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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。)

Material composition and structural design are important factors influencing the electromagnetic wave (EMW) absorption performance of materials. To alleviate the impedance mismatch attributed to the high dielectric constant of Ti3C2Tx MXene, we have successfully synthesized core‐shell structured SiO2@MXene@MoS2 nanospheres. This architecture, comprising SiO2 as the core, MXene as the intermediate layer, and MoS2 as the outer shell, is achieved through an electrostatic self‐assembly method combined with a hydrothermal process. This complex core‐shell structure not only provides a variety of loss mechanisms that effectively dissipate electromagnetic energy but also prevents self‐aggregation of MXene and MoS2 nanosheets. Notably, the synergistic combination of SiO2 and MoS2 with highly conductive MXene enables the suitable dielectric constant of the composites, ensuring optimal impedance matching. Therefore, the core‐shell structured SiO2@MXene@MoS2 nanospheres exhibit excellent EMW absorption performance, featuring a remarkable minimum reflection loss (RLmin) of −52.11 dB (2.4 mm). It is noteworthy that these nanospheres achieve an ultra‐wide effective absorption bandwidth (EAB) of 6.72 GHz. This work provides a novel approach for designing and synthesizing high‐performance EMW absorbers characterized by "wide bandwidth and strong reflection loss." [ABSTRACT FROM AUTHOR]