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Communications Biology Jun 2024Human learning varies greatly among individuals and is related to the microstructure of major white matter tracts in several learning domains, yet the impact of the...
Human learning varies greatly among individuals and is related to the microstructure of major white matter tracts in several learning domains, yet the impact of the existing microstructure of white matter tracts on future learning outcomes remains unclear. We employed a machine-learning model selection framework to evaluate whether existing microstructure might predict individual differences in learning a sensorimotor task, and further, if the mapping between tract microstructure and learning was selective for learning outcomes. We used diffusion tractography to measure the mean fractional anisotropy (FA) of white matter tracts in 60 adult participants who then practiced drawing a set of 40 unfamiliar symbols repeatedly using a digital writing tablet. We measured drawing learning as the slope of draw duration over the practice session and measured visual recognition learning for the symbols using an old/new 2-AFC task. Results demonstrated that tract microstructure selectively predicted learning outcomes, with left hemisphere pArc and SLF3 tracts predicting drawing learning and the left hemisphere MDLFspl predicting visual recognition learning. These results were replicated using repeat, held-out data and supported with complementary analyses. Results suggest that individual differences in the microstructure of human white matter tracts may be selectively related to future learning outcomes.
Topics: Humans; White Matter; Male; Female; Adult; Diffusion Tensor Imaging; Young Adult; Learning; Machine Learning; Anisotropy
PubMed: 38909103
DOI: 10.1038/s42003-024-06420-1 -
Scientific Reports Jun 2024Sarcopenia is linked to chronic inflammation and muscle wasting. This research aims to compare the screening accuracy of tools for sarcopenia in axial spondyloarthritis... (Comparative Study)
Comparative Study
Sarcopenia is linked to chronic inflammation and muscle wasting. This research aims to compare the screening accuracy of tools for sarcopenia in axial spondyloarthritis (axSpA). A cross-sectional study involving 104 axSpA patients was conducted at Phramongkutklao Hospital between January 2020 and February 2021. Sarcopenia was diagnosed according to the AWGS 2019 criteria. Appendicular skeletal muscle mass was measured using DXA. SARC-F, SARC-CalF, and SARC-F+EBM, muscle strength, and physical performance were assessed. The screening tests were evaluated using ROC curves. The optimal cutoffs were identified with the Youden index. Most patients were male (74%), with a mean (SD) age and disease duration of 42.6 (12.22) and 8.3 (8.5), respectively. The prevalence of sarcopenia was 22.1%. The AUCs (95% CI) for calf circumference, SARC-F, SARC-CalF, SARC-F+EBM, handgrip strength, chair stand time, gait speed, and time and go test were 0.830 (0.734, 0.925), 0.509 (0.373-0.645), 0.782 (0.670-0.894), 0.856 (0.758-0.954), 0.710 (0.594-0.825), 0.640 (0.508-0.772), 0.689 (0.539-0.839), and 0.711 (0.576-0.846), respectively. The optimal cutoffs for SARC-F, SARC-CalF, and SARC-F+EBM were 1, 10, and 10, with sensitivity/specificity of 81.0%/29.7%, 90.5%/68.9%, and 77.3%/87.2%, respectively. Calf circumference, SARC-CalF, and SARC-F+EBM had the best performance to screen for sarcopenia in axSpA patients. Lowering the thresholds would potentially enhance the performances of SARC-CalF and SARC-F+EBM.
Topics: Humans; Sarcopenia; Male; Female; Adult; Cross-Sectional Studies; Middle Aged; Axial Spondyloarthritis; Hand Strength; Muscle Strength; Muscle, Skeletal; Mass Screening; ROC Curve; Prevalence
PubMed: 38909047
DOI: 10.1038/s41598-024-65120-2 -
BMJ Open Jun 2024Children with developmental coordination disorder (DCD) show deviations in motor development and motor skills in early childhood where the learning and execution of...
INTRODUCTION
Children with developmental coordination disorder (DCD) show deviations in motor development and motor skills in early childhood where the learning and execution of coordinated motor skills are below the level expected for their age. Early detection of DCD is critical to provide an opportunity for intervention and support, yet many cases remain undetected until school age. The study described aims to determine the warranty, feasibility and validity of a mobility screening in Tyrolean kindergartens and evaluate its potential benefit to enhance the motor development prospects of affected children.
METHODS AND ANALYSIS
This research employs a two-stage cross-sectional approach with 6 months of follow-up assessments. The initial stage involves a playful mobility screening for all participating kindergarten children, followed by individual assessments for those displaying conspicuous motor skills. Motor skills will be evaluated using MobiScreen 4-6 and the Movement Assessment Battery for Children-2. Prior to the screening, informed consent is obtained from kindergarten bodies and authorities, parents and the children themselves. Parents are provided with information sheets and questionnaires to assess their attitudes and their child's eligibility. The study described aims to form a representative sample of kindergarten children, aged 4-6, in Tyrol. To target approximately 20-40 children with DCD for follow-up, the goal is to include 650 children, assuming an incidence of 3%-6%. For the follow-up, matching control groups will be formed and information about how identified motor deficits were addressed, including therapies or sports, will be gathered. Quantitative data will mainly be analysed descriptively, while feedback from kindergarten teachers regarding the practical implementation will be analysed using qualitative content analyses, according to Mayring.
ETHICS AND DISSEMINATION
The study has been approved by the Research Committee for Scientific Ethical Questions (RCSEQ 3369/24). Findings will be disseminated through contributions, peer-reviewed journals, and conferences.
Topics: Humans; Cross-Sectional Studies; Motor Skills Disorders; Child, Preschool; Child; Male; Female; Motor Skills; Mass Screening; Feasibility Studies; Research Design
PubMed: 38908849
DOI: 10.1136/bmjopen-2023-081311 -
Medicina 2024Visual inspection with acetic acid (VIA) is a primary alternative to reduce cervical cancer (CaCu) incidence and mortality. The study aimed to determine the proportion...
INTRODUCTION
Visual inspection with acetic acid (VIA) is a primary alternative to reduce cervical cancer (CaCu) incidence and mortality. The study aimed to determine the proportion of women aged 30-49 years who used VIA in the last two years and the factors associated with the use of the test in the primary care setting.
METHODS
Cross-sectional, multicenter study. Seven hundred and six women aged 30 to 49 years participated, users of primary health care centers in a region of Peru. The dependent variable was the use of the VIA test in the last two years and the independent variables were sociodemographic, socio-health, information and attitudinal factors.
RESULTS
The proportion of women who used the VIA test was 30.6%. The following factors were associated with greater use of the test: urban area of residence, having received a recommendation for VIA, feeling worried about acquiring CaCu, having heard about CaCu and the human papilloma virus. Also, considering having a greater or equal probability of developing CaCu compared to women of the same age, and with lower use of the test, coming from the highlands and considering it risky to undergo VIA.
CONCLUSION
The VIA screening program for CaCu would not be achieving the desired impact. There is a need to strengthen strategies and interventions in primary care to improve screening behaviors and rates.
Topics: Humans; Female; Uterine Cervical Neoplasms; Middle Aged; Acetic Acid; Cross-Sectional Studies; Adult; Primary Health Care; Peru; Early Detection of Cancer; Socioeconomic Factors; Mass Screening
PubMed: 38907967
DOI: No ID Found -
Nature Communications Jun 2024Adenosine-5'-triphosphate (ATP), the primary energy currency in cellular processes, drives metabolic activities and biosynthesis. Despite its importance, understanding...
Adenosine-5'-triphosphate (ATP), the primary energy currency in cellular processes, drives metabolic activities and biosynthesis. Despite its importance, understanding intracellular ATP dynamics' impact on bioproduction and exploiting it for enhanced bioproduction remains largely unexplored. Here, we harness an ATP biosensor to dissect ATP dynamics across different growth phases and carbon sources in multiple microbial strains. We find transient ATP accumulations during the transition from exponential to stationary growth phases in various conditions, coinciding with fatty acid (FA) and polyhydroxyalkanoate (PHA) production in Escherichia coli and Pseudomonas putida, respectively. We identify carbon sources (acetate for E. coli, oleate for P. putida) that elevate steady-state ATP levels and boost FA and PHA production. Moreover, we employ ATP dynamics as a diagnostic tool to assess metabolic burden, revealing bottlenecks that limit limonene bioproduction. Our results not only elucidate the relationship between ATP dynamics and bioproduction but also showcase its value in enhancing bioproduction in various microbial species.
Topics: Adenosine Triphosphate; Biosensing Techniques; Escherichia coli; Pseudomonas putida; Fatty Acids; Polyhydroxyalkanoates; Energy Metabolism; Carbon; Oleic Acid
PubMed: 38906854
DOI: 10.1038/s41467-024-49579-1 -
Seminars in Nuclear Medicine Jun 2024The aim of this overview was to consolidate existing evidence syntheses and provide a comprehensive overview of the evidence for F-prostate specific membrane antigen... (Review)
Review
Diagnostic Accuracy of F-Prostate Specific Membrane Antigen (PSMA) PET/CT Radiotracers in Staging and Restaging of Patients With High-Risk Prostate Cancer or Biochemical Recurrence: An Overview of Reviews.
The aim of this overview was to consolidate existing evidence syntheses and provide a comprehensive overview of the evidence for F-prostate specific membrane antigen (PSMA) PET/CT in the staging of high-risk prostate cancer and restaging after biochemical recurrence. An overview of reviews was performed and reported in line with the preferred reporting items for overview of reviews (PRIOR) statement and synthesis without meta-analysis (SWiM) reporting guidelines. A comprehensive database and grey literature search were conducted up to July 18, 2023. Systematic reviews were assessed using the risk of bias in systematic reviews (ROBIS) tool. The certainty of the evidence was assessed using grading of recommendations, assessment, development and evaluations (GRADE). 11 systematic reviews were identified; 10 were at high or unclear risk of bias. Evidence reported on a per-patient, per-lymph node, and per-lesion basis for sensitivity, specificity and overall accuracy was identified. There was a lack of data on dose, adverse events and evidence directly comparing F-PSMA PET/CT to other imaging modalities. Evidence with moderate to very low certainty indicated high sensitivity, specificity and accuracy of F-PSMA PET/CT in patients with high-risk prostate cancer and biochemical recurrence. There was considerably lower certainty evidence and greater variability in effect estimates for outcomes for the combined intermediate/high-risk cohort. While evidence gaps remain for some outcomes, and most systematic reviews were at high or unclear risk of bias, the current evidence base is broadly supportive of F-PSMA PET/CT imaging in the staging and restaging of patients with high-risk prostate cancer and biochemical recurrence.
PubMed: 38906759
DOI: 10.1053/j.semnuclmed.2024.05.003 -
The Lancet. Digital Health Jul 2024The myocardial-ischaemic-injury-index (MI) is a novel machine learning algorithm for the early diagnosis of type 1 non-ST-segment elevation myocardial infarction...
BACKGROUND
The myocardial-ischaemic-injury-index (MI) is a novel machine learning algorithm for the early diagnosis of type 1 non-ST-segment elevation myocardial infarction (NSTEMI). The performance of MI, both when using early serial blood draws (eg, at 1 h or 2 h) and in direct comparison with guideline-recommended algorithms, remains unknown. Our aim was to externally validate MI and compare its performance with that of the European Society of Cardiology (ESC) 0/1h-algorithm.
METHODS
In this secondary analysis of a multicentre international diagnostic cohort study, adult patients (age >18 years) presenting to the emergency department with symptoms suggestive of myocardial infarction were prospectively enrolled from April 21, 2006, to Feb 27, 2019 in 12 centres from five European countries (Switzerland, Spain, Italy, Poland, and Czech Republic). Patients were excluded if they presented with ST-segment-elevation myocardial infarction, did not have at least two serial high-sensitivity cardiac troponin I (hs-cTnI) measurements, or if the final diagnosis remained unclear. The final diagnosis was centrally adjudicated by two independent cardiologists using all available medical records, including serial hs-cTnI measurements and cardiac imaging. The primary outcome was type 1 NSTEMI. The performance of MI was directly compared with that of the ESC 0/1h-algorithm.
FINDINGS
Among 6487 patients, (median age 61·0 years [IQR 49·0-73·0]; 2122 [33%] female and 4365 [67%] male), 882 (13·6%) patients had type 1 NSTEMI. The median time difference between the first and second hs-cTnI measurement was 60·0 mins (IQR 57·0-70·0). MI performance was very good, with an area under the receiver-operating-characteristic curve of 0·961 (95% CI 0·957 to 0·965) and a good overall calibration (intercept -0·09 [-0·2 to 0·02]; slope 1·02 [0·97 to 1·08]). The originally defined MI score of less than 1·6 identified 4186 (64·5%) patients as low probability of having a type 1 NSTEMI (sensitivity 99·1% [95% CI 98·2 to 99·5]; negative predictive value [NPV] 99·8% [95% CI 99·6 to 99·9]) and an MI score of 49·7 or more identified 915 (14·1%) patients as high probability of having a type 1 NSTEMI (specificity 95·0% [94·3 to 95·5]; positive predictive value [PPV] 69·1% [66·0-72·0]). The sensitivity and NPV of the ESC 0/1h-algorithm were higher than that of MI (difference for sensitivity 0·88% [0·19 to 1·60], p=0·0082; difference for NPV 0·18% [0·05 to 0·32], p=0·016), and the rule-out efficacy was higher for MI (11% difference, p<0·0001). Specificity and PPV for MI were superior (difference for specificity 3·80% [3·24 to 4·36], p<0·0001; difference for PPV 7·84% [5·86 to 9·97], p<0·0001), and the rule-in efficacy was higher for the ESC 0/1h-algorithm (5·4% difference, p<0·0001).
INTERPRETATION
MI performs very well in diagnosing type 1 NSTEMI, demonstrating comparability to the ESC 0/1h-algorithm in an emergency department setting when using early serial blood draws.
FUNDING
Swiss National Science Foundation, Swiss Heart Foundation, the EU, the University Hospital Basel, the University of Basel, Abbott, Beckman Coulter, Roche, Idorsia, Ortho Clinical Diagnostics, Quidel, Siemens, and Singulex.
Topics: Humans; Male; Female; Middle Aged; Aged; Early Diagnosis; Machine Learning; Algorithms; Non-ST Elevated Myocardial Infarction; Troponin I; Prospective Studies; Cohort Studies; Europe; Myocardial Infarction; Emergency Service, Hospital; Biomarkers
PubMed: 38906613
DOI: 10.1016/S2589-7500(24)00088-8 -
The Lancet. Digital Health Jul 2024Despite the availability of effective treatments, most depressive disorders remain undetected and untreated. Internet-based depression screening combined with automated... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Despite the availability of effective treatments, most depressive disorders remain undetected and untreated. Internet-based depression screening combined with automated feedback of screening results could reach people with depression and lead to evidence-based care. We aimed to test the efficacy of two versions of automated feedback after internet-based screening on depression severity compared with no feedback.
METHODS
DISCOVER was an observer-masked, three-armed, randomised controlled trial in Germany. We recruited individuals (aged ≥18 years) who were undiagnosed with depression and screened positive for depression on an internet-based self-report depression rating scale (Patient Health Questionnaire-9 [PHQ-9] ≥10 points). Participants were randomly assigned 1:1:1 to automatically receive no feedback, non-tailored feedback, or tailored feedback on the depression screening result. Randomisation was stratified by depression severity (moderate: PHQ-9 score 10-14 points; severe: PHQ-9 score ≥15 points). Participants could not be masked but were kept unaware of trial hypotheses to minimise expectancy bias. The non-tailored feedback included the depression screening result, a recommendation to seek professional diagnostic advice, and brief general information about depression and its treatment. The tailored feedback included the same basic information but individually framed according to the participants' symptom profiles, treatment preferences, causal symptom attributions, health insurance, and local residence. Research staff were masked to group allocation and outcome assessment as these were done using online questionnaires. The primary outcome was change in depression severity, defined as change in PHQ-9 score 6 months after random assignment. Analyses were conducted following the intention-to-treat principle for participants with at least one follow-up visit. This trial was registered at ClinicalTrials.gov, NCT04633096.
FINDINGS
Between Jan 12, 2021, and Jan 31, 2022, 4878 individuals completed the internet-based screening. Of these, 1178 (24%) screened positive for depression (mean age 37·1 [SD 14·2] years; 824 [70%] woman, 344 [29%] men, and 10 [1%] other gender identity). 6 months after random assignment, depression severity decreased by 3·4 PHQ-9 points in the no feedback group (95% CI 2·9-4·0; within-group d 0·67; 325 participants), by 3·5 points in the non-tailored feedback group (3·0-4·0; within-group d 0·74; 319 participants), and by 3·7 points in the tailored feedback group (3·2-4·3; within-group d 0·71; 321 participants), with no significant differences among the three groups (p=0·72). The number of participants seeking help for depression or initiating psychotherapy or antidepressant treatment did not differ among study groups. The results remained consistent when adjusted for fulfilling the DSM-5-based criteria for major depressive disorder or subjective belief of having a depressive disorder. Negative effects were reported by less than 1% of the total sample 6 months after random assignment.
INTERPRETATION
Automated feedback following internet-based depression screening did not reduce depression severity or prompt sufficient depression care in individuals previously undiagnosed with but affected by depression.
FUNDING
German Research Foundation.
Topics: Humans; Male; Female; Germany; Adult; Internet; Middle Aged; Depression; Mass Screening; Feedback; Depressive Disorder; Surveys and Questionnaires
PubMed: 38906611
DOI: 10.1016/S2589-7500(24)00070-0 -
BMJ Paediatrics Open Jun 2024Peripheral perfusion index (PPI) is useful in a variety of neonatal settings. Currently, available reference values are from small numbers and highly variable.
BACKGROUND
Peripheral perfusion index (PPI) is useful in a variety of neonatal settings. Currently, available reference values are from small numbers and highly variable.
METHODS
We sought to generate reference values of PPI by analysing previously collected data from newborns who underwent mandated universal pulse oximetry and PPI screening from 2018 to 2021 using uniform protocol and equipment. Q-Q plots and boxplots were used to visualise distributions. Kernel density estimation for heaped and rounded data was used to estimate percentiles of the distributions.
RESULTS
Data from 388 205 newborns who underwent universal pulse oximetry screening in the first week of life were used for this analysis. Pre and postductal values showed a non-normal distribution and skewed to the left, the former had a thicker tail with more extreme values. Minor, but statistically significant differences were seen in the PPI values from day 1 to 7. Median preductal PPI (2.77, IQR:1.83-3.93) was significantly higher than postductal (2.38 IQR: 1.41-3.55) (p<0.01). PPI values increased with weight and boys had higher PPI. Kernel estimates of the percentiles in the overall sample and subgroups for gender and weight have been provided for preductal and post-ductal values.
CONCLUSION
This study, based on the largest available dataset, provides reference values for PPI in newborns. A significant influence of gender and birth weight on PPI values in newborns has been identified. Future research on understanding the influence of age, sex, birth weight, gestational age, ambient temperature and genetic factors on PPI is recommended.
Topics: Humans; Infant, Newborn; Reference Values; Male; Female; Oximetry; Neonatal Screening; Perfusion Index
PubMed: 38906560
DOI: 10.1136/bmjpo-2024-002607 -
Med (New York, N.Y.) Jun 2024Obesity rates have nearly tripled in the past 50 years, and by 2030 more than 1 billion individuals worldwide are projected to be obese. This creates a significant...
BACKGROUND
Obesity rates have nearly tripled in the past 50 years, and by 2030 more than 1 billion individuals worldwide are projected to be obese. This creates a significant economic strain due to the associated non-communicable diseases. The root cause is an energy expenditure imbalance, owing to an interplay of lifestyle, environmental, and genetic factors. Obesity has a polygenic genetic architecture; however, single genetic variants with large effect size are etiological in a minority of cases. These variants allowed the discovery of novel genes and biology relevant to weight regulation and ultimately led to the development of novel specific treatments.
METHODS
We used a case-control approach to determine metabolic differences between individuals homozygous for a loss-of-function genetic variant in the small integral membrane protein 1 (SMIM1) and the general population, leveraging data from five cohorts. Metabolic characterization of SMIM1 individuals was performed using plasma biochemistry, calorimetric chamber, and DXA scan.
FINDINGS
We found that individuals homozygous for a loss-of-function genetic variant in SMIM1 gene, underlying the blood group Vel, display excess body weight, dyslipidemia, altered leptin to adiponectin ratio, increased liver enzymes, and lower thyroid hormone levels. This was accompanied by a reduction in resting energy expenditure.
CONCLUSION
This research identified a novel genetic predisposition to being overweight or obese. It highlights the need to investigate the genetic causes of obesity to select the most appropriate treatment given the large cost disparity between them.
FUNDING
This work was funded by the National Institute of Health Research, British Heart Foundation, and NHS Blood and Transplant.
PubMed: 38906141
DOI: 10.1016/j.medj.2024.05.015