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BACKGROUND: Alzheimers disease (AD) is the most common neurodegenerative disease. Studying the effects of drug treatments on multiple health outcomes related to AD could be beneficial in demonstrating which drugs reduce the disease burden and increase survival. METHODS: We conducted a comprehensive causal inference study implementing doubly robust estimators and using one of the largest high-quality medical databases, the Oracle Electronic Health Records (EHR) Real-World Data. Our work was focused on the estimation of the effects of the two common Alzheimers disease drugs, Donepezil and Memantine, and their combined use on the five-year survival since initial diagnosis of AD patients. Also, we formally tested for the presence of interaction between these drugs. RESULTS: Here, we show that the combined use of Donepezil and Memantine significantly elevates the probability of five-year survival. In particular, their combined use increases the probability of five-year survival by 0.050 (0.021, 0.078) (6.4%), 0.049 (0.012, 0.085), (6.3%), 0.065 (0.035, 0.095) (8.3%) compared to no drug treatment, the Memantine monotherapy, and the Donepezil monotherapy respectively. We also identify a significant beneficial additive drug-drug interaction effect between Donepezil and Memantine of 0.064 (0.030, 0.098). CONCLUSIONS: Based on our findings, adopting combined treatment of Memantine and Donepezil could extend the lives of approximately 303,000 people with AD living in the USA to be beyond five-years from diagnosis. If these patients instead have no drug treatment, Memantine monotherapy or Donepezil monotherapy they would be expected to die within five years.

Alzheimers disease is the most common type of dementia that currently affects over 6.5 million people in the U.S. Currently there is no cure and the existing drug therapies attempt to delay the mental decline and improve cognitive abilities. Two of the most commonly prescribed such drugs are Donepezil and Memantine. We formally tested and confirmed the presence of a beneficial drug-drug interaction of Donepezil and Memantine using a causal inference analysis. We applied doubly robust estimators to one of the largest and high-quality medical databases to estimate the effect of two commonly prescribed Alzheimers disease (AD) medications, Donepezil and Memantine, on the average number of hospital or emergency department visits per year among patients diagnosed with AD. Our results show that, compared to the absence of medication scenario, the Memantine monotherapy, and the Donepezil monotherapy, the combined use of Donepezil and Memantine treatment significantly reduces the average number of hospital or emergency department visits per year by 0.078 (13.8%), 0.144 (25.5%), and 0.132 days (23.4%), respectively. The assessed decline in the average number of hospital or emergency department visits per year is consequently associated with a substantial reduction in medical costs. As of 2022, according to the Alzheimers Disease Association, there were over 6.5 million individuals aged 65 and older living with AD in the US alone. If patients who are currently on no drug treatment or using either Donepezil or Memantine alone were switched to the combined used of Donepezil and Memantine therapy, the average number of hospital or emergency department visits could decrease by over 613 thousand visits per year. This, in turn, would lead to a remarkable reduction in medical expenses associated with hospitalization of AD patients in the US, totaling over 940 million dollars per year.

Objective To evaluate the Orem support-education system theory in nursing of patients with autogenous arteriovenous fistula (AVF) for hemodialysis. Methods By the convenience sampling method, 60 cases of registered hemodialysis patients were recruited and divided into two groups by dialysis date: 30 cases in the control group (receiving dialysis on Tuesday, Thursday and Saturday) were given routine health education, and 30 cases in the intervention group(receiving dialysis on Monday, Wednesday and Friday) were given 3 months Orem support-education system intervention on the basis of conventional education. The self-care behavior level and dysfunction of arteriovenous fistula were measured and compared between two groups. Results After the intervention, the score of assessment of self-care behaviors with arteriovenous fistula in hemodialysis (ASBHD-AVF) increased in both two groups and ASBHD-AVF score was significantly higher in the intervention group than that in the control group (P＜0. 05). The incidence of internal fistula stenosis, infection and thrombosis in the intervention group was significantly lower than that in the control group (P＜0. 05). Conclusion Orem support-education system not only improves the level of self-care behavior of patients autogenous arteriovenous fistula for hemodialysis, but also plays an important role in reducing the incidence of arteriovenous fistula complications. (目的 探讨Orem自护理论中的支持-教育系统在血液透析患者自体动静脉内瘘护理中的应用效果。方法 采用便利抽样法, 抽取医院血液透析中心登记血液透析患者60例作为研究对象。按透析时间进行分组, 透析时间为周一、三、五的30例患者为干预组, 在常规教育基础上给予3个月支持-教育系统干预, 透析时间为周二、四、六的30例患者为对照组, 给予常规健康教育。干预3个月后对两组患者的AVF自我护理行为水平和瘘管失功情况进行比较。结果 干预后, 两组血液透析患者动静脉内瘘自我护理行为量表(ASBHD – AVF)得分均较干预前提高, 且干预组ASBHD–AVF量表得分高于对照组, 差异有统计学意义(P＜0. 05)。干预组内瘘狭窄、感染和血栓形成发生率较对照组低, 差异有统计学意义(P＜0. 05)。结论 Orem支持-教育系统不仅提高血液透析患者自体动静脉内瘘自我护理行为水平, 而且对降低动静脉内瘘并发症的发生率具有重要意义。)

The accurate measurement of cable force plays an important role in the structural form, structural behavior, and safety evaluation of large-span cable-stayed bridges. A fast cable-force estimation method is proposed based on the alignment recognition method and smartphone-captured video. This method can realize real-time, non-contact, and non-destructive force measurements. Videos of bridge cables were collected using a portable smartphone, and an alignment recognition method was employed to obtain the lateral displacement along the cable, followed by numerical differentiation of the lateral displacement of the cable to acquire the acceleration time history. Based on the fundamental dynamic equation of beam elements, a unified explicit formula for cable-force calculation considering service characteristics was established in the frequency method. Finally, the method was applied to the cable-force measurement during the operation and maintenance stage of the Gengcun Dou Bridge. The measured cable forces were compared with the values obtained from the on-site monitoring system. The results show that the proposed method can accurately identify the acceleration time history at different positions of the cable, and the corresponding frequency components are essentially consistent. The average relative deviation of the measured cable forces from the reference method is within 3%. The proposed cable-force measurement method is simple as regards equipment, convenient for operation, and high in efficiency, providing a new method for the measurement of cable forces in large-span cable-stayed bridges, which can offer reliable measured cable-force data for structural analysis during bridge operation and the maintenance stage. [ABSTRACT FROM AUTHOR]

Vacuum induction melting is a more energy-efficient process for the preparation of a titanium alloy with good homogeneity and low cost. But the crucial problem for this technology is in developing a crucible refractory with high stability. In the present work, a novel (Ca,Sr,Ba)ZrO3 crucible was prepared by slip casting and its performance in melting NiTi alloy was studied. The results showed that a single solid solution was formed with a homogeneous distribution of metal elements after sintering at 1500 °C. It was found that the total content of oxygen and nitrogen remaining in the TiNi alloy after melting in the (Ca,Sr,Ba)ZrO3 crucible was 0.0173 wt.%, which fulfills the ASTM standard on biomedical TiNi alloys. The good resistance of the (Ca,Sr,Ba)ZrO3 crucible to molten NiTi has a relationship with the sluggish diffusion effect of high-entropy ceramics. This study provides insights into the process of designing highly suitable crucible material for melting a NiTi alloy. [ABSTRACT FROM AUTHOR]

A biodegradable film was successfully prepared using pullulan and ε-polylysine (ε-PL). The impact of ε-PL contents on biodegradable film was explored through mechanical properties, water vapor permeability, and an FTIR spectroscopy test. Amongst all the prepared films, the 0.5% ε-PL had the most desirable results in film performance. The TS, EAB, and WVP values were 5.63 MPa, 21.5%, and 0.27 × 10−6 g m/Pa h m2, respectively. The blueberries coated with 0.5% ε-PL and pullulan were stored at 20 °C for 12 days. The effect of edible coatings on the performance of blueberries was evaluated by detecting the physicochemical properties and the contents of antioxidants. The experimental results displayed that ε-PL and a pullulan blend film could decrease the weight loss and maintain the hardness, polyphenol, anthocyanin, and antioxidant capacity of the blueberry preservation. The results indicated that the biodegradable film is a potential fruit-coating material. [ABSTRACT FROM AUTHOR]

Because of the COVID-19 epidemic situation, the advantages of intelligent express cabinet stand out, compared with the traditional terminal distribution. It can not only solve the problem of terminal delivery difficulty but also that of the user privacy assurance, in which the contactless delivery becomes deeply popular because cross-infection is avoided. This paper studies the domestic present situation of the application of intelligent express cabinet and the existing problems, according to the data of 207 copies of questionnaires, analyses the consumer cognition and attitude towards intelligent express cabinet. In order to expand the application market of intelligent express cabinets, the paper puts forward measures such as integrating resources, improving the utilization rate, investigating the needs, reasonable layout, integrating community services, and enriching the profit model.