- 著者
- Tomomi KIMURA Toshifumi SUGITANI Takuya NISHIMURA Masanori ITO
- 出版者
- Japanese Society for Pharmacoepidemiology
- 雑誌
- 薬剤疫学 (ISSN:13420445)
- 巻号頁・発行日
- vol.24, no.2, pp.53-64, 2019-08-27 (Released:2019-10-07)
- 参考文献数
- 25
- 被引用文献数
- 15 14
Objective: The Charlson and Elixhauser comorbidity indices (CCI and ECI, respectively) are widely used to study comorbid conditions but these indices have not been validated in Japanese datasets. In this study, our objective was to validate and recalibrate CCI and ECI in a Japanese insurance claims database.Methods: All hospitalizations for patients aged≥18 years discharged between January 2011 and December 2016 were randomly allocated to derivation and validation cohorts. Predictability for hospital death and re-admission was evaluated using C statistics from multivariable logistic regression models including age, sex, and individual CCI/ECI conditions at admission month or the derived score in the derivation cohort. After stepwise variable selection, weighted risk scores for each condition were re-assigned using odds ratios (CCI) or beta coefficients (ECI). The modified models were evaluated in the validation cohort.Results: The original CCI/ECI had good discriminatory power for hospital death: C statistics (95% confidence interval) for individual comorbidities and score models were 0.845 (0.835-0.855) and 0.823 (0.813-0.834) for CCI, and 0.839 (0.828-0.850) and 0.801 (0.790-0.812) for ECI, respectively. Modified CCI and ECI had reduced numbers of comorbidities (17 to 10 and 30 to 21, respectively) but maintained comparable discriminatory abilities: C statistics for modified individual comorbidities and score models were 0.843 (0.833-0.854) and 0.838 (0.827-0.848) for CCI, and 0.840 (0.828-0.852) and 0.839 (0.827-0.851) for ECI, respectively.Conclusions: The original and modified models showed comparable discriminatory abilities and both can be used in future studies using insurance claims databases.
- 著者
- Jun Tamogami Takashi Kikukawa Toshifumi Nara Makoto Demura Tomomi Kimura-Someya Mikako Shirouzu Shigeyuki Yokoyama Seiji Miyauchi Kazumi Shimono Naoki Kamo
- 出版者
- 一般社団法人 日本生物物理学会
- 雑誌
- Biophysics and Physicobiology (ISSN:21894779)
- 巻号頁・発行日
- vol.14, pp.49-55, 2017 (Released:2017-03-18)
- 参考文献数
- 25
- 被引用文献数
- 7
A spectrally silent change is often observed in the photocycle of microbial rhodopsins. Here, we suggest the presence of two O intermediates in the photocycle of Acetabularia rhodopsin II (ARII or also called Ace2), a light-driven algal proton pump from Acetabularia acetabulum. ARII exhibits a photocycle including a quasi-equilibrium state of M, N, and O (M<=>N<=>O→) at near neutral and above pH values. However, acidification of the medium below pH ~5.5 causes no accumulation of N, resulting in that the photocycle of ARII can be described as an irreversible scheme (M→O→). This may facilitate the investigation of the latter part of the photocycle, especially the rise and decay of O, during which molecular events have not been sufficiently understood. Thus we analyzed the photocycle under acidic conditions (pH ≤ 5.5). Analysis of the absorbance change at 610 nm, which mainly monitors the fractional concentration changes of K and O, was performed and revealed a photocycle scheme containing two sequential O-states with the different molar extinction coefficients. These photoproducts, termed O1 and O2, may be even produced at physiological pH, although they are not clearly observed under this condition due to the existence of a long M-N-O equilibrium.