Category: Nevin Manimala

Pediatr Obes. 2023 Dec 14:e13087. doi: 10.1111/ijpo.13087. Online ahead of print.

ABSTRACT

BACKGROUND: Cord blood (CB) leptin is positively associated with adiposity at birth, but the association with child adiposity is unclear.

OBJECTIVES: We hypothesized that CB leptin is positively associated with adiposity in peripubertal children and with childhood leptin.

METHODS: Leptin was measured in 986 CB and 931 childhood stored samples from a prospective birth cohort. Adiposity measures were collected at birth and mean age 11.5 years. Linear and logistic regression analyses were used to evaluate associations between log-transformed CB leptin and neonatal and childhood adiposity measures as continuous and categorical variables, respectively.

RESULTS: CB leptin was positively associated with neonatal and childhood adiposity. Childhood associations were attenuated when adjusted for maternal body mass index (BMI) and glucose, but remained statistically significant for childhood body fat percentage (β = 1.15%, confidence interval [CI] = 0.46-1.84), body fat mass (β = 0.69 kg, 95% CI = 0.16-1.23), sum of skin-folds (β = 1.77 mm, 95% CI = 0.31-3.24), log-transformed child serum leptin (β = 0.13, 95% CI = 0.06-0.20), overweight/obesity (OR = 1.21, 95% CI = 1.03-1.42), obesity (OR = 1.31, 95% CI = 1.04-1.66) and body fat percentage >85th percentile (OR = 1.38, 95% CI = 1.12-1.73). Positive associations between newborn adiposity measures and CB leptin confirmed previous reports.

CONCLUSION: CB leptin is positively associated with neonatal and childhood adiposity and child leptin levels, independent of maternal BMI and maternal hyperglycemia. CB leptin may be a biomarker of future adiposity risk.

PMID:38095062 | DOI:10.1111/ijpo.13087

Future Oncol. 2023 Dec 14. doi: 10.2217/fon-2023-0736. Online ahead of print.

ABSTRACT

Aim: To develop a shiny app for doctors to investigate breast cancer treatments through a new approach by incorporating unsupervised clustering and survival information. Materials & methods: Analysis is based on the Molecular Taxonomy of Breast Cancer International Consortium (METABRIC) dataset, which contains 1726 subjects and 22 variables. Cox regression was used to identify survival risk factors for K-means clustering. Logrank tests and C-statistics were compared across different cluster numbers and Kaplan-Meier plots were presented. Results & conclusion: Our study fills an existing void by introducing a unique combination of unsupervised learning techniques and survival information on the clinician side, demonstrating the potential of survival clustering as a valuable tool in uncovering hidden structures based on distinct risk profiles.

PMID:38095059 | DOI:10.2217/fon-2023-0736

Rev Med Liege. 2023 Dec;78(12):725-732.

ABSTRACT

Finerenone, a new nonsteroidal mineralocorticoid receptor antagonist, showed a significant reduction in a primary composite renal outcome in FIDELIO-DKD and a significant reduction in a primary composite cardiovascular outcome in FIGARO-DKD in patients with type 2 diabetes (T2D) and a chronic kidney disease (CKD). In a subsequent analysis that combined these two clinical trials (FIDELITY), the reduction becomes statistically significant when compared to placebo for both outcomes, with a hazard ratio of 0.86 (95 % confidence interval 0.78-0.95; P = 0.0018) for the cardiovascular outcome and 0.77 (0.67-0.88; P = 0.0002) for the renal outcome. Furthermore, all renal events occurred less frequently with finerenone than with placebo, including the progression to end-stage CKD independently of the baseline levels of glomerular filtration rate and albuminuria and regardless of associated medications (including gliflozins). The safety profile was excellent. However, a significant increase in serum potassium level was observed. Even if it is less pronounced than the increase usually seen with spironolactone, the risk of hyperkalemia requires some caution regarding both patient selection and monitoring. Finerenone (Kerendia®) is indicated in the treatment of CKD with albuminuria in adult patients with T2D. In Belgium, it is reimbursed with conditions in combination with a renin-angiotensin blocker.

PMID:38095038

J Psychiatr Ment Health Nurs. 2023 Dec 14. doi: 10.1111/jpm.13010. Online ahead of print.

ABSTRACT

INTRODUCTION: The reason for this study was void of a data-driven imminent risk assessment instrument for aggression in psychiatry clinics in Estonia. The predictive accuracy of the observer-rated Dynamic Assessment of Situational Aggression (DASA) has been repeatedly demonstrated. However, the research gap remains regarding a deeper conceptual understanding of the underlying latent structure of the DASA.

AIM: Comprehensively evaluate the psychometric properties of the Estonian DASA version for cross-cultural clinical use.

METHOD: We used a prospective repeated measure design and collected 6097 risk evaluations from 381 adult inpatients, 151 of whom committed 1013 aggressive incidents during the study.

RESULTS: The Estonian DASA version has acceptable inter-rater reliability (Kendall’s τ = 0.74) and is a useful instrument with excellent predictive validity (AUC = 0.86) for identifying potentially aggressive inpatients. In our sample, the DASA has a bi-factorial structure which explains 83% of the total variance.

DISCUSSION: The adapted DASA has acceptable validity and reliability indices for measuring imminent aggression risk in adult inpatient units.

IMPLICATIONS FOR PRACTICE: Evidence-based risk assessment of aggression in psychiatric clinics enhances recognition of the signs of potentially aggressive behaviour in order to apply preventive actions and reduce aggression, thereby improving the quality of the care provided.

PMID:38095026 | DOI:10.1111/jpm.13010

Biometrika. 2022 Dec;109(4):1047-1066. doi: 10.1093/biomet/asac011. Epub 2022 Feb 16.

ABSTRACT

This paper addresses the task of estimating a covariance matrix under a patternless sparsity assumption. In contrast to existing approaches based on thresholding or shrinkage penalties, we propose a likelihood-based method that regularizes the distance from the covariance estimate to a symmetric sparsity set. This formulation avoids unwanted shrinkage induced by more common norm penalties, and enables optimization of the resulting nonconvex objective by solving a sequence of smooth, unconstrained subproblems. These subproblems are generated and solved via the proximal distance version of the majorization-minimization principle. The resulting algorithm executes rapidly, gracefully handles settings where the number of parameters exceeds the number of cases, yields a positive-definite solution, and enjoys desirable convergence properties. Empirically, we demonstrate that our approach outperforms competing methods across several metrics, for a suite of simulated experiments. Its merits are illustrated on international migration data and a case study on flow cytometry. Our findings suggest that the marginal and conditional dependency networks for the cell signalling data are more similar than previously concluded.

PMID:38094986 | PMC:PMC10716840 | DOI:10.1093/biomet/asac011

Innov Aging. 2023 Jul 13;7(10):igad074. doi: 10.1093/geroni/igad074. eCollection 2023.

ABSTRACT

BACKGROUND AND OBJECTIVES: Despite its prevalence and impact, pain is underdetected and undermanaged in persons with dementia. Family caregivers are well positioned to detect pain and facilitate its management in their care recipients, but they lack training in symptom recognition and communication. This study reports findings from a pilot trial evaluating the Pain Identification and Communication Toolkit (PICT), a multicomponent intervention that provides training in observational pain assessment and coaching in pain communication techniques.

RESEARCH DESIGN AND METHODS: Family caregivers of persons with comorbid pain and moderate-to-advanced dementia were randomly assigned to PICT (n = 19) or a control condition (n = 15). Caregivers in the PICT group participated in four weekly sessions delivered by telephone with a trained interventionist; caregivers in the control group received an information pamphlet about pain and dementia. All participants completed surveys at baseline and 12 weeks. Caregivers in the intervention group also completed semistructured interviews at 12 weeks. Quantitative data were analyzed using descriptive statistics and t tests; qualitative data were analyzed using content analysis.

RESULTS: All participants (100%) in the PICT group completed the intervention and most completed the 12-week assessment (94%). PICT randomized caregivers reported that the intervention helped them to feel more confident in their ability to recognize (67%) and communicate about pain symptoms (83%). At 12 weeks, caregivers in the PICT group showed a statistically significant improvement in self-efficacy in pain-related communication. In qualitative interviews, caregivers emphasized the utility of PICT’s components, including pain assessment tools, and offered considerations for future enhancements, such as technology-based adaptations and integration within care delivery systems.

DISCUSSION AND IMPLICATIONS: This pilot trial demonstrates that PICT is feasible to implement, acceptable to caregivers, and has the potential to improve confidence in recognizing and communicating about pain. Results support conducting a fully powered efficacy trial, an important step toward future integration into real-world care delivery.

CLINICAL TRIAL REGISTRATION NUMBER: NCT03853291.

PMID:38094933 | PMC:PMC10714902 | DOI:10.1093/geroni/igad074

Innov Aging. 2023 Sep 16;7(10):igad100. doi: 10.1093/geroni/igad100. eCollection 2023.

ABSTRACT

BACKGROUND AND OBJECTIVES: Previous studies have found that pain is associated with fall worry among community-dwelling older people. However, both pain and fall worry are poorly understood and underaddressed among community-dwelling older people with cognitive impairment (CI). It is essential to examine the association between pain and fall worry, and how sociodemographic and health characteristics may shape fall worry among this subgroup.

RESEARCH DESIGN AND METHODS: We used data from the 2015 National Health and Aging Trends Study (analytic sample: n = 1150 community-dwelling older people with CI; were self-interviewed; mean age: 81; age range: 65-107). The number of pain sites in the prior month was assessed by presenting a card listing common pain sites (eg, back, knees). Two questions assessed past-month fall worry, “did you worry about falling down” and “did this worry ever limit your activities.” Following descriptive statistics, we fit multinomial logistic regression models to examine the associations between different pain characteristics (number of sites, severity, location) and non-activity-limiting and activity-limiting fall worry.

RESULTS: Non-activity-limiting fall worry was endorsed by 21.1% and activity-limiting fall worry by 13.6% of community-dwelling older people with CI. After adjusting for sociodemographic characteristics and fall-worry-related covariates, multinomial logistic regression analysis found that a greater number of pain sites (relative risk ratio [RRR] = 1.22, 95% Confidence Interval [95% CI] = 1.12-1.33, p <.001) and severe pain (RRR = 2.05, 95% CI = 1.12-3.75, p = .020) was associated with activity-limiting fall worry. Both lower body (knee, foot, and leg) and upper body (hand, wrist, shoulder, neck, and stomach) pain were found to be associated with a high risk of activity-limiting fall worry.

DISCUSSION AND IMPLICATIONS: These findings suggest pain and fall worry are common among community-dwelling older people with CI and can be elicited directly from those who are communicative. Fall prevention for this population should prioritize pain management to mitigate activity-limiting fall worry because activity limitation increases the risk of falls.

PMID:38094927 | PMC:PMC10714914 | DOI:10.1093/geroni/igad100

J Med Imaging (Bellingham). 2023 Nov;10(6):064004. doi: 10.1117/1.JMI.10.6.064004. Epub 2023 Dec 12.

ABSTRACT

PURPOSE: The utility of fluorescence microscopy imaging comes with the challenge of low resolution acquisitions, which severely limits information extraction and quantitative analysis. Image denoising is a technique that aims to remove noise from microscopy acquisitions by taking into account prior statistics of the corrupting noise. In this work, we propose an image denoising technique for fluorescence microscopy imaging.

APPROACH: The proposed technique is based on the principle of multifractal feature extraction from a noisy sample followed by a reconstruction technique from these features. It is observed that by following a proper hierarchical classification procedure, meaningful features can be extracted from a noisy image. A denoised image is then estimated from this sparse feature set through proper formulation of an optimization problem.

RESULTS: Experiments are performed on both synthetic image databases as well as on real fluorescence microscopy data. Superior denoising results, in comparison to multiple comparing techniques, validate the potential of the proposed approach.

CONCLUSION: The proposed method gives superior denoising results for low resolution fluorescence microscopy image acquisitions and can be used for post processing of data by biologists.

PMID:38094902 | PMC:PMC10715713 | DOI:10.1117/1.JMI.10.6.064004

Eur J Philos Sci. 2023;13(4):58. doi: 10.1007/s13194-023-00561-6. Epub 2023 Dec 11.

ABSTRACT

We propose an interpretation of physics named potentiality realism. This view, which can be applied to classical as well as to quantum physics, regards potentialities (i.e. intrinsic, objective propensities for individual events to obtain) as elements of reality, thereby complementing the actual properties taken by physical variables. This allows one to naturally reconcile realism and fundamental indeterminism in any theoretical framework. We discuss our specific interpretation of propensities, that require them to depart from being probabilities at the formal level, though allowing for statistics and the law of large numbers. This view helps reconcile classical and quantum physics by showing that most of the conceptual problems that are customarily taken to be unique issues of the latter — such as the measurement problem — are actually in common to all indeterministic physical theories.

PMID:38094896 | PMC:PMC10713789 | DOI:10.1007/s13194-023-00561-6

Front Pharmacol. 2023 Nov 24;14:1098378. doi: 10.3389/fphar.2023.1098378. eCollection 2023.

ABSTRACT

Introduction: Zuotai is an ancient mineral-herbal mixture containing β-HgS in Tibetan medicine. It is used to treat nervous system diseases, similar to Chinese medicine cinnabar and Indian Ayurveda medicine Rasasindura. However, one of the key problems faced by Zuotai is that its indications are ambiguous. Our previous study found that Zuotai exhibited the activity of ameliorating depressive-like behaviors in a chronic mild stress model. However, due to the inherent limitations of animal models in simulating human disease, clear results often require more than one model for confirmation. Methods: Therefore, another depression model, chronic restraint stressed (CRS) mice, was used to validate the antidepression effect of Zuotai. Prophylactic treatment was conducted for 21 consecutive days while mice were subjected to chronic restraint stress. Results: It was observed that Zuotai and β-HgS alleviated anhedonia, behavioral despair, stereotype behavior, and reduced exploratory and spontaneous movement in CRS mice. Zuotai and β-HgS also reversed the increases of stress hormone corticosterone (Cort) in serum and pro-inflammatory cytokines in serum and brain, and increased the serotonin in cortex in CRS mice, with positive dose-effect relationship. The number of Ki67-positive cells in the dentate gyrus and the level of brain-derived neurotrophic factor (BDNF) in the hippocampus were slightly elevated in CRS mice treated with Zuotai; however, there was no statistically significant difference. Although Zuotai increased the total Hg concentration in main organs, the levels remained below those needed to result in observed adverse effect, at least for kidney and liver; and Zuotai showed no observed adverse effect on the brain histopathology, the cell proliferation in dentate gyrus, as well as the hippocampal and cortical organ coefficients. Conclusion: Zuotai exhibited the alleviation of depressive-like behaviors in CRS mice, accompanying with ameliorating stress hormone, peripherical and cerebral inflammation, and monoamine neurotransmitter.

PMID:38094892 | PMC:PMC10718046 | DOI:10.3389/fphar.2023.1098378