Excerpts from the United States Renal Data System 2004 annual data report: atlas of end-stage renal disease in the United States.
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Adolescent↗
Biomedical subjects
Qiao Fan
Publications and source records attributed to Qiao Fan.
Reuse-associated mortality in incident hemodialysis patients in the United States, 2000 to 2001.
BACKGROUND: The impact of dialyzer reuse on the mortality of hemodialysis patients is debated. This study assesses reuse-associated mortality across US dialysis provider systems (for-profit, not-for-profit; hospital-based, and freestanding units) in incident patients. METHODS: Incident Medicare hemodialysis patients who initiated dialysis therapy from January 1, 2000, to December 31, 2001, were included and followed up to December 31, 2002. A 3-month entry period was used to determine comorbidity and disease severity. Applying various analytic approaches, mortality rates for patients treated with reused (or reprocessed) or single-use dialyzers were compared. Because of differences among dialysis units, facility clustering was addressed. RESULTS: Of 75,831 patients, 61,391 patients (81.0%) were classified as on reuse, and 14,440 patients (19.0%), as on single use, as of the start of follow-up. The overall mortality rate was 25.0/100 patient-years. No difference in mortality risk was found between patients treated with reuse compared with single use in an intent-to-treat approach (hazard ratio, 0.98; 95% confidence interval, 0.94 to 1.02; P = 0.266) after adjusting for chain affiliation, for-profit status, year of dialysis inception, age, sex, race, renal diagnosis, comorbidity, and hospitalization days. Findings were similar in an as-treated approach (hazard ratio, 0.97; 95% confidence interval, 0.93 to 1.01; P = 0.136). No survival advantage associated with single use was found for subgroups. CONCLUSION: No overall survival advantage or disadvantage is associated with dialyzer reuse compared with single use in incident hemodialysis patients in the United States; however, continued monitoring is advised.
Adult↗
Preparing a large data set for analysis: using the minimum data set to study perineal dermatitis.
AIM: The aim of this paper is to present a practical example of preparing a large set of Minimum Data Set records for analysis, operationalizing Minimum Data Set items that defined risk factors for perineal dermatitis, our outcome variable. BACKGROUND: Research with nursing home elders remains a vital need as 'baby boomers' age. Conducting research in nursing homes is a daunting task. The Minimum Data Set is a standardized instrument used to assess many aspects of a nursing home resident's functional capability. United States Federal Regulations require a Minimum Data Set assessment of all nursing home residents. These large data would be a useful resource for research studies, but need to be extensively refined for use in most statistical analyses. Although fairly comprehensive, the Minimum Data Set does not provide direct measures of all clinical outcomes and variables of interest. METHOD: Perineal dermatitis is not directly measured in the Minimum Data Set. Additional information from prescribers' (physician and nurse) orders was used to identify cases of perineal dermatitis. The following steps were followed to produce Minimum Data Set records appropriate for analysis: (1) identification of a subset of Minimum Data Set records specific to the research, (2) identification of perineal dermatitis cases from the prescribers' orders, (3) merging of the perineal dermatitis cases with the Minimum Data Set data set, (4) identification of Minimum Data Set items used to operationalize the variables in our model of perineal dermatitis, (5) determination of the appropriate way to aggregate individual Minimum Data Set items into composite measures of the variables, (6) refinement of these composites using item analysis and (7) assessment of the distribution of the composite variables and need for transformations to use in statistical analysis. RESULTS: Cases of perineal dermatitis were successfully identified and composites were created that operationalized a model of perineal dermatitis. CONCLUSION: Following these steps resulted in a data set where data analysis could be pursued with confidence. Incorporating other sources of data, such as prescribers' orders, extends the usefulness of the Minimum Data Set for research use.
Aged↗
The lipid-regulating effects of atorvastatin on type 2 elder diabetes patients with hyperlipidemia.
To investigate the effect of atorvastatin on lipid metabolism in type 2 elder diabetes patients with hyperlipidemia, 26 patients with type 2 elder diabetes complicated with hyperlipidemia were treated with atorvastatin (10 mg/d) for 8 weeks. The serum triglyceride (TG), high density protein cholesterol (HDL-C) and low density protein cholesterol (LDL-C) were measured before and after the treatment. Meanwhile, the non-denaturing polyacrylamide gradient gel electrophoresis was used for detection of small-sized LDL(SLDL). Our results showed that TG dropped from 4.88 +/- 0.72 mmol/L to 2.65 +/- 0.32 mmol/L; HDL-C was increased from 0.85 +/- 0.31 mmol/L to 1.28 +/- 0.29 mmol/L; LDL-C was declined from 3.71 +/- 2.98 mmol/L to 2.10 +/- 1.22 mmol/L, sLDL-A was increased from (42.49 +/- 8.1)% to (53.27 +/- 7.5)%; LDL-B was decreased from (57.91 +/- 8.1)% to (46.73 +/- 7.5% ) (P<0.05). The level of blood glucose was not changed at the end of 8th week. It is concluded that atorvastatin has satisfactory lipid-regulating effects on type 2 elder diabetes patients with hyperlipidemia.
Aged↗
[Study on the distribution of serum homocysteine and on multi-stepwise regression analysis of the associated factors in the population of community areas in Wuhan].
OBJECTIVE: To study the serum homocysteine (Hcy) distribution and characteristics in different sex and age groups in the community residents in Wuhan, and to analyse its associated factors with multi-stepwise regression analysis. METHODS: The population under study was from three community areas in Wuhan. Demographic distribution and the correlation with other risk factors of serum Hcy were analyzed statistically. RESULTS: (1) Geometric mean of serum Hcy was 14.43 micromol/L in males and 10.89 micromol/L in females with P <0.001. (2) Hcy of per age level in males was also higher (P <0.001). (3) The prevalence rate of hyperhomocysteinemia was 23.94% in the general population in Wuhan. The prevalence rate of hyperhomocysteinemia in males was 2.62 times higher than in females. (4) Multi-stepwise regression analysis showed that Hcy had different affecting factors in males and females. The affecting factors of Hcy in males were daily cigarettes smoking, urine micro-albumin (UMALB) and times of exercise per week. The affecting factors of Hcy in females were duration of exercise each time, weight, triglyceride (TG), high-density lipoprotein (HDL), urine micro-albumin (UMALB) and age. CONCLUSIONS: (1) Hcy at the population level was significantly different by sex and age. (2) Population living in the community in Wuhan had a higher serum level and prevalence rate of Hcy comparing to some other cities in China and even in developed countries. (3) The important affecting factors of Hcy in population also showed sex difference, unlike the reports from other countries or other areas in China. Serum Hcy seemed to be affected by environmental and other factors.
Adolescent↗
On the precision of the conditionally autoregressive prior in spatial models.
Bayesian analyses of spatial data often use a conditionally autoregressive (CAR) prior, which can be written as the kernel of an improper density that depends on a precision parameter tau that is typically unknown. To include tau in the Bayesian analysis, the kernel must be multiplied by tau(k) for some k. This article rigorously derives k = (n - I)/2 for the L2 norm CAR prior (also called a Gaussian Markov random field model) and k = n - I for the L1 norm CAR prior, where n is the number of regions and I the number of "islands" (disconnected groups of regions) in the spatial map. Since I = 1 for a spatial structure defining a connected graph, this supports Knorr-Held's (2002, in Highly Structured Stochastic Systems, 260-264) suggestion that k = (n - 1)/2 in the L2 norm case, instead of the more common k = n/2. We illustrate the practical significance of our results using a periodontal example.
Bayes Theorem↗
One-year outcome of a combination of weight loss therapies for subjects with type 2 diabetes: a randomized trial.
OBJECTIVE: The purpose of this study was to evaluate the effects of a combination weight loss program using intermittent low-calorie diets, energy-controlled meal replacement products, and sibutramine on weight loss, diabetes control, and cardiovascular risk factors in overweight or obese subjects with type 2 diabetes. RESEARCH DESIGN AND METHODS: Overweight or obese individuals with type 2 diabetes treated with diet or oral medication were randomly assigned to either a standard therapy or combination therapy group. Both groups received a standardized program to facilitate weight loss. The combination therapy group also received 10-15 mg sibutramine daily, low-calorie diets using meal replacement products for 1 week every 2 months, and between low-calorie diet weeks, once daily use of meal replacement product and snack bars to replace one usual meal and snack. Primary outcome measures were changes in body weight, glycemic control, plasma lipids, blood pressure, pulse, and body composition at 1 year. RESULTS: At 1 year, combination therapy, compared with standard therapy, resulted in significantly more weight loss (-7.3 +/- 1.3 kg vs. -0.8 +/- 0.9 kg, P < 0.001) and reduction in HbA(1c) (-0.6 +/- 0.3 vs. 0.0 +/- 0.2%, P = 0.05). Combination therapy resulted in reduced requirement for diabetes medications and decreased fat mass and lean body mass. A 5-kg decrease in weight at 1 year was associated with a decrease of 0.4% in HbA(1c) (P = 0.006). Changes in fasting glucose, lipids, pulse, and blood pressure did not differ between groups. CONCLUSIONS: This combination weight loss program resulted in greater weight loss and improved diabetes control compared with a standard weight loss program in overweight or obese subjects with type 2 diabetes.
Blood Glucose↗
Effect of alpha2M on earthworm fibrinolytic enzyme III-1 from Lumbricus rubellus.
Though it is known that human alpha2-macroglobulin (alpha2M) inhibits most proteases, the effect of alpha2M has not been investigated on earthworm fibrinolytic enzymes (EFEs) from Lumbricus rubellus, which could be transported from intestine epithelium into blood as an intact molecule (Fan et al., Biochim. Biophys. Acta 1526 (2001) 286). The activity of earthworm fibrinolytic III-1 (EFE-III-1) decreased to 65% when incubated with alpha2M, while it decreased to 30% in plasma under the same conditions. The first order rate of the inactivation of EFE-III-1 with alpha2M was similar to that of fast phase with plasma, indicating that alpha2M may be the inhibitor initially binding to the enzyme in blood. SDS-PAGE showed that incubation of EFE-III-1 with alpha2M a released fragment ( approximately 90 kDa), followed by formation of a high molecular weight complex (approximately 700 kDa). There was a linear relationship between the apparent inhibition rate constant (k1) and [alpha2M], by double reciprocal plot. It was suggested, as described by Tsou (Acta Biochem. Biophys. Sinica 5 (1965) 398) and Tian (Biochem. J. 21 (1982) 1028), that the mechanism of alpha2M/EFE-III-1 interaction could be coincided with a complexing irreversible inhibition. Experiments in both the inactivation and the intrinsic fluorescence showed that alpha2M bound to the enzyme mole by mole equivalently. The intrinsic fluorescence of alpha2M was enhanced with an observable blue shift in emission maxima, suggesting that alpha2M was one of the important inhibitors to EFEs when it absorbed into blood.
Animals↗