cardiology 2020年第4期17卷 177-183页

作者： Wei-Jia WANG darleen Lessard Hawa Abu david d.mcmanus Tanya Mailhot Jerry H.Gurwitz Robert J.Goldberg Jane Saczynski division of Cardiovascular Medicine Department of MedicineUniversity of Massachusetts Medical SchoolWorcesterMAUSA department of Population and Quantitative Health Sciences University of Massachusetts Medical SchoolWorcesterMAUSA department of Pharmacy and Health System Sciences Northeastern UniversityBostonMAUSA Meyers Primary Care Institute University of Massachusetts Medical SchoolWorcesterMAUSA

Objective To examine the association between hearing loss and cognitive function cross-sectionally and prospectively among older adults with atrial fibrillation(AF).Methods Patients with AF≥65-year-old(n=1244)in the SAGE(Systematic Assessment of Geriatric Elements)-AF study were recruited from five internal medicine or cardiology clinics in Massachusetts and *** was assessed by a structured questionnaire at *** function was assessed by Montreal Cognitive Assessment(MoCA)at baseline and one *** impairment was defined as score≤23 on the *** associations between hearing loss and cognitive function were examined by multivariable adjusted logistic *** Participants with hearing loss(n=451,36%)were older,more likely to be male,and have depressive symptoms than patients without hearing *** baseline,528(42%)participants were cognitively *** with hearing loss were significantly more likely to have cognitive impairment at baseline[adjusted odds ratio(OR)=1.37,95%confidence interval(CI):1.05–1.81].Among the 662 participants who did not have cognitive impairment at baseline and attended the one-year follow-up visit,106(16%)developed incident cognitive *** with,versus those without,hearing loss were significantly more likely to develop incident cognitive impairment at one year(adjusted OR=1.68,95%CI:1.07–2.64).Conclusions Hearing loss is a prevalent but under-recognized factor associated with cognitive impairment in patients with *** for hearing loss may be indicated among these patients to identify individuals at high-risk for adverse outcomes.

关键词： Atrial fibrillation Cognitive function Hearing

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Health behavior outcomes in stroke survivors prescribed wearables for atrial fibrillation detection stratified by age

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Journal of Geriatric Cardiology 2024年第3期21卷 323-330页

作者： Joanne Mathew Jordy Mehawej Ziyue Wang Taylor Orwig Eric ding Andreas Filippaios Syed Naeem Edith Mensah Otabil Alex Hamel Kamran Noorishirazi IrinaRadu Jane Saczynski david d.mcmanus Khanh-Van Tran division of Cardiovascular Medicine Department of MedicineUniversity of Massachusetts Chan Medical SchoolLake Avenue NorthWorcesterUSA department of Internal Medicine Central Michigan UniversityMount PleasantUSA department of Pharmacy and Health Systems Sciences School of PharmacyNortheastern UniversityBostonUSA department of Population and Quantitative Health Sciences University of Massachusetts Chan Medical SchoolLake Avenue NorthWorcesterUSA

BACKGROUNd Smartwatches have become readily accessible tools for detecting atrial fibrillation(AF).There remains limited data on how they affect psychosocial outcomes and engagement in older *** examine the health behavior outcomes of stroke survivors prescribed smartwatches for AF detection stratified by *** We analyzed data from the Pulsewatch study,a randomized controlled trial that enrolled patients(≥50 years)with a history of stroke or transient ischemic attack and CHA2dS2-VASc≥*** participants were equipped with a cardiac patch monitor and a smartwatch-app dyad,while control participants wore the cardiac patch monitor for up to 44 *** evaluated health behavior parameters using standardized tools,including the Consumer Health Activation Index,the Generalized Anxiety disorder questionnaire,the 12-Item Short Form Health Survey,and wear time of participants categorized into three age groups:Group 1(ages 50-60),Group 2(ages 61-69),and Group 3(ages 70-87).We performed statistical analysis using a mixedeffects repeated measures linear regression model to examine differences amongst age *** Comparative analysis between Groups 1,2 and 3 revealed no significant differences in anxiety,patient activation,perception of physical health and wear *** use of smartwatch technology was associated with a decrease in perception of mental health for Group 2 compared to Group 1(β=-3.29,P=0.046).CONCLUSION Stroke survivors demonstrated a willingness to use smartwatches for AF ***,among these study participants,the majority did not experience negative health behavior outcomes or decreased engagement as age increased.

关键词： prescribed stratified wear

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Self-reported risk of stroke and factors associated with underestimation of stroke risk among older adults with atrial fibrillation: the SAGE-AF study

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Journal of Geriatric Cardiology 2020年第8期17卷 502-509页

作者： Jordy Mehawej Jane Saczynski Jerry H.Gurwitz Hawa O.Abu Benita A.Bamgbade Wei-Jia WANG Tenes Paul Katherine Trymbulak Connor Saleeba Zi-Yue WANG Catarina I.Kiefe Robert J.Goldberg david d.Mc Manus division of Cardiovascular Medicine Department of MedicineUniversity of Massachusetts Medical SchoolWorcesterMAUSA department of Pharmacy and Health Systems Sciences School of PharmacyNortheastern UniversityBostonMAUSA department of Population and Quantitative Health Sciences University of Massachusetts Medical SchoolWorcesterMAUSA division of Geriatric Medicine and Meyers Primary Care Institute University of Massachusetts Medical SchoolWorcesterMAUSA

Background Though engaging patients with atrial fibrillation(AF) in understanding their stroke risk is encouraged by guidelines, little is known regarding AF patients' perceived stroke risk or its relationship with oral anticoagulation(OAC) use. We aim to identify factors associated with underestimation of stroke risk among older patients with AF and relate this to OAC use. Methods data are from the ongoing SAGE(Systematic Assessment of Geriatric Elements)-AF study, which included older patients(> 65 years) with non-valvular AF and a CHA2 dS2-VASc score of ≥ 2. Participants reported their perceived risk of having a stroke without OAC. We compared the perceived risk to CHA2 dS2-VASc predicted stroke risk and classified participants as "over" or "under" estimators, and identified factors associated with underestimation of risk using multiple logistic regression. Results The average CHA2 dS2-VASc score of 915 participants(average age: 75 years, 47% female, 86% white) was 4.3 ± 1.6, 43% of participants had discordant predicted and self-reported stroke risks. Among the 376 participants at highest risk(CHA2 dS2-VASc score ≥ 5), 46% of participants underestimated their risk. Older participants(≥ 85 years) were more likely and OAC treated patients less likely to underestimate their risk of developing a future stroke than respective comparison groups. Conclusions A significant proportion of study participants misperceived their stroke risk, mostly by overestimating. Almost half of participants at high risk of stroke underestimated their risk, with older patients more likely to do so. Patients on OAC were less likely to underestimate their risk, suggesting that successful efforts to educate patients about their stroke risk may influence treatment choices.

关键词： Anticoagulation Atrial fibrillation Stroke

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Making bridges between preclinical and clinical insights into age-related cognitive decline

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Neural Regeneration Research 2025年第8期20卷 2321-2322页

作者： david VC Brito Clévio Nóbrega Algarve Biomedical Center-Research Institute(ABC-RI) Campus GambelasFaroPortugal Algarve Biomedical Center-(ABC) Campus GambelasFaroPortugal Faculty of Medicine and Biomedical Sciences(FMCB) University of AlgarveGambelas CampusFaroPortugal

With people living longer,the societal impact of age-related cognitive decline is becoming more pronounced(Crimmins,2015).Thus,it is increasingly important to comprehend the cognitive shifts linked to aging-whether th... 详细信息

关键词： bridges becoming insight

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Women in visual neural regeneration research

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Neural Regeneration Research 2025年第2期20卷 489-490页

作者： Tonia S.Rex david J.Calkins Vanderbilt Eye Institute Vanderbilt University Medical CenterNashvilleTNUSA

The year 2024 marks the 60^(th)anniversary of Title IX and 25 years since the New York Times revealed bias against female faculty members at the Massachusetts Institute of *** take an opportunity here to examine the state of gender bias in a relatively new yet already prominent field,neural regeneration in the visual system,for which there is a well-defined context useful for this *** National Eye Institute(NEI)provided the first round of research funding for its Audacious Goals Initiative(AGI)on visual neural regeneration in 2013 and the last round in ***,we focus on this *** sources included PubMed,the National Science Foundation(NSF),the NEI,the Blue Ridge Institute for Medical Research and data from the major professional organization for eye and vision research,the Association for Research in Vision and Ophthalmology(ARVO).

关键词： neural visual Times

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Critical quality indicators of high-performance polyetherimide(ULTEM)over the MEX 3d printing key generic control parameters:Prospects for personalized equipment in the defense industry

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defence Technology(防务技术) 2025年第1期43卷 150-167页

作者： Nectarios Vidakis Markos Petousis Constantine david Nektarios K.Nasikas dimitrios Sagris Nikolaos Mountakis Mariza Spiridaki Amalia Moutsopoulou Emmanuel Stratakis dept.of Mechanical Engineering Hellenic Mediterranean UniversityHeraklion 71410Greece dept.of Mechanical Engineering International Hellenic UniversitySerres Campus 62124Greece division of Mathematics and Engineering Sciences Department of Military SciencesHellenic Army AcademyGR 16673VariAtticaGreece Institute of Electronic Structure and Laser(IESL) Foundation for Research and Technology(FORTH)N.Plastira 100Vassilika Vouton 70013HeraklionCreteGreece Qingdao Innovation and development Center Harbin Engineering UniversityQingdao 266000China

Additive Manufacturing(AM)can provide customized parts that conventional techniques fail to *** important parameter in AM is the quality of the parts,as a result of the material extrusion 3d printing(3d-P)*** can be very important in defense-related applications,where optimum performance needs to be *** quality of the Polyetherimide 3d-P specimens was examined by considering six control parameters,namely,infill percentage,layer height,deposition angle,travel speed,nozzle,and bed *** quality indicators were the root mean square(Rq)and average(Ra)roughness,porosity,and the actual to nominal dimensional *** examination was performed with optical profilometry,optical microscopy,and micro-computed tomography *** Taguchi design of experiments was applied,with twenty-five runs,five levels for each control parameter,on five *** additional confirmation runs were conducted,to ensure *** equations were constructed to express the quality indicators in terms of the control *** modeling approaches were applied to the experimental data,to compare their efficiency,i.e.,Linear Regression Model(LRM),Reduced Quadratic Regression Model,and Quadratic Regression Model(QRM).QRM was the most accurate one,still the differences were not high even considering the simpler LRM model.

关键词： Polyetherimide(PEI) Material extrusion(MEX) Three-dimensional printing(3d-P) Critical quality indicators(CQIs) Quadratic regression model(QRM) Taguchi

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Incident frailty and cognitive impairment by heart failure status in older patients with atrial fibrillation: the SAGE-AF study

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Journal of Geriatric Cardiology 2020年第11期17卷 653-658页

作者： Wei-Jia WANG darleen Lessard Jane Saczynski Robert J Goldberg Alan S.Go Tenes Paul Ely Gracia david d.mcmanus department of Medicine University of Massachusetts Medical SchoolWorcesterMAUSA department of Population and Quantitative Health Sciences University of Massachusetts Medical SchoolWorcesterMAUSA department of Pharmacy and Health System Sciences Northeastern UniversityBostonMAUSA division of Research Kaiser Permanente Northern CaliforniaOaklandCAUSA

Background Atrial fibrillation(AF) and heart failure(HF) frequently co-occur in older individuals. Among patients with AF, HF increases risks for stroke and death, but the associations between HF and incident cognition and physical impairment remain unknown. We aimed to examine the cross-sectional and prospective associations between HF, cognition, and frailty among older patients with AF. Methods The SAGE-AF(Systematic Assessment of Geriatric Elements in AF) study enrolled 1244 patients with AF(mean age 76 years, 48% women) from five practices in Massachusetts and Georgia. HF at baseline was identified from electronic health records using ICd-9/10 codes. At baseline and 1-year, frailty was assessed by Cardiovascular Health Survey score and cognition was assessed by the Montreal Cognitive Assessment. Results Patients with prevalent HF(n = 463, 37.2%) were older, less likely to be non-Hispanic white, had less education, and had greater cardiovascular comorbidity burden and higher CHA2 dS2 VASC and HAS-BLEd scores than patients without HF(all P's djusted regression models, HF(present vs. absent) was associated with both prevalent frailty(adjusted odds ratio [a OR]: 2.38, 95% confidence interval [CI]: 1.64-3.46) and incident frailty at 1 year(a OR: 2.48, 95% CI: 1.37-4.51). HF was also independently associated with baseline cognitive impairment(a OR: 1.60, 95% CI: 1.22-2.11), but not with developing cognitive impairment at 1 year(a OR 1.04, 95%CI: 0.64-1.70). Conclusions Among ambulatory older patients with AF, the co-existence of HF identifies individuals with physical and cognitive impairments who are at higher short-term risk for becoming frail. Preventive strategies to this vulnerable subgroup merit consideration.

关键词： Atrial fibrillation Cognitive impairment Heart failure Frailty

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Fever without source in infants aged 22–60 days:how laboratory tests perform at identifying bacterial infections and predicting the need for a lumbar puncture?

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World Journal of Emergency Medicine 2025年第1期16卷 74-77页

作者： Keven Vachon Geneviève Gravel Samuel Leduc Alexandra Larouche Myriam Mallet david Simonyan Mahukpe Narcisse Ulrich Singbo Julie Ouellet-Pelletier Simon Berthelot Centre de Recherche du CHU de Québec-UniversitéLaval Population Health and Optimal Health Practices AxisQuébec G1V 4G2Canada Faculty of Medicine UniversitéLavalQuébec G1V 0A6Canada Centre Hospitalier de l’UniversitéLaval(CHUL) Québec G1V 4G2Canada

Febrile infants are at greater risk of invasive bacterial infections (IBI),which include bacterial meningitis and *** bacterial meningitis is uncommon,^([1-2])it remains a concern for clinicians treating infants younger than 90 *** for investigating fever without a source(meaning without an apparent source of infection,or of nonobvious origin) are numerous around the world but remain conflicting,particularly on whether to perform a lumbar puncture for cerebrospinal fluid (CSF) analysis in infants older than 22 d and hence at lower risk than younger infants.

关键词： puncture infections lumbar

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Probing deeper into the Milky Way for Pulsars

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Research in Astronomy and Astrophysics 2025年第1期25卷 9页

作者： david A.Smith Université Bordeaux CNRS Laboratoire d’Astrophysique de Bordeaux Universitéde BordeauxCNRSB18Nallée Geoffroy Saint-Hilaire

The FAST radio telescope has significantly better sensitivity than any other current radio ***,FAST has discovered over a thousand new pulsars in sky regions already searched for 50 *** Galactic Plane Pulsar Snapshot(GPPS) survey found three-quarters of these new *** article by Han et al.(2025) details the latest batch of 473discoveries,bringing the total to *** 473 new pulsars enable diverse *** are millisecond pulsars (MSPs) spinning perfectly smoothly:Nature's most precise clocks,they will likely contribute to measurements of nanohertz gravitational waves from pairs of supermassive black holes in distant *** have spindown and binary orbits perturbed by the pulsar's intense plasma wind blasting its stellar companion—these test models of binary *** star mass measurements from such systems constrain the nuclear equation of state.

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ESTIMATING CROSS-TRAINING CALL CENTER CAPACITY THROUGH SIMULATION

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Journal of Systems Science and Systems Engineering 2016年第4期25卷 448-468页

作者： david A. Munoz Nathaniel d. Bastian department of Industrial and Manufacturing Engineering The Pennsylvania State University

Call centers have grown world-wide during the past decade. One of the most important aspects considered by call center managers is the optimization of its operators, which implies covering the highly variable demand and f＇mding an efficient way to assign people to certain shifts in order to achieve a desirable service level and abandonment rate. Another challenge is determining which system setup is appropriate for the specific call center. Should we have a single-skill call center or multi-skill call center？ If we do have the latter, how many multi-skill agents should we have on staff？. In this case study, we generate and analyze discrete-event systems simulation-optimization models to test the behavior of a real-world call center under the actual configuration and under different levels of cross-training. The model results help call center managers by： 1） determining the optimal number of operators needed for different staff configtmations in order to achieve the targets for service level and abandonment; 2） providing information about the trade-off between the key measurements in the call center; and 3） providing useful information about the number of operators needed and used for each hour of operation to estimate the number of four-hour shifts required to achieve the performance targets. Our experimental f＇mdings from this case study suggest that a bi-skill call center is economically better in the long-rtm compared to a full-skill or single-skill call center. This case study augments the call center body of knowledge by providing additional managerial insights for the operations management community.

关键词： Call centers cross-training discrete-event systems simulation simulation optimization service operations service systems

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