790 research outputs found
A revised index of manufacturing capacity
Industrial capacity ; Manufacturing industries
The Federal Reserve-MIT economic model
Econometric models ; Monetary policy
Determinants of cerebral white matter lesions: A longitudinal population based MRI study
W hite matter lesions are frequently found on cerebral magnetic resonance
imaging scans of elderly non-demented and demented people.
l-4 The pathogenesis of white matter lesions is largely unknown. However
age and high diastolic and systolic blood pressure levels and indicators
of atherosclerosis have consistently been reported as risk factors for
white matter lesions, regardless of their location.2-s Many other, especially
vascular, risk factors have been associated with white matter lesions, but
these relations were mostly not consistent throughout studies.
There is growing evidence that white matter lesions play an important
role in the development of cognitive decline and dementia.4 .6 -8 The
white matter can be distinguished into two separate anatomical regions,
namely the peri ventricular white matter (a strip of white matter adjacent
to the lateral ventricles) and the subcortical white matter (the white mattcr
just underneath the gray matter). Only a few studies have distinguished
between these two locations and have reported on their determinants
separately.9,10 Yet it may be that different risk factors underlie white
matter lesions at different locations, or that lesions in different locations
may have different cognitive consequences
Apathy, but not depression, predicts all-cause dementia in cerebral small vessel disease
Objective: To determine whether apathy or depression predicts all-cause dementia in small vessel disease (SVD) patients. Methods: Analyses used two prospective cohort studies of SVD: St. George’s Cognition and Neuroimaging in Stroke (SCANS; n=121) and Radboud University Nijmegen Diffusion Tensor and Magnetic Resonance Cohort (RUN DMC; n=352). Multivariate Cox regressions were used to predict dementia using baseline apathy and depression scores in both datasets. Change in apathy and depression was used to predict dementia in a subset of 104 participants with longitudinal data from SCANS. All models were controlled for age, education and cognitive function. Results: Baseline apathy scores predicted dementia in SCANS (HR 1.49, 95% CI 1.05 to 2.11, p=0.024) and RUN DMC (HR 1.05, 95% CI 1.01 to 1.09, p=0.007). Increasing apathy was associated with dementia in SCANS (HR 1.53, 95% CI 1.08 to 2.17, p=0.017). In contrast, baseline depression and change in depression did not predict dementia in either dataset. Including apathy in predictive models of dementia improved model fit. Conclusions: Apathy, but not depression, may be a prodromal symptom of dementia in SVD, and may be useful in identifying at-risk individuals
Determinants of extended door-to-needle time in acute ischemic stroke and its influence on in-hospital mortality:results of a nationwide Dutch clinical audit
Background Intravenous thrombolysis (IVT) plays a prominent role in the treatment of acute ischemic stroke (AIS). The sooner IVT is administered, the higher the odds of a good outcome. Therefore, registering the in-hospital time to treatment with IVT, i.e. the door-to-needle time (DNT), is a powerful way to measure quality improvement. The aim of this study was to identify determinants that are associated with extended DNT. Methods Patients receiving IVT in 2015 and 2016 registered in the Dutch Acute Stroke Audit were included. DNT and onset-to-door time (ODT) were dichotomized using the median (i.e. extended DNT) and the 90th percentile (i.e. severely extended DNT). Logistic regression was performed to identify determinants associated with (severely) extended DNT/ODT and its effect on in-hospital mortality. A linear model with natural spline was used to investigate the association between ODT and DNT. Results Included were 9518 IVT treated patients from 75 hospitals. Median DNT was 26 min (IQR 20-37). Determinants associated with a higher likelihood of extended DNT were female sex (OR 1.17, 95% CI 1.05-1.31) and admission during off-hours (OR 1.12, 95% CI 1.01-1.25). Short ODT correlated with longer DNT, whereas longer ODT correlated with shorter DNT. Young age (OR 1.38, 95% CI 1.07-1.76) and admission to a comprehensive stroke center (OR 1.26, 1.10-1.45) were associated with severely extended DNT, which was associated with in-hospital mortality (OR 1.54, 95%CI 1.19-1.98). Conclusions Even though DNT in the Netherlands is short compared to other countries, lowering the DNT may be achievable by focusing on specific subgroups
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