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Application of machine learning algorithms to predict osteoporosis in postmenopausal women with type 2 diabetes mellitus. J Endocrinol Invest 2023; 46:2535-2546. [PMID: 37171784 DOI: 10.1007/s40618-023-02109-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 05/03/2023] [Indexed: 05/13/2023]
Abstract
PURPOSE The screening and diagnosis of osteoporosis in patients with type 2 diabetes mellitus (T2DM) based on bone mineral density remains challenging because of the limited availability and accessibility of dual-energy X-ray absorptiometry. We aimed to develop and validate models to predict the risk of osteoporosis in postmenopausal women with T2DM based on machine learning (ML) algorithms. METHODS This retrospective study included 303 postmenopausal women with T2DM. To develop prediction models for osteoporosis, we applied nine ML algorithms combined with demographic, clinical, and laboratory data. The least absolute shrinkage and selection operator were used to perform feature selection. We used the bootstrap resampling technique for model training and validation. To test the performance of the models, we calculated indices including the area under the receiver operating characteristic curve (AUROC), accuracy, sensitivity, specificity, positive predictive value, negative predictive value, F1 score, calibration curve, and decision curve analysis. Furthermore, we conducted fivefold cross-validation for parameter optimization and model validation. Feature importance was assessed using the SHapley additive explanation (SHAP). RESULTS We identified 10 independent predictors as the most valuable features. An AUROC of 0.616-1.000 was observed for nine ML algorithms. The extreme gradient boosting (XGBoost) model exhibited the best performance, outperforming conventional risk assessment tools and registering 0.993 in the training set, 0.798 in the validation set, and 0.786 in the test set for fivefold cross-validation. Using SHAP, we found that the explanatory variables contributed to the model and their relationship with osteoporosis occurrence. Furthermore, we developed a user-friendly tool for calculating the risk of osteoporosis. CONCLUSIONS With the integration of demographic and clinical risk factors, ML algorithms can accurately predict osteoporosis. The XGBoost model showed ideal performance. With the incorporation of these models in the clinic, patients may benefit from early osteoporosis diagnosis and treatment.
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Cadherin-11 blockade activates pyroptosis-mediated anti-tumor immunity in bladder cancer. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00585-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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312P ClinMatch: A clinical trial matching platform that improves trial accessibility among NSCLC patients through comprehensive genomic and clinical profiling. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.10.341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2022] Open
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408EMF Do Framing and Time Pressure Influence Diagnostic Reasoning Among Emergency Physicians? Ann Emerg Med 2022. [DOI: 10.1016/j.annemergmed.2022.08.425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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351 The Accuracy of Handheld Ultrasound in the Evaluation of Symptomatic Pregnant Patients in the Emergency Department. Ann Emerg Med 2022. [DOI: 10.1016/j.annemergmed.2022.08.380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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EFFICACY AND SAFETY OF SEQUENTIAL DIFFERENT B CELL ANTIGEN-TARGETED CAR T-CELL THERAPY FOR PEDIATRIC REFRACTORY/ RELAPSED BURKITT LYMPHOMA WITH SECONDARY CENTRAL NERVOUS SYSTEM INVOLVEMENT. Leuk Res 2022. [DOI: 10.1016/s0145-2126(22)00240-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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OA14.05 Intraoperative Molecular Imaging Guided Resection of CEACAM5+ Lung Tumors: First In-Human SGM-101 Lung Cancer Surgical Trial. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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326 High patient acceptability of social needs screening in dermatology clinic. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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335 Developing a treatment decision aid for patients with moderate to severe atopic dermatitis. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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POS-050 THE PATIENT JOURNEY FOR IMMUNOGLOBULIN A NEPHROPATHY: DIAGNOSTIC DELAY AND CHANGE IN KIDNEY FUNCTION FROM FIRST CLINICAL SIGN. Kidney Int Rep 2022. [DOI: 10.1016/j.ekir.2022.04.072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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96P Transbronchial microwave ablation: Important role in the battle of lung preservation for multifocal lung primaries or metastases. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.02.106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Novel role of estrogen receptor-α on regulating chondrocyte phenotype and response to mechanical loading. Osteoarthritis Cartilage 2022; 30:302-314. [PMID: 34767957 DOI: 10.1016/j.joca.2021.11.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 10/29/2021] [Accepted: 11/01/2021] [Indexed: 02/09/2023]
Abstract
OBJECTIVE In knee cartilage from patients with osteoarthritis (OA), both preserved cartilage and damaged cartilage are observed. In this study, we aim to compare preserved with damaged cartilage to identify the molecule(s) that may be responsible for the mechanical loading-induced differences within cartilage degradation. METHODS Preserved and damaged cartilage were harvested from the same OA knee joint. RNA Sequencing was performed to examine the transcriptomic differences between preserved and damaged cartilage cells. Estrogen receptor-α (ERα) was identified, and its function of was tested through gene knockin and knockout. The role of ERα in mediating chondrocyte response to mechanical loading was examined via compression of chondrocyte-laded hydrogel in a strain-controlled manner. Findings from the studies on human samples were verified in animal models. RESULTS Level of estrogen receptor α (ERα) was significantly reduced in damaged cartilage compared to preserved cartilage, which were observed in both human and mice samples. Knockdown of ESR1, the gene encoding ERα, resulted in an upregulation of senescence- and OA-relevant markers in chondrocytes. Conversely, knockin of ESR1 partially reversed the osteoarthritic and senescent phenotype of OA chondrocytes. Using a three-dimensional (3D) culture model, we demonstrated that mechanical overload significantly suppressed ERα level in chondrocytes with concomitant upregulation of osteoarthritic phenotype. When ESR1 expression was suppressed, mechanical loading enhanced hypertrophic and osteogenic transition. CONCLUSION Our study demonstrates a new estrogen-independent role of ERα in mediating chondrocyte phenotype and its response to mechanical loading, and suggests that enhancing ERα level may represent a new method to treat osteoarthritis.
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Sensor-based detection of parturition in beef cattle grazing in an extensive landscape: a case study using a commercial GNSS collar. ANIMAL PRODUCTION SCIENCE 2022. [DOI: 10.1071/an21528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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FP08.03 Outcomes With Multi-Disciplinary Management of Central Lung Tumors Treated With Percutaneous High-Dose-Rate Brachytherapy. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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211 Long Term Effects of Mobile Health and Augmented Social Support on Emergency Department Patients With Diabetes. Ann Emerg Med 2021. [DOI: 10.1016/j.annemergmed.2021.09.223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Current assessment of parental and health professional perception of the colour of neonatal vomiting: Results of a scoping survey. Pediatr Surg Int 2021; 37:1243-1250. [PMID: 33899141 DOI: 10.1007/s00383-021-04908-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/10/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE To determine current perceptions of doctors, nurses and parents for the colour of a neonatal vomit which should prompt an urgent surgical review. METHODS A voluntary scoping survey of parents/guardians of patients and non-surgical healthcare professionals was conducted with respondents asked to choose from 8 different selections in a colour swatch from pale yellow to dark green. A control group consisted of 13 paediatric surgeons. Data were analysed using the paired t test, Fishers exact test. A p value of < 0.05 was considered to be significant. RESULTS 365 participants responded: 36% (131/365) parents, 18% (64/365) nurses and 46% (166/365) doctors. 4/365 (1%) did not state their role. 343 participants completed all questions and responses were analysed using total responses for each question. 82% (121/148) of doctors and 78% (50/64) of nurses had more than 3 years of post-graduate experience. Overall, 63% (227/361) of participants (100% paediatric surgeons, 78% other doctors, 75% nurses/midwives & 30% parents) considered dark and light green vomits to be a sign of intestinal obstruction. 67% (242/361) of participants (100% paediatric surgeons, 72% other doctors, 56% nurses/midwives and 62% parents) believed dark and light green vomiting needed an urgent surgical referral. There were significant differences between the control group and other groups in terms of whether the neonate could wait until the next day for a review; nursing staff (p = 0.0002), postnatal/midwifery (p = < 0.0001), emergency medicine (p = 0.04), general practice (p = 0.002), neonatal (p = 0.0001) and paediatricians (p = 0.005). Only the neonatologists (p = 0.04), nursing staff (p = 0.001) and postnatal/midwifery (p = 0.004) believed that the neonate could have safe observation. CONCLUSION Although the perception that green vomiting is potentially serious is acknowledged by the majority of healthcare professionals surveyed, there is still a requirement for more targeted educational practices in nursing, midwifery and medical staff.
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LB742 Predictors of post-discharge follow-up attendance among hospitalized dermatology patients. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.07.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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P-176 A multicenter, randomized phase 1b/2 study of gemcitabine and cisplatin with or without CPI-613 as first-line therapy for patients with advanced unresectable biliary tract cancer (BilT-04). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.05.231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Using a remote monitoring kit to predict re-admissions for patients discharged following radical cystectomy. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01356-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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241 Association of ruxolitinib with NMSCs risk in patients with polycythemia vera and myelofibrosis. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Discontinuation Patterns and Cost Avoidance of a Pharmacist-Driven Methicillin-Resistant Staphylococcus aureus Nasal Polymerase Chain Reaction Testing Protocol for De-escalation of Empiric Vancomycin for Suspected Pneumonia. Open Forum Infect Dis 2021; 8:ofab099. [PMID: 34386545 PMCID: PMC8355456 DOI: 10.1093/ofid/ofab099] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 03/02/2021] [Indexed: 12/28/2022] Open
Abstract
A pharmacist-driven methicillin-resistant Staphylococcus aureus (MRSA) nasal polymerase chain reaction (PCR)-based testing protocol with a 70% acceptance rate for vancomycin discontinuation within 24 hours of negative results significantly reduced unnecessary vancomycin use with an estimated cost avoidance of $40 per vancomycin course. We found high concordance (141 of 147, 96%) of culture-based versus PCR-based MRSA nasal screening.
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POS-419 GENOTYPE-PHENOTYPE CORRELATIONS OF PREDICTED LOSS OF FUNCTION MUTATIONS IN ATYPICAL ADPKD GENES. Kidney Int Rep 2021. [DOI: 10.1016/j.ekir.2021.03.442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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OA05.05 Economic Impact of Next-Generation Sequencing (NGS) vs. Single-gene Testing Strategies to Detect Genomic Alterations (GAs) in mNSCLC in Asia. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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391P Economic impact of next-generation sequencing (NGS) versus single-gene testing modalities to detect genomic alterations (GAs) in metastatic non-small cell lung cancer (mNSCLC) in Asia. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.10.385] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Perioperative intravenous contrast administration and the incidence of acute kidney injury after major gastrointestinal surgery: prospective, multicentre cohort study. Br J Surg 2020; 107:1023-1032. [PMID: 32026470 DOI: 10.1002/bjs.11453] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 09/21/2019] [Accepted: 11/08/2019] [Indexed: 01/14/2023]
Abstract
BACKGROUND This study aimed to determine the impact of preoperative exposure to intravenous contrast for CT and the risk of developing postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery. METHODS This prospective, multicentre cohort study included adults undergoing gastrointestinal resection, stoma reversal or liver resection. Both elective and emergency procedures were included. Preoperative exposure to intravenous contrast was defined as exposure to contrast administered for the purposes of CT up to 7 days before surgery. The primary endpoint was the rate of AKI within 7 days. Propensity score-matched models were adjusted for patient, disease and operative variables. In a sensitivity analysis, a propensity score-matched model explored the association between preoperative exposure to contrast and AKI in the first 48 h after surgery. RESULTS A total of 5378 patients were included across 173 centres. Overall, 1249 patients (23·2 per cent) received intravenous contrast. The overall rate of AKI within 7 days of surgery was 13·4 per cent (718 of 5378). In the propensity score-matched model, preoperative exposure to contrast was not associated with AKI within 7 days (odds ratio (OR) 0·95, 95 per cent c.i. 0·73 to 1·21; P = 0·669). The sensitivity analysis showed no association between preoperative contrast administration and AKI within 48 h after operation (OR 1·09, 0·84 to 1·41; P = 0·498). CONCLUSION There was no association between preoperative intravenous contrast administered for CT up to 7 days before surgery and postoperative AKI. Risk of contrast-induced nephropathy should not be used as a reason to avoid contrast-enhanced CT.
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FRI0450 MEASURES OF DISEASE SEVERITY PREDICT DISABILITY AND QUALITY OF LIFE DIFFERENTLY IN RHEUMATOID ARTHRITIS AND CHRONIC CHIKUNGUNYA DISEASE. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Chronic rheumatological manifestations similar to those of rheumatoid arthritis (RA) have been described after chikungunya virus infection. However, the clinical significance of the symptoms and disease severity in the two conditions has not been directly compared.Objectives:To compare, using identical measures of disease severity and patient outcomes, the impact of disease severity measures and symptoms on outcomes in RA and chronic chikungunya disease.Methods:Forty patients with chronic chikungunya arthralgia two years post-infection and 40 matched patients with RA were enrolled in Roraima, Brazil. Twenty-eight joints were assessed for tenderness and swelling, a pain intensity visual analogue scale, musculoskeletal stiffness questionnaire, modified Health Assessment Questionnaire and the EuroQol EQ5D-5L quality of life assessment were completed. The importance of the various measures of disease severity were analysed using Spearman’s rank correlation and regression analysis.Results:Tender and swollen joint counts, pain and stiffness were all predictive of the HAQ disability index in RA, but only stiffness was significantly associated with disability in chikungunya patients (Table 1). Tender and swollen joint counts, pain and stiffness were predictive for all EQ5D quality of life domains (except anxiety/depression) in RA patients. In contrast, in chikungunya disease, tender joint counts were predictive only of usual daily activities; pain was predictive of impaired mobility, self-care and discomfort, while stiffness was predictive for the mobility and anxiety/depression domains (Figure 1). Swollen joint counts were not associated with any of the patient outcomes in chikungunya disease. Linear regression analysis confirmed (p=0.003) that the effect of swollen joint count on the HAQ disability index depends on the underlying disease.Table 1.Association of disease severity with HAQ disability index in rheumatoid and CHIKV+ arthritisSeverity measureRheumatoid arthritisCHIKV+ arthritisr (p)r (p)Tender joint count0.56 (0.0002)0.24 (0.14)Swollen joint count0.60 (<0.0001)0.002 (0.99)Joint pain (VAS)0.55 (0.0002)0.29 (0.07)Stiffness severity0.57 (0.0001)0.38 (0.02)Figure 1.Association of disease severity with quality of life domains in rheumatoid and CHIKV+ arthritisConclusion:The value of all the disease severity measures tested in RA were confirmed, but tender joint counts may have more limited value in the assessment of chronic chikungunya disease. Joint swelling appears to have little impact for chikungunya patients, while stiffness appears to be an important metric to quantify chikungunya arthritis disease severity.Disclosure of Interests:Hugh Watson Shareholder of: Sanofi, Employee of: Sanofi, Ramão Luciano Nogueira-Hayd: None declared, Maony Rodrigues-Moreno: None declared, Felipe Naveca: None declared, Giulia Calusi: None declared, Richard Amdur: None declared, Karol Suchowiecki: None declared, Gary S. Firestein: None declared, Gary Simon: None declared, Aileen Chang: None declared
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0303 Heart Rate and Systolic Blood Pressure Increase During Experimental Sleep Restriction. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Experimental sleep restriction is associated with elevated daytime cardiac activity, including heart rate (HR) and blood pressure (BP). However, some studies have found changes in systolic (SBP) but not diastolic blood pressure (DBP) or found changes in neither. Although findings are mixed, there may be a dose-response effect of cumulative sleep loss on daytime cardiac activity, such that HR and BP increase above basal levels with additional nights of insufficient sleep. This study examined changes in cardiac activity during experimental sleep restriction.
Methods
We used multilevel models with random effects for individuals to analyze data from 15 healthy males (M=22.3 years old, SD=2.8) in an 11-day inpatient protocol consisting of three nights of 10-hour/night baseline sleep opportunity, five nights of sleep restriction (5-hour/night sleep opportunity), and then two recovery nights (10-hour/night sleep opportunity). HR and BP were measured approximately every two hours during wake.
Results
HR increased 0.75 beats/minute with each successive night of sleep restriction (SE=0.18, p<0.001). HR was 5.13 beats/minute higher during the recovery condition than during baseline or sleep restriction (SE=1.05, p<0.001). During sleep restriction only, HR was lower in the later morning and evening compared to the earliest morning timepoint of the day, F(10, 743)=10.44, p<0.001. SBP increased 0.33 mmHg following each successive night of sleep restriction (SE=0.16, p=0.041); however, SBP was only marginally higher during the sleep restriction condition than during baseline (b=1.90, SE=1.09, p=0.082).
Conclusion
Our findings suggest that HR and SBP increase with each additional day of experimental sleep restriction, even after accounting for diurnal effects on HR and SBP. HR did not recover to baseline levels following a night of recovery sleep, suggesting that longer recovery sleep may be necessary to recover from a week of sleep restriction.
Support
Grant UL1TR000127 (Chang PI), Clinical and Translational Science Institute; College of Health and Human Development at Pennsylvania State University.
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0296 Less Self-Reported Alertness and Motivation During Sleep Restriction are Associated with Decreased Attentional Performance. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Some individuals demonstrate more performance decrements on the psychomotor vigilance task (PVT) after sleep restriction (SR). We investigated whether individuals who reported less alertness and/or less motivation after SR demonstrated poorer performance on the PVT.
Methods
Fifteen healthy men (22.3±2.8 years) participated in a 10-night inpatient protocol with three nights of 10-hour baseline time in bed (TIB), five nights of SR (5-hour TIB), then two recovery (10-hour TIB) nights. Participants completed the 10-minute PVT (Joggle Research® battery) approximately every two hours during wake. Outcomes included number of false starts (<100 ms reaction time, RT) and number of lapses (≥500 ms RT). Participants reported alertness and motivation levels after each PVT. Median splits were used to characterize changes in alertness (“sleepy,” n=8, versus “alert,” n=7) and motivation (“unmotivated,” n=7, versus “motivated,” n=8) from the last day of baseline to the last day of SR. Outcomes were analyzed in mixed models with the predictor day*alertness or day*motivation, excluding the first three baseline days to preclude practice effects.
Results
There were significant interactions between day and alertness (p=.025) and day and motivation (p=.043) for false starts. False starts followed a quadratic inverted-U shape across days in sleepy (b=-0.16, p=.003) and unmotivated (b=-0.16, p=.004) participants, but not in alert or motivated participants (p>.05). There was a significant interaction between day and alertness for lapses (p=.008); lapses followed a quadratic inverted-U shape across days with a stronger effect in sleepy (b=-0.43, p<.001) versus alert (b=-0.15, p=.031) participants. There was no interaction between day and motivation for lapses.
Conclusion
Participants reporting less alertness were more likely to make both false starts and lapses after SR; those reporting less motivation were more likely to make false starts, but not lapses. Findings suggest greater motivation is sufficient to preserve inhibitory control but not vigilance after sleep restriction. In contrast, greater alertness despite sleep restriction was sufficient to preserve inhibitory control and resulted in lower vigilance decrements.
Support
This study was funded by grant UL1TR000127 from the Clinical and Translational Science Institute and the College of Health and Human Development at the Pennsylvania State University (Chang PI).
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0085 Vulnerability to Sleep Restriction is Associated with Decreased Working Memory Performance. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
We investigated whether individuals with more lapses on the psychomotor vigilance task (PVT) after sleep restriction (SR) demonstrated poorer working memory compared to those with fewer PVT lapses.
Methods
Fifteen healthy men (22.3±2.8 years) participated in a 10-night inpatient protocol with three nights of 10-hour baseline time in bed (TIB), five nights of SR (5-hour TIB), then two recovery (10-hour TIB) nights. Participants completed the Visual Object Learning Task (VOLT) and Fractal 2-Back (F2B; visual n-back) measuring working memory and the PVT (Joggle Research® battery) approximately every two hours during wake. During the VOLT, participants indicated whether presented images had been shown previously. Outcomes included number of misses and false alarms. During the F2B, participants tapped the screen when an image appeared that had been shown 2 images previously. Outcomes included sensitivity and specificity. Median split of mean PVT lapses after the last night of SR was used to categorize participants into “vulnerable” (n=8) versus “resistant” (n=7) groups. Outcomes were analyzed in mixed models with the predictor day*vulnerability, excluding the first three baseline days to preclude practice effects.
Results
There was a significant interaction between day and attentional vulnerability for VOLT misses (p<.001); misses increased linearly across days in vulnerable (b=.18, p<.001) but not resistant (p=.956) participants. There was no interaction between day and vulnerability for VOLT false alarms, which did not change across days. There was a significant interaction between day and attentional vulnerability for F2B sensitivity (p=.002); sensitivity increased linearly across days in resistant (b=.02, p<.001) but not in vulnerable (p=.273) participants. There was no interaction between day and vulnerability for F2B specificity, which did not change across days.
Conclusion
Performance on the VOLT decreased in vulnerable participants only; performance on the F2B improved in resistant participants likely due to practice effects not seen in vulnerable participants. Findings indicate vulnerability to attentional lapses after SR is a marker of vulnerability to working memory decrements.
Support
This study was funded by grant UL1TR000127 from the Clinical and Translational Science Institute (Chang PI) and the College of Health and Human Development at the Pennsylvania State University.
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P152 CLINICAL ACTIVITY OF AK002, AN ANTI-SIGLEC-8 ANTIBODY, IN MULTIPLE FORMS OF UNCONTROLLED CHRONIC URTICARIA. Ann Allergy Asthma Immunol 2019. [DOI: 10.1016/j.anai.2019.08.256] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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P.43Targeting DUX4 expression, the root cause of FSHD: identification of a drug target and development candidate. Neuromuscul Disord 2019. [DOI: 10.1016/j.nmd.2019.06.072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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LB1106 An exploratory open label phase 1b study of secukinumab in patients with moderate to severe papulopustular rosacea. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.06.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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IMRT Improves Late Toxicity Compared to Conventional RT: An Update on NRG Oncology-RTOG 1203. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.480] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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471 Genetic mutations underlying phenotypic plasticity in basosquamous carcinoma. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.07.521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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LB1144 Quantitative analysis of differentially expressed proteins in papulopustular rosacea. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.06.117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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SUN-009 ISOLATED BOWMAN CAPSULAR AMYLOID DEPOSITION. Kidney Int Rep 2019. [DOI: 10.1016/j.ekir.2019.05.403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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SAT-336 Non-Neoplastic Renal Diseases Are Common and Underdiagnosed in Nephroureterectomy Specimens. Kidney Int Rep 2019. [DOI: 10.1016/j.ekir.2019.05.383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Response to the letter to the editor re 'Evidence-based treatment of multicystic dysplastic kidney: A systematic review'. J Pediatr Urol 2019; 15:293. [PMID: 30987866 DOI: 10.1016/j.jpurol.2019.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 03/05/2019] [Indexed: 12/01/2022]
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683 Exploratory study to examine the gene expression effects of topical retinol on aging-related pathways in individuals of East Asian descent. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.03.759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Survival for Combined Heart-Lung Transplant (HLT) Recipients over the Past 30 Years. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.1073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Utilization of PHS Increased Risk Donors in Lung Transplant Reduces Median Waitlist Time without Reducing Survival. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Preparation and molecular structure of lanthanum–FcCOO−–DTBbpy complexes. Inorganica Chim Acta 2019. [DOI: 10.1016/j.ica.2019.01.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Past is Not Prologue - Immune Function Assay Results as a Predictor of Malignancy Post-Heart Transplant (HT). J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Is There a Mortality “Weekend Effect” in Cardiac Transplantation - A Single Center Experience? J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.1011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Use of Donor HCV NAT Positive Hearts: Expanding the Donor Pool? J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Is There a Mortality “Weekend Effect” in Cardiac Transplantation? J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.1008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Patients with isolated male factor infertility undergoing therapeutic donor insemination: to superovulate or not? Fertil Steril 2019. [DOI: 10.1016/j.fertnstert.2019.02.069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Abstract P2-06-02: Development of a first-in-class small molecule inhibitor (EC359) targeting oncogenic LIF/LIFR signaling for the treatment of triple negative breast cancer. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p2-06-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Leukemia inhibitory factor (LIF) and its receptor LIFR are over-expressed in multiple solid tumors and play a key role in tumor growth, progression, and resistance to standard anti-cancer treatments. Triple-negative breast cancer (TNBC) lacks targeted therapies and represents a disproportional share of breast cancer (BCa) mortality. TNBC exhibits autocrine stimulation of the LIF/LIFR axis and overexpression of LIF is associated with poorer relapse-free survival in BCa patients. LIF signaling also promotes maintenance of stem cells. Therefore, targeting the LIF/LIFR axis may have therapeutic utility in TNBC.
Methods: We rationally designed a small organic molecule (EC359) that emulates the LIF/LIFR binding site and functions as a LIFR inhibitor from a library of compounds. In silico docking studies were used to identify the putative interaction of the EC359 and LIF/LIFR complex. Direct binding of EC359 to LIFR was confirmed using surface plasmon resonance (SPR) and microscale thermophoresis technique (MST) assays. In vitro activity was tested using Cell-Titer Glo, MTT, invasion, and apoptosis assays. Mechanistic studies were conducted using Western blot, reporter gene assays, and RNA-seq analysis. Xenograft, patient-derived xenograft (PDX), and patient-derived explant (PDEX) models were used for preclinical evaluation and toxicity.
Results: Molecular docking studies showed that EC359 interacts at the LIF/LIFR binding interface. SPR and MST studies confirmed direct interaction of EC359 to LIFR. EC359 reduced the growth of TNBC cells with high potency (IC50 50-100nM) and promoted apoptosis. Further, EC359 treatment reduced invasion and stemness of TNBC cells. EC359 activity is dependent on the expression levels of LIFR and showed little or no activity on TNBC cells that have low levels of LIFR or ER+ve BCa cells. Further, EC359 significantly reduced the viability of cisplatin and taxane-resistant TNBC cells and enhanced the efficacy of HDAC inhibitors. Mechanistic and biochemical studies showed that EC359 interacts with LIFR and effectively blocking LIF/LIFR interactions. EC359 also blocked LIFR interactions with other LIFR ligands such as oncostatin M, ciliary neurotrophic factor, and cardiotrophin-1. EC359 treatment attenuated the activation of LIF/LIFR driven pathways including STAT3, mTOR, AKT, and MAPK. RNA-seq analysis identified regulation of apoptosis as one of the important pathway modulated by EC359. In TNBC xenograft and PDX assays, EC359 significantly reduced tumor progression. Further, using human primary BCa PDEX cultures, we demonstrated that EC359 has the potential to substantially reduce the proliferation of human BCa. Pharmacologically, EC359 exhibited high oral bioavailability and long half-life with a wide therapeutic window.
Conclusions: EC359 is a novel targeted therapeutic agent that inhibits LIF/LIFR oncogenic signaling in TNBC via a unique mechanism of action. EC359 has the distinct pharmacologic advantages of oral bioavailability, in vivo stability, and is associated with minimal systemic side effects. (DOD BCRP grant #BC170312)
Citation Format: Viswanadhapalli S, Luo Y, Sareddy GR, Santhamma B, Zhou M, Li M, Pratap UP, Altwegg KA, Li X, Srinivasan U, Ma S, Chang A, Riveros AC, Zhang KY, Dileep KV, Pan X, Murali R, Bajda M, Raj G, Brenner A, Manthati V, Rao M, Tekmal RR, Nair HB, Nickisch KJ, Vadlamudi RK. Development of a first-in-class small molecule inhibitor (EC359) targeting oncogenic LIF/LIFR signaling for the treatment of triple negative breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P2-06-02.
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Outbreak DIY: A new tool for public communication about infectious disease and one health. Int J Infect Dis 2019. [DOI: 10.1016/j.ijid.2018.11.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Evidence-based treatment of multicystic dysplastic kidney: a systematic review. J Pediatr Urol 2018; 14:510-519. [PMID: 30396841 DOI: 10.1016/j.jpurol.2018.09.018] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Accepted: 09/27/2018] [Indexed: 02/05/2023]
Abstract
OBJECTIVES There is a lack of a standardised protocol for the investigation and non-operative management of paediatric multicystic dysplastic kidney (MCDK). Institutional protocols for non-operative management remain essentially ad hoc. The primary outcome of this systematic review is to establish the incidence of hypertension associated with an MCDK. The secondary outcome is to determine the malignancy risk associated with an MCDK. The tertiary outcome is to assess the rate of MCDK involution. Subsequent to these, an evidence-based algorithm for follow-up is described. METHODOLOGY A systematic review of all relevant studies published between 1968 and April 2017 was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies were identified by specific inclusion and exclusion criteria, all of which included data relevant to the primary, secondary and tertiary outcomes. Hypertension was defined as systolic blood pressure greater than the 95th centile for gender, age and height centile. Subset analysis was performed for hypertension associated with an MCDK. RESULTS The primary outcome measure revealed a 3.2% (27/838) risk of developing hypertension associated with an MCDK. The secondary outcome measure noted a 0.07% malignancy risk (2/2820). The tertiary outcome measure established that 53.3% (1502/2820) had evidence of involution of the dysplastic kidney. A total of 44 cohort studies (2820 patients) were analysed. CONCLUSION Given the low risk of hypertension and malignancy, which is similar to the general population, the current conservative non-operative pathway is an appropriate management strategy. An algorithm to help support clinicians with ongoing management is proposed.
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