Tag: pubmed

Endokrynol Pol. 2021 May 19. doi: 10.5603/EP.a2021.0034. Online ahead of print.

ABSTRACT

Introduction Elevated serum parathormone (PTH) levels have been observed in acute kidney injury and are related to calcium-phosphate metabolism disturbance, decreased renal production of 1,25 dihydroxyvitamin D3, impaired renal PTH excretion and other renal-independent factors. There are no data regarding PTH concentration kinetics in critically ill patients undergoing continuous renal replacement therapies (CRRT) in an intensive care setting. The primary objective of this study was to investigate trends in PTH serum levels in critically ill patients with multiorgan failure, undergoing CRRT by performing periodic PTH measurements in the acute phase of critical illness. Material and methods Single center, prospective, observational study conducted in an mixed, university affiliated, intensive care unit. Critically ill patients were included who fulfilled all of the following criteria: respiratory failure; circulatory failure; acute kidney injury treated by CRRT; sequential organ failure assessment score (SOFA score) of 5 or more. Patients who met any of the following criteria were excluded: acute liver failure; hypercalcemia at admission (total calcium serum level > 10.6 mg/dl; total ionized calcium plasma level > 1.35 mmol/l); parathyroid gland disease, end-stage renal disease, patients undergoing therapeutic plasma exchange or extracorporeal membrane oxygenation procedures, aged under 18 years, pregnant, life expectancy after admission to the intensive care unit anticipated to be less than 72 hours as assessed by the investigator. Results Thirty patients met the inclusion criteria. A statistically significant change in PTH over time was observed (Friedman ANOVA; p=0.0001). The post-hoc test showed a statistically significant decrease in PTH: measurements 5-8 relative to measurement 1, measurements 4-8 relative to measurement 2 (p.

PMID:34010434 | DOI:10.5603/EP.a2021.0034

Endokrynol Pol. 2021 May 19. doi: 10.5603/EP.a2021.0046. Online ahead of print.

ABSTRACT

BACKGROUND: There are publications with contrasting results on the relationship between night eating syndrome and obesity. The aim of this study was to investigate the frequency and relationship between night eating syndrome (NES) in obese and non-obese participants.

MATERIAL AND METHODS: Between 1 January 2018 and 1 May 2018, 420 people ages 18-65 years who applied to İzmir Katip Çelebi University Atatürk Training and Research Hospital Family Medicine and Endocrinology outpatient clinics for any reason enrolled in this study. Body mass index (BMI = weight [kg]/height² [m²]) was calculated by measuring participants’ height and weight. BMI values between 18.50 and 24.99 were normal weight, between 25.0 and 29.99 were overweight, between 30.0 and 39.99 were obese, and 40.0 and above were considered morbidly obese. Participants’ sociodemographic data, the Night Eating Questionnaire (NEQ), and the Beck Depression Inventory (BDI) were administered by face-to-face interview technique.

RESULTS: The average age of the participants was 42 ± 13 years and 68.6% were female. The mean body mass index (BMI) of the participants was 31.8 ± 8.2. The prevalence of NES was determined: 10% of the participants had NES. The higher frequency of NES in patients with morbid obesity was found to be statistically significant compared to those without morbid obesity (p < 0.05). The mean BDS score was 23.5 ± 10.86 (min: 0, max: 46) in the NES group and 12.18 ± 88.95 (min: 0, max: 49) in the non-NES group. There was a significant difference between the two groups in terms of BDS scores (p < 0.001).

CONCLUSIONS: Because obesity has an important place in primary health care services, it is important to know the relationship between NES and depression. Recognition of NES and consideration of planned follow-up and treatment in the applicants will help to treat obesity more effectively.

PMID:34010444 | DOI:10.5603/EP.a2021.0046

Biometrics. 2021 May 19. doi: 10.1111/biom.13486. Online ahead of print.

ABSTRACT

In the form of multi-dimensional arrays, tensor data have become increasingly prevalent in modern scientific studies and biomedical applications such as computational biology, brain imaging analysis, and process monitoring system. These data are intrinsically heterogeneous with complex dependencies and structure. Therefore, ad-hoc dimension reduction methods on tensor data may lack statistical efficiency and can obscure essential findings. Model-based clustering is a cornerstone of multivariate statistics and unsupervised learning; however, existing methods and algorithms are not designed for tensor-variate samples. In this article, we propose a Tensor Envelope Mixture Model (TEMM) for simultaneous clustering and multiway dimension reduction of tensor data. TEMM incorporates tensor-structure-preserving dimension reduction into mixture modeling and drastically reduces the number of free parameters and estimative variability. An EM-type algorithm is developed to obtain likelihood-based estimators of the cluster means and covariances, which are jointly parameterized and constrained onto a series of lower-dimensional subspaces known as the tensor envelopes. We demonstrate the encouraging empirical performance of the proposed method in extensive simulation studies and a real data application in comparison with existing vector and tensor clustering methods. This article is protected by copyright. All rights reserved.

PMID:34010459 | DOI:10.1111/biom.13486

J Natl Cancer Inst. 2021 May 19:djab095. doi: 10.1093/jnci/djab095. Online ahead of print.

ABSTRACT

BACKGROUND: The prognostic significance of patients with low-risk Recurrence Score (RS) results in the context of the American Joint Committee on Cancer (AJCC) 8th-edition pathologic prognostic staging has not been investigated. We evaluated if expanded RS criteria can be considered for downstaging in AJCC pathologic prognostic staging.

METHODS: Using Surveillance, Epidemiology, and End Results data we identified patients with T1-3N0-3M0 HR-positive/HER2-negative breast cancer treated from 2010-2015 with follow-up data through 2016. We evaluated TNM categories, grade, and RS result. The primary outcome measured was 5-year disease-specific survival (DSS) of patients with low-risk RS results not already pathologic prognostic stage IA, determined by T and N categories per AJCC 8th edition. All statistical tests were 2-sided.

RESULTS: Of 154,050 patients with median follow-up of 49 months (range = 0-83), RS results were obtained in 60,886 (39.5%): RS was <11 in 13,570 (22.3%), 11-17 in 22,719 (37.3%), 18-25 in 16,521 (27.1%), and ≥ 26 in 8,076 (13.3%). Five-year DSS for pathologic prognostic stage IA patients (n = 114,910, 74.6%) was 98.8%. Among N0-1 patients with RS < 18 not staged as pathologic prognostic stage IA by current criteria, 5-year DSS was excellent and not statistically significantly different than for pathologic prognostic stage IA patients (97.2%-99.7%, P > .05). For those with RS 18-25, there was a small decrease in DSS for T2N0 (2.3%) and modest decrease for T1-2N1 (4.2%-6.4%) compared to pathologic prognostic stage IA patients (P < .001).

CONCLUSION: Patients with RS < 18 have excellent 5-year DSS regardless of T category for N0-1 disease suggesting further modification of the AJCC staging system using this cutoff.

PMID:34010423 | DOI:10.1093/jnci/djab095

J Parasitol. 2021 May 1;107(3):404-410. doi: 10.1645/20-142.

ABSTRACT

Foodborne pathogens continue to pose a public health risk and can cause serious illness and outbreaks of disease in consumers. The consumption of raw or undercooked infected meat, such as pork containing infectious stages of Toxoplasma gondii, may be a major route of transmission to humans. Given the occasional presence of T. gondii in pork meat and the frequent use of pork for products not intended to be cooked, such as dry-cured ham, a potential risk exists for T. gondii transmission to consumers of these products. The purpose of this study was to determine the seroprevalence of T. gondii in U.S. market hogs and sows at slaughter. A total of 20,209 sera samples collected from 22 U.S. slaughterhouses, including 15 of the top 25 largest slaughter plants in the United States, were tested for T. gondii antibodies using a commercial ELISA assay. Seroprevalence in this study was 0.74%, with a herd prevalence of 10.86%. We compared seroprevalence of T. gondii in market hogs vs. sows from a separate but geographically similar set of slaughterhouse locations, with serum samples screened using the T. gondii modified agglutination test. This set of market hogs demonstrated 0% seroprevalence for T. gondii, while sows from geographically similar but separate slaughter facilities demonstrated a seroprevalence of 1.03%. Overall, both analyses show low seroprevalence of T. gondii in U.S market hogs and sows, respectively, and a marked drop in prevalence in market hogs and sows compared to previous studies.

PMID:34010426 | DOI:10.1645/20-142

J Natl Cancer Inst. 2021 May 19:djab079. doi: 10.1093/jnci/djab079. Online ahead of print.

ABSTRACT

BACKGROUND: Recent trends of hepatocellular carcinoma (HCC) mortality and outcome remain unknown in the United States (US). We investigated the recent trends of primary liver cancer (excluding intrahepatic cholangiocarcinoma) mortality and HCC stage, treatment, and overall survival (OS) in the US.

METHODS: US Cancer Mortality database was analyzed to investigate the trend of primary liver cancer mortality. We analyzed the SEER 18 database to assess the temporal trend of tumor size, stage, treatment, and OS of HCC. Cox regression analysis investigated the association between HCC diagnosis year and OS. All statistical tests were 2-sided.

RESULTS: During 2000-2018, liver cancer mortality rates increased until 2013, plateaued during 2013-2016 (annual percent change [APC] = 0.1%/yr, 95% confidence interval [CI] = -2.1% to 2.4%; P=0.92), and started to decline during 2016-2018 (APC = -1.5%/yr, 95% CI= -3.2% to 0.2%; P=0.08). However, mortality continues to increase in American Indians/Alaska Natives, individuals aged 65 or older, and in 33 states. There was a 0.61% (95% CI = 0.53% to 0.69%; P<0.001) increase in localized stage HCC and 0.86 mm (95% CI= -1.10 to -0.62; P<0.001) decrease in median tumor size per year. One-year OS rate increased from 36.3% (95% CI = 34.3% to 38.3%) to 58.1% (95% CI = 56.9% to 59.4%) during 2000-2015, and five-year OS rate almost doubled from 11.7% (95% CI = 10.4% to 13.1%) to 21.3% (95% CI = 20.2% to 22.4%) during 2000-2011. Diagnosis year (per year) (adjusted hazard ratio = 0.96; 95% CI = 0.96 to 0.97) was independently associated with OS in multivariable analysis.

CONCLUSIONS: Primary liver cancer mortality rates have started to decline in the US with demographic and state-level variation. With an increasing detection of localized HCC, the OS of HCC has improved over the past decades.

PMID:34010422 | DOI:10.1093/jnci/djab079

Integr Comp Biol. 2021 May 19:icab066. doi: 10.1093/icb/icab066. Online ahead of print.

ABSTRACT

Populations of the same species occupying different microhabitats can either exhibit generalized traits across them or display intraspecific variability, adapting to each microhabitat in order to maximize performance. Intraspecific variability contributes to the generation of diversity, following selection and adaptation, and understanding such variability is important for comprehending how individuals choose their microhabitats. Compared to interspecific variability, however, intraspecific variability in functional morphology and its relationship with microhabitat preference and use have been relatively little studied. Here we examined whether populations of the gecko Mediodactylus kotschyi that differ in the substrates they occupy, display habitat-specific behaviours and differing morphologies associated with functional adaptation to their microhabitats. We collected 207 geckos from under or on rocks or on trees from seven populations in Greece. On large islands individuals occupy both substrates; whereas small islets are devoid of trees and the geckos are restricted to rocks, while on the mainland they are only found on trees.We determined gecko substrate preferences in the lab, together with their clinging abilities to the different substrates. We measured their limbs, digits and claws and assessed how these measurements relate to clinging ability.Geckos from all populations preferred the tree made available to them, but this preference was not statistically significant. Geckos from both large and small islands clung better to the tree than to the rock in the lab, while those from the mainland clung similarly to both substrates. Geckos collected from trees had longer manual digits and hind limbs. Geckos collected from large and small islands had taller (longer on the dorso-ventral axis; henceforth “deeper”) claws. Longer digits and deeper but shorter claws were associated with a better ability to cling to rocks. Our findings suggest that while M. kotschyi is potentially preferentially arboreal, due to the great variation and plasticity it possesses, it can successfully also exploit the habitats available on the smallest, treeless islets in the Aegean Sea. Our study suggests that the dichotomous use of generalist vs. specialist in describing species’ habitat use is oversimplified, and we suggest the use of a generalist-specialist gradient instead.

PMID:34010416 | DOI:10.1093/icb/icab066

J Pediatr Psychol. 2021 May 19:jsab033. doi: 10.1093/jpepsy/jsab033. Online ahead of print.

ABSTRACT

OBJECTIVE: This study examines prevalence rates of elevated depression symptoms utilizing the Patient Health Questionnaire-9 Item Modified for Adolescents (PHQ-9A), characterizes recommendations and interventions by primary care providers (PCPs) and behavioral health clinicians (BHCs) in response to elevated PHQ-9As, and identifies factors associated with improved PHQ-9A scores at follow-up pediatric primary care visits.

METHODS: A mixed methods approach was taken. Visit data, demographics, and PHQ-9A scores for 2,107 adolescents aged 11-18 were extracted using clinical informatics between January 3, 2017 and August 31, 2018. Descriptive statistics and chi-square analyses were conducted, followed by conventional content analysis of electronic medical records to examine qualitative results. Qualitative analyses were transformed into quantitative results and analyzed using point biserial correlations.

RESULTS: Of the 2,107 adolescents, 277 (13%) had an elevated PHQ-9A. Content analysis resulted in 40 actions (17 PCP codes, 23 BHC codes) in response to an elevated PHQ-9A. Significant correlations were found between an improved PHQ-9A at a follow-up visit and the PCP referring to integrated behavioral health (r = .20, p < .01), and BHCs recommending and checking in at a follow-up visit (r = .20, p < .05), conducting a risk assessment (r = .15, p < .05), and providing psychoeducation about mood symptoms (r = .15, p < .05).

CONCLUSIONS: Primary care is an ideal setting to address the public health crisis of untreated adolescent depression. Implications for screening processes, practice implications for PCPs and BHCs, future directions, and limitations are discussed.

PMID:34010421 | DOI:10.1093/jpepsy/jsab033

Gerontologist. 2021 May 19:gnab065. doi: 10.1093/geront/gnab065. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVES: Neighbourhood environments are an important aspect of well-being for older people. Developments of the general ecological model recognise older people as active agents who adapt their environments to fit their changing needs. We provide empirical support for a model suggested by Wahl et al., by examining interactions between neighbourhood environments, personal situations, relocation, and quality of life among older people.

RESEARCH DESIGN AND METHODS: Two statistical models were tested with a sample of community dwelling participants (aged 55-89) in the New Zealand Health, Work and Retirement longitudinal surveys conducted in 2016 (T1) and 2018 (T2). Multiple linear regression assessed the association of perceptions of housing and neighbourhood with quality of life (QoL) at T1 (n = 3682).

RESULTS: QoL was predicted by housing satisfaction, and neighbourhood satisfaction, accessibility, and trust (controlling for age, gender, marital status, home ownership, SES, physical health and mental health). Mixed ANOVA showed that those who moved house between T1-T2 reported lower housing and neighbourhood satisfaction than non-movers at T1. Over time T1-T2, movers reported less decline in housing satisfaction, and more positive change on all neighbourhood perceptions, with higher perceptions of neighbourhood accessibility than non-movers at T2.

DISCUSSION AND IMPLICATIONS: These findings support the theoretical model and provide impetus for more detailed study of the effects of the environment on well-being in older age. Housing and neighbourhood environments are a very practical focus for social policy change at local and national levels.

PMID:34010393 | DOI:10.1093/geront/gnab065

J Clin Endocrinol Metab. 2021 May 19:dgab357. doi: 10.1210/clinem/dgab357. Online ahead of print.

ABSTRACT

BACKGROUND: Clinicians have long been struggling to find an effective tool to predict onset of puberty.

OBJECTIVE: To explore stimulability of inhibin B after exogenous FSH and it’s potential role for prediction of onset of puberty.

DESIGN AND PARTICIPANTS: Study subjects were enrolled into “exploratory cohort”(n=42) and “validation cohort”(n=19). “Exploratory cohort” was further divided into Group-1(Healthy children with spontaneous puberty: SP, n=26) and Group-2 (Patients of hypogonadotropic hypogonadism: HH, n=16). “Validation cohort” included children who presented with complaints of delayed puberty.

INTERVENTION AND OUTCOME: Participants were subjected to FSH stimulation test and GnRHa stimulation test. Cut-offs derived from “exploratory cohort” for basal and FSH stimulated inhibin B(FSH-iB) were applied on “validation cohort” .Basal LH, GnRHa stimulated LH, basal inhibin B and FSH-iB were compared with clinical outcome on prospective follow-up for prediction of onset of puberty.

RESULTS: There was statistically significant increment in inhibin B after exogenous FSH in Group 1(SP) in both male(188.8 pg/ml;p-value-0.002) and female (1065 pg/ml;p-value-0.023) subjects. The increment was not statistically significant in Group 2(HH) in both genders. FSH-iB at a cut-off of 116.14 pg/ml in male and 116.50 pg/ml in female had 100% sensitivity and specificity for labelling entry into puberty. On application of these cut-offs on “validation cohort”, FSH-iB had 100% PPV, NPV and diagnostic accuracy for prediction of onset of puberty.

CONCLUSION: Inhibin B was stimulable in both male and female subjects. FSH-iB can be considered as novel and promising investigation for prediction of onset of puberty. Future studies are required for further validation.

PMID:34010394 | DOI:10.1210/clinem/dgab357