Bai et al investigate the predictive value of T lymphocyte proportion in Alzheimer's disease(AD)prognosis.Through a retrospective study involving 62 AD patients,they found that a decrease in T lymphocyte proportio...Bai et al investigate the predictive value of T lymphocyte proportion in Alzheimer's disease(AD)prognosis.Through a retrospective study involving 62 AD patients,they found that a decrease in T lymphocyte proportion correlated with a poorer prognosis,as indicated by higher modified Rankin scale scores.While the study highlights the potential of T lymphocyte proportion as a prognostic marker,it suggests the need for larger,multicenter studies to enhance generalizability and validity.Additionally,future research could use cognitive exams when evaluating prognosis and delve into immune mechanisms underlying AD progression.Despite limitations inherent in retrospective designs,Bai et al's work contributes to understanding the immune system's role in AD prognosis,paving the way for further exploration in this under-researched area.展开更多
BACKGROUND Within the normal range,elevated alanine aminotransferase(ALT)levels are associated with an increased risk of metabolic dysfunction-associated fatty liver disease(MAFLD).AIM To investigate the associations ...BACKGROUND Within the normal range,elevated alanine aminotransferase(ALT)levels are associated with an increased risk of metabolic dysfunction-associated fatty liver disease(MAFLD).AIM To investigate the associations between repeated high-normal ALT measurements and the risk of new-onset MAFLD prospectively.METHODS A cohort of 3553 participants followed for four consecutive health examinations over 4 years was selected.The incidence rate,cumulative times,and equally and unequally weighted cumulative effects of excess high-normal ALT levels(ehALT)were measured.Cox proportional hazards regression was used to analyse the association between the cumulative effects of ehALT and the risk of new-onset MAFLD.RESULTS A total of 83.13%of participants with MAFLD had normal ALT levels.The incidence rate of MAFLD showed a linear increasing trend in the cumulative ehALT group.Compared with those in the low-normal ALT group,the multivariate adjusted hazard ratios of the equally and unequally weighted cumulative effects of ehALT were 1.651[95%confidence interval(CI):1.199-2.273]and 1.535(95%CI:1.119-2.106)in the third quartile and 1.616(95%CI:1.162-2.246)and 1.580(95%CI:1.155-2.162)in the fourth quartile,respectively.CONCLUSION Most participants with MAFLD had normal ALT levels.Long-term high-normal ALT levels were associated with a cumulative increased risk of new-onset MAFLD.展开更多
Background:Under-reporting and,thus,uncertainty around the true incidence of health events is common in all public health reporting systems.While the problem of underreporting is acknowledged in epidemiology,the guida...Background:Under-reporting and,thus,uncertainty around the true incidence of health events is common in all public health reporting systems.While the problem of underreporting is acknowledged in epidemiology,the guidance and methods available for assessing and correcting the resulting bias are obscure.Objective:We aim to design a simple modification to the Susceptible e Infected e Removed(SIR)model for estimating the fraction or proportion of reported infection cases.Methods:The suggested modification involves rescaling of the classical SIR model producing its mathematically equivalent version with explicit dependence on the reporting parameter(true proportion of cases reported).We justify the rescaling using the phase plane analysis of the SIR model system and show how this rescaling parameter can be estimated from the data along with the other model parameters.Results:We demonstrate how the proposed method is cross-validated using simulated data with known disease cases and then apply it to two empirical reported data sets to estimate the fraction of reported cases in Missoula County,Montana,USA,using:(1)flu data for 2016e2017 and(2)COVID-19 data for fall of 2020.Conclusions:We establish with the simulated and COVID-19 data that when most of the disease cases are presumed reported,the value of the additional reporting parameter in the modified SIR model is close or equal to one,so that the original SIR model is appropriate for data analysis.Conversely,the flu example shows that when the reporting parameter is close to zero,the original SIR model is not accurately estimating the usual rate parameters,and the re-scaled SIR model should be used.This research demonstrates the role of under-reporting of disease data and the importance of accounting for underreporting when modeling simulated,endemic,and pandemic disease data.Correctly reporting the“true”number of disease cases will have downstream impacts on predictions of disease dynamics.A simple parameter adjustment to the SIR modeling framework can help alleviate bias and uncertainty around crucial epidemiological metrics(e.g.:basic disease reproduction number)and public health decision making.展开更多
文摘Bai et al investigate the predictive value of T lymphocyte proportion in Alzheimer's disease(AD)prognosis.Through a retrospective study involving 62 AD patients,they found that a decrease in T lymphocyte proportion correlated with a poorer prognosis,as indicated by higher modified Rankin scale scores.While the study highlights the potential of T lymphocyte proportion as a prognostic marker,it suggests the need for larger,multicenter studies to enhance generalizability and validity.Additionally,future research could use cognitive exams when evaluating prognosis and delve into immune mechanisms underlying AD progression.Despite limitations inherent in retrospective designs,Bai et al's work contributes to understanding the immune system's role in AD prognosis,paving the way for further exploration in this under-researched area.
基金National Natural Science Foundation of China,No.72101236China Postdoctoral Science Foundation,No.2022M722900+1 种基金Collaborative Innovation Project of Zhengzhou City,No.XTCX2023006Nursing Team Project of the First Affiliated Hospital of Zhengzhou University,No.HLKY2023005.
文摘BACKGROUND Within the normal range,elevated alanine aminotransferase(ALT)levels are associated with an increased risk of metabolic dysfunction-associated fatty liver disease(MAFLD).AIM To investigate the associations between repeated high-normal ALT measurements and the risk of new-onset MAFLD prospectively.METHODS A cohort of 3553 participants followed for four consecutive health examinations over 4 years was selected.The incidence rate,cumulative times,and equally and unequally weighted cumulative effects of excess high-normal ALT levels(ehALT)were measured.Cox proportional hazards regression was used to analyse the association between the cumulative effects of ehALT and the risk of new-onset MAFLD.RESULTS A total of 83.13%of participants with MAFLD had normal ALT levels.The incidence rate of MAFLD showed a linear increasing trend in the cumulative ehALT group.Compared with those in the low-normal ALT group,the multivariate adjusted hazard ratios of the equally and unequally weighted cumulative effects of ehALT were 1.651[95%confidence interval(CI):1.199-2.273]and 1.535(95%CI:1.119-2.106)in the third quartile and 1.616(95%CI:1.162-2.246)and 1.580(95%CI:1.155-2.162)in the fourth quartile,respectively.CONCLUSION Most participants with MAFLD had normal ALT levels.Long-term high-normal ALT levels were associated with a cumulative increased risk of new-onset MAFLD.
基金supported by National Institute of General Medical Sciences of the National Institutes of Health,United States(Award numbers P20GM130418 and U54GM104944).
文摘Background:Under-reporting and,thus,uncertainty around the true incidence of health events is common in all public health reporting systems.While the problem of underreporting is acknowledged in epidemiology,the guidance and methods available for assessing and correcting the resulting bias are obscure.Objective:We aim to design a simple modification to the Susceptible e Infected e Removed(SIR)model for estimating the fraction or proportion of reported infection cases.Methods:The suggested modification involves rescaling of the classical SIR model producing its mathematically equivalent version with explicit dependence on the reporting parameter(true proportion of cases reported).We justify the rescaling using the phase plane analysis of the SIR model system and show how this rescaling parameter can be estimated from the data along with the other model parameters.Results:We demonstrate how the proposed method is cross-validated using simulated data with known disease cases and then apply it to two empirical reported data sets to estimate the fraction of reported cases in Missoula County,Montana,USA,using:(1)flu data for 2016e2017 and(2)COVID-19 data for fall of 2020.Conclusions:We establish with the simulated and COVID-19 data that when most of the disease cases are presumed reported,the value of the additional reporting parameter in the modified SIR model is close or equal to one,so that the original SIR model is appropriate for data analysis.Conversely,the flu example shows that when the reporting parameter is close to zero,the original SIR model is not accurately estimating the usual rate parameters,and the re-scaled SIR model should be used.This research demonstrates the role of under-reporting of disease data and the importance of accounting for underreporting when modeling simulated,endemic,and pandemic disease data.Correctly reporting the“true”number of disease cases will have downstream impacts on predictions of disease dynamics.A simple parameter adjustment to the SIR modeling framework can help alleviate bias and uncertainty around crucial epidemiological metrics(e.g.:basic disease reproduction number)and public health decision making.
