Serum cholinesterase levels to predict all-cause mortality in a community-based study: The Takahata study

Introduction: Serum albumin (Alb) levels have been found to be independent predictors of all-cause mortality in a community-based population, but whether this is the case for serum cholinesterase (ChE) levels is uncertain. This study aimed to determine whether serum ChE levels are independent predictors of all-cause mortality in a community-based population. Methods: A total of 3,504 subjects (mean age 62.5 years) from Takahata, Japan participated and were followed up for 13.5 years (median 13.2 years). Based on baseline serum Alb and ChE levels, subjects were stratified by interquartile range as low, middle, and high. The correlation between serum Alb and ChE levels was examined by calculating correlation coefficients. The association between each group and all-cause mortality was examined by Kaplan-Meier and Cox proportional hazards analysis. Results: During follow-up, 568 subjects died. There was a positive correlation between serum Alb and ChE levels (r=0.30). Kaplan-Meier analysis showed that all-cause mortality in the low group was significantly higher for both serum Alb and ChE levels (log-rank P<0.01). Adjusted Cox proportional hazards analysis showed that the serum Alb level was not an independent predictor of all-cause mortality (hazard ratio (HR) 1.18, 95% confidence interval (CI) 0.95-1.46 for all-cause mortality in the low group compared to the middle group), whereas the serum ChE level was an independent predictor of all-cause mortality (HR 1.30, 95% CI 1.06-1.59 for all-cause mortality in the low group compared to the middle group). Conclusion: The serum ChE level is an independent predictor of all-cause mortality in the general community-based population.

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Association between milk and yogurt intake and mortality: a community-based cohort study (Yamagata study)

BMC Nutrition ◽

10.1186/s40795-021-00435-1 ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Akiko Nakanishi ◽

Erika Homma ◽

Tsukasa Osaki ◽

Ri Sho ◽

Masayoshi Souri ◽

...

Keyword(s):

Proportional Hazards ◽

Proportional Hazards Model ◽

Hazard Analysis ◽

Total Mortality ◽

Cox Proportional Hazards ◽

Cox Proportional Hazards Model ◽

Milk Intake ◽

Community Based ◽

Hazards Model ◽

Kaplan Meier

Abstract Background Dairy products are known as health-promoting foods. This study prospectively examined the association between milk and yogurt intake and mortality in a community-based population. Methods The study population comprised of 14,264 subjects aged 40–74 years who participated in an annual health checkup. The frequency of yogurt and milk intake was categorized as none (< 1/month), low (< 1/week), moderate (1–6/week), and high (> 1/day) intake. The association between yogurt and milk intake and total, cardiovascular, and cancer-related mortalities was determined using the Cox proportional hazards model. Results During the follow-up period, there were 265 total deaths, 40 cardiovascular deaths and 90 cancer-related deaths. Kaplan–Meier analysis showed that the total mortality in high/moderate/low yogurt intake and moderate/low milk intake groups was lower than that in none group (log-rank, P < 0.01). In the multivariate Cox proportional hazard analysis adjusted for possible confounders, the hazard ratio (HR) for total mortality significantly decreased in high/moderate yogurt intake group (HR: 0.62, 95% confidence interval [CI]: 0.42–0.91 for high intake, HR: 0.70, 95%CI: 0.49–0.99 for moderate intake) and moderate milk intake group (HR: 0.67, 95% CI: 0.46–0.97) compared with the none yogurt and milk intake groups. A similar association was observed for cancer-related mortality, but not for cardiovascular mortality. Conclusions Our study showed that yogurt and milk intake was independently associated with a decrease in total and cancer-related mortalities in the Japanese population.

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Absence of Obesity Paradox in All-Cause Mortality Among Chinese Patients With an Implantable Cardioverter Defibrillator: A Multicenter Cohort Study

Frontiers in Cardiovascular Medicine ◽

10.3389/fcvm.2021.730368 ◽

2021 ◽

Vol 8 ◽

Author(s):

Bin Zhou ◽

Xuerong Sun ◽

Na Yu ◽

Shuang Zhao ◽

Keping Chen ◽

...

Keyword(s):

Implantable Cardioverter Defibrillator ◽

Proportional Hazards ◽

Obesity Paradox ◽

Cox Proportional Hazards ◽

Chinese Patients ◽

Proportional Hazards Models ◽

Cardioverter Defibrillator ◽

Kaplan Meier ◽

Cox Proportional Hazards Models ◽

All Cause Mortality

Background: The results of studies on the obesity paradox in all-cause mortality are inconsistent in patients equipped with an implantable cardioverter-defibrillator (ICD). There is a lack of relevant studies on Chinese populations with large sample size. This study aimed to investigate whether the obesity paradox in all-cause mortality is present among the Chinese population with an ICD.Methods: We conducted a retrospective analysis of multicenter data from the Study of Home Monitoring System Safety and Efficacy in Cardiac Implantable Electronic Device–implanted Patients (SUMMIT) registry in China. The outcome was all-cause mortality. The Kaplan–Meier curves, Cox proportional hazards models, and smooth curve fitting were used to investigate the association between body mass index (BMI) and all-cause mortality.Results: After inclusion and exclusion criteria, 970 patients with an ICD were enrolled. After a median follow-up of 5 years (interquartile, 4.1–6.0 years), in 213 (22.0%) patients occurred all-cause mortality. According to the Kaplan–Meier curves and multivariate Cox proportional hazards models, BMI had no significant impact on all-cause mortality, whether as a continuous variable or a categorical variable classified by various BMI categorization criteria. The fully adjusted smoothed curve fit showed a linear relationship between BMI and all-cause mortality (p-value of 0.14 for the non-linearity test), with the curve showing no statistically significant association between BMI and all-cause mortality [per 1 kg/m2 increase in BMI, hazard ratio (HR) 0.97, 95% CI 0.93–1.02, p = 0.2644].Conclusions: The obesity paradox in all-cause mortality was absent in the Chinese patients with an ICD. Prospective studies are needed to further explore this phenomenon.

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The Significance of Follow-Up Serum Uric Acid Levels in Predicting All-Cause Mortality and Cardiovascular Mortality in Peritoneal Dialysis Patients

10.21203/rs.3.rs-146953/v1 ◽

2021 ◽

Author(s):

Pingping Ren ◽

Qilong Zhang ◽

Yixuan Pan ◽

Yi Liu ◽

Chenglin Li ◽

...

Keyword(s):

Uric Acid ◽

Peritoneal Dialysis ◽

Serum Uric Acid ◽

Cardiovascular Mortality ◽

Proportional Hazards ◽

Cox Proportional Hazards ◽

Kaplan Meier ◽

Significant Difference ◽

All Cause Mortality

Abstract Background: Studies on the correlation between serum uric acid (SUA) and all-cause mortality in peritoneal dialysis (PD) patients were mainly based on the results of baseline SUA. We aimed to analyze the change of SUA level post PD, and the correlation between follow-up SUA and prognosis in PD patients. Methods: All patients who received PD catheterization and maintaining PD in our center from March 2, 2001 to March 8, 2017 were screened. Kaplan-Meier and Cox proportional-hazards regression models were used to analyze the effect of SUA levels on the risks of death. We graded SUA levels at baseline, 6 months, 12 months, 18 months and 24 months post PD by mean of SUA plus or minus a standard deviation as cut-off values, and compared all-cause and cardiovascular mortality among patients with different SUA grades. Results: A total of 1402 patients were included, 763 males (54.42%) and 639 females (45.58%). Their average age at PD start was 49.50±14.20 years. The SUA levels were 7.97±1.79mg/dl at baseline, 7.12±1.48mg/dl at 6 months, 7.05±1.33mg/dl at 12 months, 7.01±1.30mg/dl at 18 months, and 6.93±1.26mg/dl at 24 months. During median follow-up time of 31 (18, 49) months, 173 (12.34%) all-cause deaths occurred, including 68 (4.85%) cardiovascular deaths. There were no significant differences on all-cause mortality among groups with graded SUA levels at baseline, 12 months, 18 months and 24 months during follow-up or on cardiovascular mortality among groups with graded SUA levels at baseline, 6 months, 12 months, 18 months and 24 months during follow-up. At 6 months post PD，Kaplan Meier analysis showed there was significant difference on all-cause mortality among graded SUA levels (c2=11.315, P=0.010), and the all-cause mortality was lowest in grade of 5.65mg/dl≤SUA<7.13mg/dl. Conclusion: SUA level decreased during follow up post PD. At 6 months post PD, a grade of 5.65mg/dl≤SUA<7.13mg/dl was appropriate for better patients’ survival.

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Cognitive Leisure Activity and All-cause Mortality in Older Adults: A 4-Year Community-based Cohort

10.21203/rs.3.rs-42686/v2 ◽

2021 ◽

Author(s):

Qianyi Xiao ◽

Xin Liu ◽

Ye Ruan ◽

Limei Huang ◽

Yanfei Guo ◽

...

Keyword(s):

Older Adults ◽

Computer Use ◽

Proportional Hazards ◽

Activity Index ◽

Strong Association ◽

Leisure Activity ◽

Cox Proportional Hazards ◽

Community Based ◽

Risk Of Death ◽

All Cause Mortality

Abstract Background: Cognitive leisure activity, such as reading, playing mahjong or cards and computer use, is common among older adults in China. Previous studies suggest a protective role of cognitive leisure activity against cognitive impairment. However, the relationship between cognitive leisure activity and all-cause mortality has rarely been reported.Objectives: This study aims to explore the relationships between cognitive leisure activity and all-cause mortality in a community-based elderly cohort in China.Methods: The current study sample comprised 4003 community residents aged ≥ 60 y who were enrolled in June 2015, and were followed up every year from 2015 to 2018. Reading, playing mahjong or cards and computer use were measured by questionnaires and summed into a cognitive leisure activity index (CLAI) score. Cox proportional hazards analysis and Kaplan-Meier survival analysis were used to examine the association of cognitive leisure activity with all-cause mortality.Results: During the 4-year follow-up of 4003 participants, 208 (5.2%) deaths were registered. Of all participants, 66.8%, 26.7%, 6.1% and 0.35% reported CLAI scores of 0, 1, 2 and 3, respectively. A strong association was noted between the CLA score and all-cause mortality (adjusted hazard ratio [HR] = 0.72, 95% confidence intervals [CI]: 0.54-0.96, P = 0.025). Stratified analysis suggested that a higher CLAI score was significantly associated with a decreased risk of all-cause mortality mainly among those who were male, aged ≥ 80 y, cognitively impaired, and not diagnosed with cancer (P < 0.05).Conclusion: Cognitive leisure activity has beneficial effect on reduced risk of death from all cause among the elderly in China, which helped promote a comprehensive understanding of health characteristics at advanced ages.

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Abstract P003: Survival after Incident Atrial Fibrillation: A Community-Based Study

Circulation ◽

10.1161/circ.127.suppl_12.ap003 ◽

2013 ◽

Vol 127 (suppl_12) ◽

Author(s):

Alanna M Chamberlain ◽

Bernard J Gersh ◽

Alvaro Alonso ◽

Lin Y Chen ◽

Cecilia Berardi ◽

...

Keyword(s):

Atrial Fibrillation ◽

Time Trends ◽

Proportional Hazards ◽

Cox Proportional Hazards ◽

Community Based ◽

Risk Of Death ◽

Diagnostic Codes ◽

Kaplan Meier ◽

Hazard Ratios ◽

Age Range

Background: Atrial fibrillation (AF) is the most common cardiac arrhythmia in clinical practice, causes substantial morbidity, and is associated with an excess risk of mortality. However, information on contemporary time trends in survival after AF is lacking. Thus, we aimed to determine whether survival after incident AF has changed over the last decade in a community-based cohort of 3413 individuals with incident AF between 2000 and 2010. Methods: Olmsted County, MN residents 18 years of age and older with a first-ever AF or atrial flutter event between 2000 and 2010 were identified using inpatient and outpatient diagnostic codes and electrocardiograms. Deaths from any cause were ascertained through August 31, 2012 and time trends in survival after AF were examined using Kaplan-Meier curves and Cox proportional hazards regression. Results: Among 3413 individuals with incident AF (52% men, age range 18-104) between 2000 and 2010, 1561 deaths were observed over a median follow-up of 3.4 years. Survival did not differ by year of AF diagnosis (figure). In addition, the proportion of cardiovascular disease-related deaths compared to non-cardiovascular deaths did not differ over time. After adjustment for age, sex, and Charlson comorbidity index, the hazard ratios for all-cause mortality were 1.09 (95% CI 0.97-1.23) for those diagnosed with AF in 2004-2007 vs. 2000-2003 and 1.04 (95% CI 0.90-1.12) for 2008-2010 vs. 2000-2003. Furthermore, the risk of death did not differ by sex after adjustment for age and comorbidity (HR 1.00, 95% CI 0.90-1.11 for men vs. women). Conclusions: In the community, survival after AF has remained constant over the last decade despite substantial changes in the recommendations for treatment of AF. This underscores the importance of identification of prognostic factors and continued surveillance of outcomes in AF, as well as a better understanding of how to optimize the management of AF to improve outcomes in these patients.

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Geriatric Nutritional Risk Index Is a Simple Predictor of Mortality in Chronic Hemodialysis Patients

Blood Purification ◽

10.1159/000381798 ◽

2015 ◽

Vol 39 (4) ◽

pp. 281-287 ◽

Cited By ~ 19

Author(s):

Mizuki Komatsu ◽

Masayuki Okazaki ◽

Ken Tsuchiya ◽

Hiroshi Kawaguchi ◽

Kosaku Nitta

Keyword(s):

Proportional Hazards ◽

Risk Index ◽

Cox Proportional Hazards ◽

Nutritional Risk ◽

Geriatric Nutritional Risk Index ◽

Kaplan Meier ◽

Nutritional Risk Index ◽

All Cause Mortality ◽

Overall Mortality

Background: Malnutrition is common in hemodialysis (HD) patients, and it is associated with increasing risk of mortality. The geriatric nutritional risk index (GNRI) has been developed as a tool to assess the nutritional risk. The aim of this study was to examine the reliability of the GNRI as a mortality predictor in a Japanese HD cohort. Methods: We prospectively examined the GNRI of 332 maintenance HD patients aged 65.4 ± 13.2, 213 males, and followed up on them for 36 months. The patients were divided into quartiles (Q) according to GNRI values (Q1: <91.6, Q2: 91.7-97.0, Q3: 97.1-102.2, Q4: >102.3). Predictors for all-cause mortality were examined using Kaplan-Meier and Cox proportional-hazards analyses. Results: The GNRI presented a normal distribution. During the follow-up period of 36 months, 76 patients died. The overall mortality at the end of the 3-year observational period was 22.3%. At the 3-year follow-up period, Kaplan-Meier survival rates for all-cause mortality were 72.3, 79.3, 84.9 and 92.6% in Q1, Q2, Q3, and Q4, respectively (p = 0.0067). Multivariate Cox proportional-hazards analysis demonstrated that the GNRI was a significant predictor of adjusted all-cause mortality (HR 0.958; 95% CI 0.929-0.989, p = 0.0073). Conclusions: The results of the present study demonstrate that the GNRI is a strong predictor of overall mortality in HD patients. However, cardiovascular mortality was not associated with GNRI values, and did not differ among the GNRI quartiles. The GNRI score can be considered a simple and reliable marker of predictor for mortality risk in Japanese HD patients.

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Association of polymorphisms in androgen production, uptake, and conversion chain (APUC) genes with mortality of prostate cancer patients.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.15_suppl.5528 ◽

2020 ◽

Vol 38 (15_suppl) ◽

pp. 5528-5528

Author(s):

Sean Thomas McSweeney ◽

Anna Prizment ◽

Nathan Pankratz ◽

Corinne E Joshu ◽

Elizabeth A. Platz ◽

...

Keyword(s):

Proportional Hazards ◽

Snp Array ◽

Cox Proportional Hazards ◽

Gain Of Function ◽

Atherosclerosis Risk In Communities ◽

Kaplan Meier ◽

Hazard Ratios ◽

Increased Risk ◽

All Cause Mortality ◽

Aric Study

5528 Background: Genes involved in APUC may affect prognosis in PC. We tested the association of four SNPs involved in the APUC pathway: hydroxy-delta-5-steroid dehydrogenase, 3 beta-and steroid delta-isomerase 1 ( HSD3B1), 5α reductase enzyme ( SRD5A), and solute carrier organic ion ( SLCO2B1) with all-cause and PC mortality 596 in the Atherosclerosis Risk in Communities (ARIC) study. Methods: Between 1987 & 2015 596 men were diagnosed with PC. Median age at diagnosis was 70 (range 53-86) years; 21% of all PC patients were African American. After diagnosis, follow-up was median 8.4 years (max 26.7 years) until PrC death (N = 60), death from any cause (N = 253), or end of 2015. SNPs were genotyped using the Affymetrix Genome-Wide Human SNP Array 6.0 and imputed to the 1000 Genomes Phase 3 reference panel. To examine survival, we used Kaplan-Meier curves and Cox proportional hazards regression. Hazard ratios (HR) and 95% confidence intervals (CI) were adjusted for age, field center, stage and grade at diagnosis. We also controlled for confounding by ancestry by adjusting for genetic principal components. The analyses were conducted in all PrCa patients and in Whites PrCa patients only. Polymorphisms tested included rs1047303 (A = > C, also called 1245C); rs523349 (C = > G); and rs1789693 (A = > T) and rs12422149 (G = > A), located in the aforementioned genes. Results: The A allele for SLCO2B1 rs1789693 (A = > T) was significantly associated with an increased risk of PC mortality (versus T): multivariable-adjusted HRs (95%CI) were (2.06, 1.14-3.74; p = 0.02) and all-cause mortality (1.29, 1.00-1.66; p = 0.05) among Whites. The associations were similar when Whites and African-Americans were combined and when accounting for ancestry. The C allele for HSD3B1 rs1047303 (C = > A) was not statistically significantly associated with either PC or all-cause mortality in the whole cohort (which included localized disease), although HRs were increased for men diagnosed with stage 4 disease (n = 35) in both additive and dominant models. For carriers of the C allele (gain of function) versus AA, HRs were 5.32 (1.16-24.33; p = 0.03) and 6.13 (1.51-24.86; p = 0.01) for PC and all-cause mortality, respectively. All associations with SRDA2 (rs12422149) and SLCO2B1 (rs12422149) were not significant. Conclusions: The gain of function allele in HSD3B1 rs1047303 (1245C) was associated with increased PC and all-cause mortality in men diagnosed with metastatic PC, paralleling prior findings. Associations with SLCO2B1 SNP rs1789693 require validation in larger studies.

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Survival among Veterans Obtaining Dialysis in VA and Non-VA Settings

Journal of the American Society of Nephrology ◽

10.1681/asn.2018050521 ◽

2018 ◽

Vol 30 (1) ◽

pp. 159-168 ◽

Cited By ~ 6

Author(s):

Virginia Wang ◽

Cynthia J. Coffman ◽

Karen M. Stechuchak ◽

Theodore S.Z. Berkowitz ◽

Paul L. Hebert ◽

...

Keyword(s):

Proportional Hazards ◽

Proportional Hazards Model ◽

Care Program ◽

Veterans Affairs ◽

Cox Proportional Hazards ◽

Cox Proportional Hazards Model ◽

Community Based ◽

Hazards Model ◽

All Cause Mortality ◽

Financial Arrangements

BackgroundOutcomes of veterans with ESRD may differ depending on where they receive dialysis and who finances this care, but little is known about variation in outcomes across different dialysis settings and financial arrangements.MethodsWe examined survival among 27,241 Veterans Affairs (VA)–enrolled veterans who initiated chronic dialysis in 2008–2011 at (1) VA-based units, (2) community-based clinics through the Veterans Affairs Purchased Care program (VA-PC), (3) community-based clinics under Medicare, or (4) more than one of these settings (“dual” care). Using a Cox proportional hazards model, we compared all-cause mortality across dialysis settings during the 2-year period after dialysis initiation, adjusting for demographic and clinical characteristics.ResultsOverall, 4% of patients received dialysis in VA, 11% under VA-PC, 67% under Medicare, and 18% in dual settings (nearly half receiving dual VA and VA-PC dialysis). Crude 2-year mortality was 25% for veterans receiving dialysis in the VA, 30% under VA-PC, 42% under Medicare, and 23% in dual settings. After adjustment, dialysis patients in VA or in dual settings had significantly lower 2-year mortality than those under Medicare; mortality did not differ in VA-PC and Medicare dialysis settings.ConclusionsMortality rates were highest for veterans receiving dialysis in Medicare or VA-PC settings and lowest for veterans receiving dialysis in the VA or dual settings. These findings inform institutional decisions about provision of dialysis for veterans. Further research identifying processes associated with improved survival for patients receiving VA-based dialysis may be useful in establishing best practices for outsourced veteran care.

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Impact of Extended and Restricted Antibiotic Deescalation on Mortality

Antibiotics ◽

10.3390/antibiotics11010022 ◽

2021 ◽

Vol 11 (1) ◽

pp. 22

Author(s):

Hwei Lin Teh ◽

Sarimah Abdullah ◽

Anis Kausar Ghazali ◽

Rahela Ambaras Khan ◽

Anitha Ramadas ◽

...

Keyword(s):

Proportional Hazards ◽

Survival Curve ◽

Survival Rates ◽

Pressure Sore ◽

Cox Proportional Hazards ◽

Kaplan Meier ◽

Risk Of Mortality ◽

Increased Risk ◽

All Cause Mortality ◽

The Impact

Background: More data are needed about the safety of antibiotic de-escalation in specific clinical situations as a strategy to reduce exposure to broad-spectrum antibiotics. This study aims to compare the survival curve of patient de-escalated (early or late) against those not de-escalated on antibiotics, to determine the association of patient related, clinical related, and pressure sore/device related characteristics on all-cause 30-day mortality and determine the impact of early and late antibiotic de-escalation on 30-day all-cause mortality. Methods: This is a retrospective cohort study on patients in medical ward Hospital Kuala Lumpur, admitted between January 2016 and June 2019. A Kaplan–Meier survival curve and Fleming–Harrington test were used to compare the overall survival rates between early, late, and those not de-escalated on antibiotics while multivariable Cox proportional hazards regression was used to determine prognostic factors associated with mortality and the impact of de-escalation on 30-day all-cause mortality. Results: Overall mortality rates were not significantly different when patients were not de-escalated on extended or restricted antibiotics, compared to those de-escalated early or later (p = 0.760). Variables associated with 30-day all-cause mortality were a Sequential Organ Function Assessment (SOFA) score on the day of antimicrobial stewardship (AMS) intervention and Charlson’s comorbidity score (CCS). After controlling for confounders, early and late antibiotics were not associated with an increased risk of mortality. Conclusion: The results of this study reinforce that restricted or extended antibiotic de-escalation in patients does not significantly affect 30-day all-cause mortality compared to continuation with extended and restricted antibiotics.

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Glycated Hemoglobin and All-Cause and Cause-Specific Mortality Among Adults With and Without Diabetes

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2018-02536 ◽

2019 ◽

Vol 104 (8) ◽

pp. 3345-3354 ◽

Cited By ~ 5

Author(s):

Fu-Rong Li ◽

Xi-Ru Zhang ◽

Wen-Fang Zhong ◽

Zhi-Hao Li ◽

Xiang Gao ◽

...

Keyword(s):

Mortality Risk ◽

Hba1c Level ◽

Proportional Hazards ◽

Cox Proportional Hazards ◽

Community Based ◽

Hazard Ratios ◽

Risk Of Mortality ◽

All Cause Mortality ◽

History Of

Abstract Context The patterns of associations between glycated Hb (HbA1c) and mortality are still unclear. Objective To explore the extent to which ranges of HbA1c levels are associated with the risk of mortality among participants with and without diabetes. Design, Setting, and Patients This was a nationwide, community-based prospective cohort study. Included were 15,869 participants (median age 64 years) of the Health and Retirement Study, with available HbA1c data and without a history of cancer. Cox proportional hazards regression models were used to estimate hazard ratios with 95% CIs for mortality. Results A total of 2133 participants died during a median follow-up of 5.8 years. In participants with diabetes, those with an HbA1c level of 6.5% were at the lowest risk of all-cause mortality. When HbA1c level was <5.6% or >7.4%, the increased all-cause mortality risk became statistically significant as compared with an HbA1c level of 6.5%. As for participants without diabetes, those with an HbA1c level of 5.4% were at the lowest risk of all-cause mortality. When the HbA1c level was <5.0%, the increased all-cause mortality risk became statistically significant as compared with an HbA1c level of 5.4%. However, we did not observe a statistically significant elevated risk of all-cause mortality above an HbA1c level of 5.4%. Conclusions A U-shaped and reverse J-shaped association for all-cause mortality was found among participants with and without diabetes. The corresponding optimal ranges for overall survival are predicted to be 5.6% and 7.4% and 5.0% and 6.5%, respectively.

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