Category: Nevin Manimala

J Frailty Aging. 2021;10(3):254-258. doi: 10.14283/jfa.2021.3.

ABSTRACT

BACKGROUND: The relationship between frailty and variables such as housing are the least included in models of frailty and research on frailty or social frailty and relocation is negligible. The decision to relocate is complex and demanding for older adults with a loss of independence but little is known about what makes older adults relocate to congregated housing designated for older adults, let alone in combination with social frailty, and how they navigate this transition.

OBJECTIVES: This mixed method descriptive study aims to understand the influence of social frailty for a population of French-speaking semi-independent older adults relocating to a housing continuum community.

DESIGN: Semi-structured individual interviews including sociodemographic data and the PRISMA-7 Frailty Scale were conducted with recently relocated older adults.

SETTING: A newly opened French-speaking housing continuum community in Eastern Canada that offers luxury apartments for independent older adults, two assisted living facilities for semi-independent older adults along with a long-term care facility.

PARTICIPANTS: Twenty-nine older adults with a mean age of 85 years, mostly female, married or widowed and highly educated.

MEASUREMENTS: Content analysis of the transcribed recorded interviews and descriptive statistical analyses to examine relationships between the frailty PRISMA-7 scale, answers to additional questions and the sociodemographic data.

RESULTS: There was not a significant difference in the scores for socialization before and after relocation nor between prior help and current help; however, there was a significant negative correlation between help and socialization before and after relocation. Three main themes included: imposed influences, push and pull factors and post relocation.

CONCLUSIONS: The results indicate that several social factors contributed to relocation and that participants were experiencing social frailty. Participants were at the crossover point of being vulnerable to experiencing additional deficits which would potentially have led to higher frailty had they not relocated.

PMID:34105710 | DOI:10.14283/jfa.2021.3

J Frailty Aging. 2021;10(3):272-280. doi: 10.14283/jfa.2021.7.

ABSTRACT

This systematic literature review documents the link between frailty or sarcopenia, conceptualized as dimensions of physical health, and the use of long-term care services by older individuals. Long-term care services include formal and informal care provided at home as well as in institutions. A systematic review was performed according to PRISMA requirements using the following databases: PubMed-Medline, Embase, CINAHL, Web of Science, and Academic Search Premier. We included all quantitative studies published in English between January 2000 and December 2018 focusing on individuals aged 50 or more, using a relevant measurement of sarcopenia or physical frailty and a long-term care related outcome. A quality assessment was carried out using the questionnaire established by the Good Practice Task Force Report of the International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Five subsets of long-term care outcome were considered: 1/ nursing home placement (NHP), 2/ nursing home short stay (NHSS), 3/ formal personal care (FPC), 4/ formal home help (FHH), 5/ informal care (IC). Out of 1943 studies, 17 were finally included in the review. With some studies covering several LTC outcomes, frailty and / or sarcopenia were associated with increased LTC use in 17 out of 26 cases (NHP: 5/6, NHSS: 3/4, FPC: 5/7, FHH: 1/4, IC: 3/5) The association was not consistent in 5 cases (NHP: 1/6, NHSS: 1/4, FPC: 2/7, FHH: 0/4, IC: 1/5) and the association was either not significant or the results inconclusive in the remaining 9 cases. Overall, while results on sarcopenia are scarce, evidence support a positive association between frailty and LTC use. The evidence is stronger for the association of physical frailty with nursing home placement / short stay as well as on FPC. There is less (more heterogeneous) evidence regarding the correlation between physical frailty and FHH or IC use. Results need to be confirmed by more advanced statistical methods or design based on longitudinal data.

PMID:34105712 | DOI:10.14283/jfa.2021.7

Am J Hypertens. 2021 Jun 9:hpab084. doi: 10.1093/ajh/hpab084. Online ahead of print.

ABSTRACT

BACKGROUND: Although previous studies have reported the gut microbiome is closely related to hypertension development, whether the change in blood microbiome is associated with the risk of hypertension remains unclear.

METHODS: One hundred and fifty incident hypertension cases and 150 age (± 2 years) and gender (1:1) matched non-hypertension controls included in this nested case-control study were recruited from a prospective cohort study of “135”. The composition of the blood microbiome was characterized using bacterial 16S ribosomal RNA gene sequencing. The relative abundance of detected bacteria was converted to a negative logarithm of 10 for the statistical analysis.

RESULTS: Totally, 10,689,961 high-quality sequences were acquired. The Chao1 index of the blood microbiome in non-hypertension controls was significantly higher than that in hypertensive group (2302.08±752.78 vs 1598.21±500.88, P < 0.001). Compared with the non-hypertension controls, the relative abundance of Proteobacteria phylum was significantly increased (P<0.001), while the relative abundance of phyla Firmicutes and Bacteroidetes were significantly reduced in the hypertensive cases (P<0.001 and P=0.039, respectively). At genus level, the risk of hypertension was directly associated with the relative abundance ofAcinetobacter(OR: 1.43, 95% CI: 1.01-2.03),Sphingomonas(OR: 1.84, 95% CI: 1.32-2.56), andStaphylococcus(OR: 0.51, 95% CI: 0.36-0.73), respectively.In addition, the relative abundance of Pseudomonas was minor positively correlated to the TC level. However, the relative Staphylococcus level was minor positively correlated to HDL-c level.

CONCLUSIONS: The composition of the blood microbiome is significantly associated with the development of hypertension.

PMID:34105723 | DOI:10.1093/ajh/hpab084

Sci Rep. 2021 Jun 8;11(1):11863. doi: 10.1038/s41598-021-90867-3.

ABSTRACT

Studies in children have reported associations of screen time and background TV on language skills as measured by their parents. However, few large, longitudinal studies have examined language skills assessed by trained psychologists, which is less prone to social desirability. We assessed screen time and exposure to TV during family meals at ages 2, 3 and 5-6 years in 1562 children from the French EDEN cohort. Language skills were evaluated by parents at 2 years (Communicative Development Inventory, CDI) and by trained psychologists at 3 (NEPSY and ELOLA batteries) and 5-6 years (verbal IQ). Cross-sectional and longitudinal associations were assessed by linear regression adjusted for important confounders. Overall, daily screen time was not associated with language scores, except in cross-sectional at age 2 years, where higher CDI scores were observed for intermediate screen time. Exposure to TV during family meals was consistently associated with lower language scores: TV always on (vs never) at age 2 years was associated with lower verbal IQ (- 3.2 [95% IC: – 6.0, – 0.3] points), independent of daily screen time and baseline language score. In conclusion, public health policies should better account for the context of screen watching, not only its amount.

PMID:34103551 | DOI:10.1038/s41598-021-90867-3

Transl Psychiatry. 2021 Jun 9;11(1):338. doi: 10.1038/s41398-021-01445-0.

ABSTRACT

Depression is a multifaceted illness with large interindividual variability in clinical response to treatment. In the era of digital medicine and precision therapeutics, new personalized treatment approaches are warranted for depression. Here, we use a combination of longitudinal ecological momentary assessments of depression, neurocognitive sampling synchronized with electroencephalography, and lifestyle data from wearables to generate individualized predictions of depressed mood over a 1-month time period. This study, thus, develops a systematic pipeline for N-of-1 personalized modeling of depression using multiple modalities of data. In the models, we integrate seven types of supervised machine learning (ML) approaches for each individual, including ensemble learning and regression-based methods. All models were verified using fourfold nested cross-validation. The best-fit as benchmarked by the lowest mean absolute percentage error, was obtained by a different type of ML model for each individual, demonstrating that there is no one-size-fits-all strategy. The voting regressor, which is a composite strategy across ML models, was best performing on-average across subjects. However, the individually selected best-fit models still showed significantly less error than the voting regressor performance across subjects. For each individual’s best-fit personalized model, we further extracted top-feature predictors using Shapley statistics. Shapley values revealed distinct feature determinants of depression over time for each person ranging from co-morbid anxiety, to physical exercise, diet, momentary stress and breathing performance, sleep times, and neurocognition. In future, these personalized features can serve as targets for a personalized ML-guided, multimodal treatment strategy for depression.

PMID:34103481 | DOI:10.1038/s41398-021-01445-0

Hum Genome Var. 2021 Jun 8;8(1):22. doi: 10.1038/s41439-021-00154-w.

ABSTRACT

Genome-wide association studies have been performed to identify common genetic variants associated with hepatitis B (HB). However, little is known about copy number variations (CNVs) in HB. In this study, we performed a genome-wide CNV analysis between 1830 healthy controls and 1031 patients with HB infection after quality control. Using signal calling by the Axiom Analysis Suite and CNV detection by PennCNV software, we obtained a total of 4494 CNVs across all individuals. The genes with CNVs that were found only in the HB patients were associated with the immune system, such as antigen processing. A gene-level CNV association test revealed statistically significant CNVs in the contactin 6 (CNTN6) gene. Moreover, we also performed gene-level CNV association tests in disease subgroups, including hepatocellular carcinoma patients, liver cirrhosis patients, and HBV carriers, including asymptomatic carriers and patients with HBV-derived chronic hepatitis. Our findings from germline cells suggested that patient-specific CNVs may be inherent genetic risk factors for HB.

PMID:34103483 | DOI:10.1038/s41439-021-00154-w

Eur J Cancer Prev. 2021 Jul 1;30(4):297-303. doi: 10.1097/CEJ.0000000000000627.

ABSTRACT

This study examined the association between adherence to low carbohydrate diet (LCD) and risk of gastric cancer (GC). This hospital-based case-control study was conducted in Iran Cancer Institute, Tehran, Iran between 2010 and 2012. Totally, 178 patients with GC and 276 apparently healthy controls participated in this study. Cases were histo-pathologically confirmed GC patients aged ≥40 years diagnosed with GC in the last year. Dietary intakes were assessed using a validated 146-item Diet History Questionnaire. We computed the LCD score trough the protocol explained by Halton. Patients with GC were older (60.8 vs. 53.2 years, P < 0.001) and more likely to be male (74.2 vs. 63.8%, P = 0.02), married (97.8 vs. 86.6%, P < 0.001) and illiterate (62.4% vs. 26.1%, P < 0.001) than controls. Before adjusting for covariates, adherence to LCD-diet was not associated with risk of GC [odds ratio (OR) 1.31; 95% confidence interval (CI) 0.82-2.09 for highest vs. lowest tertile; Ptrend < 0.26]. Adjustments for several potential confounders including H-pylori infection and BMI, participants in the highest tertile of LCD score were 7% more likely to have GC than those in the lowest tertile; however, it was not statistically significant (OR 1.07; 95% CI 0.59-1.95 for highest vs. lowest tertile; Ptrend < 0.79). No significant association was also seen between adherence to animal- or vegetable-based LCD diet and risk of GC. In conclusion, we failed to find any evidence on the association between consumption of LCD and odds of GC. Further studies, in particular of prospective design, are required to confirm these findings.

PMID:34103461 | DOI:10.1097/CEJ.0000000000000627

Signal Transduct Target Ther. 2021 Jun 9;6(1):217. doi: 10.1038/s41392-021-00607-2.

ABSTRACT

We examined the safety and efficacy of human umbilical cord mesenchymal stem cell (hUC-MSC) infusion for immune non-responder (INR) patients with chronic HIV-1 infection, who represent an unmet medical need even in the era of efficient antiretroviral therapy (ART). Seventy-two INR patients with HIV were enrolled in this phase II randomized, double-blinded, multicenter, placebo-controlled, dose-determination trial (NCT01213186) from May 2013 to March 2016. They were assigned to receive high-dose (1.5 × 10⁶/kg body weight) or low-dose (0.5 × 10⁶/kg body weight) hUC-MSC, or placebo. Their clinical and immunological parameters were monitored during the 96-week follow-up study. We found that hUC-MSC treatment was safe and well-tolerated. Compared with baseline, there was a statistical increase in CD4+ T counts in the high-dose (P < 0.001) and low-dose (P < 0.001) groups after 48-week treatment, but no change was observed in the control group. Kaplan-Meier analysis revealed a higher cumulative probability of achieving an immunological response in the low-dose group compared with the control group (95.8% vs. 70.8%, P = 0.004). However, no significant changes in CD4/CD8+ T counts and CD4/CD8 ratios were observed among the three groups. In summary, hUC-MSC treatment is safe. However, the therapeutic efficacy of hUC-MSC treatment to improve the immune reconstitution in INR patients still needs to be further investigated in a large cohort study.

PMID:34103473 | DOI:10.1038/s41392-021-00607-2

Georgian Med News. 2021 Apr;(313):113-117.

ABSTRACT

The aim of the article is scientific conceptualization of the problem of mental derangement as a mandatory medical criterion of limited sanity according to criminal legislation by experience of Ukraine and some foreign countries and development of new approaches to such status assessment. Empirical study base of the problem consists of judgments of conviction taken from Unified State Register of Court Rulings of Ukraine and carried out on persons who commit crimes in the state of limited sanity from March 1st, 2014, till August 1st, 2020. Results of some foreign researchers’ studies of the problem in question have been used as well. A combination of general and special scientific methods (comparative method, system structural method, method of statistical analysis, method of legal phenomenon system analysis etc.) has been applied to reach the aim in view. In conclusion: medical criterion of limited sanity (“mental derangement”) used by lawmaker does not allow defining clearly types of illnesses, represent all possible types of psychiatric pathology and also causes complications in law enforcement practice. It has been proved that increase of quantity of people having mental derangements and quantity of crimes committed by such people shows that non-application of compulsory measures of medical care, correlational programs leads to repeated crimes commitment. Taking into account absence of duration of compulsory measures of medical care application, it has been suggested to stipulate this by Ukrainian legislation and to develop classification of mental derangements and criteria of their division into severe and non-severe.

PMID:34103441

Georgian Med News. 2021 Apr;(313):163-168.

ABSTRACT

Aim of the research – to study the features of the structural reconstruction of blood vessels of the testes of experimental animals at arterial hypertension in the pulmonary circulation using a complex of morphological methods. Experiments were carried out on 78 laboratory sexually mature white male rats, which were divided into 3 groups. The 1 group included 15 intact practically healthy animals, 2 – 48 rats with hypertension in the pulmonary circulation and compensated cor pulmonale, 15 animals with pulmonary hypertension, which developed decompensation of cor pulmonale, constituted the 3 group. Arterial hypertension in the pulmonary circulation was simulated by performing a right-sided pulmonectomy. Three months after the beginning of the experiment, the rats were euthanized by bloodletting under thiopental anesthesia. Histological micropreparations were made from the testes, on which the morphometry of arteries, veins, and microvessels was performed. Quantitative indicators were processed statistically. It was revealed that postresection hypertension in the pulmonary circulation leads to structural reconstruction of arteries, microvessels, and the venous bed of the left and right testes. At the same time, the degree of remodeling of the studied vessels dominates in the microhemocirculatory bed of the left testis at decompensation of the cor pulmonale. Structural reconstruction of the vessels of the microhemocirculatory bed of the testes in case of insufficiency of the cor pulmonary is characterized by a pronounced narrowing of the arterioles, precapillary arterioles), exchange (hemocapillaries) links of the microhemocirculatory bed and the expansion of postcapillary venules and venules, venous plethora, hypoxia, impaired trophism and metabolism, dystrophy, necrobiosis of cells, tissues, infiltration and sclerosis.

PMID:34103450