ResearchPad - longitudinal-studies https://www.researchpad.co Default RSS Feed en-us © 2020 Newgen KnowledgeWorks <![CDATA[Psychological symptoms and quality of life after repeated exposure to earthquake: A cohort study in Italy]]> https://www.researchpad.co/article/elastic_article_13809 In 2005, a random sample of 200 people were assessed in Camerino, Italy, eight years after an earthquake. Psychological symptom levels were low and only one person had current Post-Traumatic Stress Disorder (PTSD). In 2016 a new earthquake occurred in Camerino. The study aims to assess the impact of the second exposure in the same cohort. A longitudinal study was conducted, 130 participants were re-interviewed between July and December 2017. Psychological symptoms were self-rated on the Brief Symptom Inventory (BSI) and the Global Severity Index (GSI) was analysed. Post-traumatic stress symptoms were self-rated on the Impact of Event Scale-Revised (IES-R). Subjective quality of life (SQOL) was assessed on the Manchester Short Assessment of Quality of Life (MANSA). Mean scores of GSI and IES-R were significantly higher than in 2005 (p<0.01 and p<0.001), whilst SQOL remained almost unchanged (p = 0.163). In 2017, 16.9% of the sample had reached the PTSD threshold whilst in 2005 only the 0.5% had reached it. Despite low symptom levels several years after an earthquake, people can show psychological distress after a new exposure, whilst average quality of life levels are not affected.

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<![CDATA[Trajectories of fatigue among stroke patients from the acute phase to 18 months post-injury: A latent class analysis]]> https://www.researchpad.co/article/Nc2795b82-f9e4-46cc-9fc3-23c3f213e7d4

Introduction

Post-stroke fatigue (PSF) is a common symptom affecting 23–75% of stroke survivors. It is associated with increased risk of institutionalization and death, and it is of many patients considered among the worst symptoms to cope with after stroke. Longitudinal studies focusing on trajectories of fatigue may contribute to understanding patients’ experience of fatigue over time and its associated factors, yet only a few have been conducted to date.

Objectives

To explore whether subgroups of stroke survivors with distinct trajectories of fatigue in the first 18 months post stroke could be identified and whether these subgroups differ regarding sociodemographic, medical and/or symptom-related characteristics.

Materials and methods

115 patients with first-ever stroke admitted to Oslo University Hospital or Buskerud Hospital were recruited and data was collected prospectively during the acute phase and at 6, 12 and 18 months post stroke. Data on fatigue (both pre- and post-stroke), sociodemographic, medical and symptom-related characteristics were collected through structured interviews, standardized questionnaires and from the patients’ medical records.

Growth mixture modeling (GMM) was used to identify latent classes, i.e., subgroups of patients, based on their Fatigue Severity Scales (FSS) scores at the four time points. Differences in sociodemographic, medical, and symptom-related characteristics between the latent classes were evaluated using univariate and multivariable ordinal regression analyses.

Results and their significance

Using GMM, three latent classes of fatigue trajectories over 18 months were identified, characterized by differing levels of fatigue: low, moderate and high. The mean FSS score for each class remained relatively stable across all four time points. In the univariate analyses, age <75, pre-stroke fatigue, multiple comorbidities, current depression, disturbed sleep and some ADL impairment were associated with higher fatigue trajectories. In the multivariable analyses, pre-stroke fatigue (OR 4.92, 95% CI 1.84–13.2), multiple comorbidities (OR 4,52,95% CI 1.85–11.1) and not working (OR 4.61, 95% CI 1.36–15,7) were the strongest predictor of higher fatigue trajectories The findings of this study may be helpful for clinicians in identifying patients at risk of developing chronic fatigue after stroke.

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<![CDATA[Neuroimaging modality fusion in Alzheimer’s classification using convolutional neural networks]]> https://www.researchpad.co/article/N4bce0426-e39d-45a0-9dc9-42db4f6cba04

Automated methods for Alzheimer’s disease (AD) classification have the potential for great clinical benefits and may provide insight for combating the disease. Machine learning, and more specifically deep neural networks, have been shown to have great efficacy in this domain. These algorithms often use neurological imaging data such as MRI and FDG PET, but a comprehensive and balanced comparison of the MRI and amyloid PET modalities has not been performed. In order to accurately determine the relative strength of each imaging variant, this work performs a comparison study in the context of Alzheimer’s dementia classification using the Alzheimer’s Disease Neuroimaging Initiative (ADNI) dataset with identical neural network architectures. Furthermore, this work analyzes the benefits of using both modalities in a fusion setting and discusses how these data types may be leveraged in future AD studies using deep learning.

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<![CDATA[Trajectories of prolonged grief one to six years after a natural disaster]]> https://www.researchpad.co/article/5c26972ed5eed0c48470ed9a

Background

The long-term trajectories of prolonged grief are poorly understood. The aims were to examine the course of grief among bereaved disaster survivors up to six years post loss and factors predicting worse bereavement outcome. A third aim was to explore differences in grief indicators between trajectories.

Methods

Bereaved Swedish tourists who survived the 2004 Indian Ocean tsunamis responded to surveys including the Inventory of Complicated Grief 1 to 6 years after the disaster. Latent growth mixture modeling was used to identify longitudinal trajectories of grief. Multinomial logistic regression analysis was used to examine predictors of class membership.

Results

Three trajectories were identified: resilient (41% of the sample), recovering (48%), and chronic (11%). The strongest predictor of chronic grief was the loss of one’s child. When examining grief indicators, the chronic trajectory was characterized by not accepting the loss, while yearning was common in all trajectories.

Conclusions

This study highlights the importance of considering how traumatically bereaved individuals can be affected by loss for several years after a disaster, especially after losing one’s child. An inability to accept the loss, more so than yearning, appears to characterize bereaved survivors at risk of a chronic trajectory of grief.

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<![CDATA[Long-term impact of a faculty mentoring program in academic medicine]]> https://www.researchpad.co/article/5c2400c7d5eed0c4840990e8

The authors conducted a prospective longitudinal study from 2009 to 2016 to assess the short and long-term impact of a formal mentorship program on junior faculty satisfaction and productivity. Junior faculty mentees enrolled in the program and junior faculty without formal mentorship were administered surveys before and after the program to assess satisfaction with their mentoring experiences. Long-term retention, promotion, and funding data were also collected. Twenty-three junior faculty mentees and 91 junior faculty controls were included in the study. Mentees came from the Departments of Radiation Oncology and Anesthesia, Critical Care, and Pain Management. After participating in the mentorship program, mentees demonstrated an increase in satisfaction from baseline in five of seven domains related to mentoring, while controls experienced no significant change in satisfaction in six of the seven domains. At long-term follow up, mentees were more likely than controls to hold senior faculty positions (percent senior faculty: 47% vs. 13%, p = 0.030) despite no difference in initial administrative rank. When comparing the subset of faculty who were Instructors at baseline, mentees were more likely to be funded and/or promoted than controls (p = 0.030). A majority of mentees reported that the program strengthened their long-term success, and many maintained their original mentoring relationships and formed new ones, highlighting the strong culture of mentorship that was instilled. Several short-term and long-term benefits were fostered from this formal mentorship program. These findings highlight the potential impact of mentorship programs in propagating a culture of mentorship and excellence.

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<![CDATA[The ethics conundrum in Recall by Genotype (RbG) research: Perspectives from birth cohort participants]]> https://www.researchpad.co/article/5b8b29ed40307c405292ca56

Purpose

Recall by genotype (RbG) research recruits on the basis of genetic variation. Increased use of this approach presents an ethical conundrum for cohort studies/biobanks: whether to inform individuals of their genetic information and deviate from standard practice of non-disclosure of results, or mask this information at the level of the individual participant. This paper examines the perspectives of research study participants on RbG research.

Methods

Fifty-three semi-structured interviews were conducted with young adult participants of the Avon Longitudinal Study of Parents and Children (ALSPAC). Topics included understandings of RbG research, expectations around recruitment and communication of research findings.

Results

Participants uniformly expressed a deep trust and faith in ALSPAC and considered themselves part of the ALSPAC team. Such perspectives, alongside a limited knowledge of genetics and modest interest in reported research outcomes, meant few participants reported immediate concerns about being recruited by genotype.

Conclusion

Our findings highlight the responsibility and duty of care on RbG researchers, and longitudinal studies more generally, and the importance of solidarity, reciprocity and co-production in study-participant relations. As such, we consider existing recommendations for conducting RbG research in longitudinal studies in light of our results and speak to recent changes in the approach used by ALSPAC.

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<![CDATA[Should prevention of falls start earlier? Co-ordinated analyses of harmonised data on falls in middle-aged adults across four population-based cohort studies]]> https://www.researchpad.co/article/5b8687e540307c73f6bbfec7

The prevalence of risk factors for falls increases during middle-age, but the prevalence of falls in this age-range is often overlooked and understudied. The aim was to calculate the prevalence of falls in middle-aged adults (aged 40–64 years) from four countries.

Data were from four population-based cohort studies from Australia (Australian Longitudinal Study on Women’s Health, n = 10556, 100% women, 51–58 years in 2004), Ireland (The Irish Longitudinal Study on Ageing, n = 4968, 57.5% women, 40–64 years in 2010), the Netherlands (Longitudinal Aging Study Amsterdam, n = 862, 51.6% women, 55–64 years in 2012–13) and Great Britain (MRC National Survey of Health and Development, n = 2821, 50.9% women, 53 years in 1999). In each study, falls assessment was based on recall of any falls in the past year. The prevalence of falls was calculated for the total group, for each country, for men and women separately, and for 5-year age-bands. The prevalence was higher in Australia (27.8%, women only) and the Netherlands (25.1%) than in Ireland (17.6%) and Great Britain (17.8%, p<0.001). Women (27.0%) had higher prevalences than men (15.2%, p<0.001). The prevalence increased from 8.7% in 40–44 year olds to 29.9% in 60–64 year olds in women, and from 14.7% in 45–49 year olds to 15.7% in 60–64 year olds in men. Even within 5-year age-bands, there was substantial variation in prevalence between the four cohorts. Weighting for age, sex and education changed the prevalence estimates by less than 2 percentage points.

The sharp increase in prevalence of falls in middle-age, particularly among women supports the notion that falls are not just a problem of old age, and that middle-age may be a critical life stage for preventive interventions.

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<![CDATA[Partial Inhibition of Adipose Tissue Lipolysis Improves Glucose Metabolism and Insulin Sensitivity Without Alteration of Fat Mass]]> https://www.researchpad.co/article/5989da54ab0ee8fa60b8e8ac

Partial inhibition of adipose tissue lipolysis does not increase fat mass but improves glucose metabolism and insulin sensitivity through modulation of fatty acid turnover and induction of fat cell de novo lipogenesis.

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<![CDATA[Trajectories of Symbolic and Nonsymbolic Magnitude Processing in the First Year of Formal Schooling]]> https://www.researchpad.co/article/5989d9d5ab0ee8fa60b658f8

Sensitivity to numerical magnitudes is thought to provide a foundation for higher-level mathematical skills such as calculation. It is still unclear how symbolic (e.g. Arabic digits) and nonsymbolic (e.g. Dots) magnitude systems develop and how the two formats relate to one another. Some theories propose that children learn the meaning of symbolic numbers by scaffolding them onto a pre-existing nonsymbolic system (Approximate Number System). Others suggest that symbolic and nonsymbolic magnitudes have distinct and non-overlapping representations. In the present study, we examine the developmental trajectories of symbolic and nonsymbolic magnitude processing skills and how they relate to each other in the first year of formal schooling when children are becoming more fluent with symbolic numbers. Thirty Grade 1 children completed symbolic and nonsymbolic magnitude processing tasks at three time points in Grade 1. We found that symbolic and nonsymbolic magnitude processing skills had distinct developmental trajectories, where symbolic magnitude processing was characterized by greater gains than nonsymbolic skills over the one-year period in Grade 1. We further found that the development of the two formats only related to one another in the first half of the school year where symbolic magnitude processing skills influenced later nonsymbolic skills. These findings indicate that symbolic and nonsymbolic abilities have different developmental trajectories and that the development of symbolic abilities is not strongly linked to nonsymbolic representations by Grade 1. These findings also suggest that the relationship between symbolic and nonsymbolic processing is not as unidirectional as previously thought.

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<![CDATA[Electronic Medical Record Cancer Incidence over Six Years Comparing New Users of Glargine with New Users of NPH Insulin]]> https://www.researchpad.co/article/5989da93ab0ee8fa60ba0c34

Background

Recent studies suggested that insulin glargine use could be associated with increased risk of cancer. We compared the incidence of cancer in new users of glargine versus new users of NPH in a longitudinal clinical cohort with diabetes for up to 6 years.

Methods and Findings

From all patients who had been regularly followed at Massachusetts General Hospital from 1/01/2005 to 12/31/2010, 3,680 patients who had a medication record for glargine or NPH usage were obtained from the electronic medical record (EMR). From those we selected 539 new glargine users (age: 60.1±13.6 years, BMI: 32.7±7.5 kg/m2) and 343 new NPH users (61.5±14.1 years, 32.7±8.3 kg/m2) who had no prevalent cancer during 19 months prior to glargine or NPH initiation. All incident cancer cases were ascertained from the EMR requiring at least 2 ICD-9 codes within a 2 month period. Insulin exposure time and cumulative dose were validated. The statistical analysis compared the rates of cancer in new glargine vs. new NPH users while on treatment, adjusted for the propensity to receive one or the other insulin. There were 26 and 28 new cancer cases in new glargine and new NPH users for 1559 and 1126 person-years follow-up, respectively. There were no differences in the propensity-adjusted clinical characteristics between groups. The adjusted hazard ratio for the cancer incidence comparing glargine vs. NPH use was 0.65 (95% CI: 0.36–1.19).

Conclusions

Insulin glargine is not associated with development of cancers when compared with NPH in this longitudinal and carefully retrieved EMR data.

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<![CDATA[Factors Associated with Participation and Attrition in a Longitudinal Study of Bacterial Vaginosis in Australian Women Who Have Sex with Women]]> https://www.researchpad.co/article/5989db07ab0ee8fa60bc8dd2

Objective

A number of social and sexual risk factors for bacterial vaginosis (BV) have been described. It is important to understand whether these factors are associated with non-participation or attrition of participants from longitudinal studies in order to examine potential for recruitment or attrition bias. We describe factors associated with participation and attrition in a 24-month prospective cohort study, investigating incident BV among Australian women who have sex with women.

Study Design and Setting

Participants negative for prevalent BV were offered enrolment in a longitudinal cohort study. Participants self-collected vaginal samples and completed questionnaires 3-monthly to endpoint (BV-positive/BV-negative by 24 months). Factors associated with participation in the cohort study were examined by logistic regression and factors associated with attrition from the cohort were examined by Cox regression.

Results

The cross-sectional study recruited 457 women. 334 BV-negative women were eligible for the cohort and 298 (89%, 95%CI 85, 92) enrolled. Lower educational levels (aOR 2.72, 95%CI 1.09, 6.83), smoking (aOR 2.44, 95%CI 1.13, 5.27), past BV symptoms (aOR 3.42, 95%CI 1.16, 10.10) and prior genital warts (aOR 2.71, 95%CI 1.14, 6.46) were associated with non-participation; a partner co-enrolling increased participation (aOR 3.73, 95%CI 1.43, 9.70). 248 participants (83%, 95%CI 78, 87) were retained to study endpoint (BV-negative at 24 months or BV-positive at any stage). Attrition was associated being <30 yrs (aHR 2.15, 95%CI 1.13, 4.10) and a male partner at enrolment (aHR 6.12, 95%CI 1.99, 18.82).

Conclusion

We achieved high participation and retention levels in a prospective cohort study and report factors influencing participation and retention of participants over a 24-month study period, which will assist in the design and implementation of future cohort studies in sexual health and disease.

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<![CDATA[On the Adaptive Partition Approach to the Detection of Multiple Change-Points]]> https://www.researchpad.co/article/5989da8bab0ee8fa60b9dded

With an adaptive partition procedure, we can partition a “time course” into consecutive non-overlapped intervals such that the population means/proportions of the observations in two adjacent intervals are significantly different at a given level . However, the widely used recursive combination or partition procedures do not guarantee a global optimization. We propose a modified dynamic programming algorithm to achieve a global optimization. Our method can provide consistent estimation results. In a comprehensive simulation study, our method shows an improved performance when it is compared to the recursive combination/partition procedures. In practice, can be determined based on a cross-validation procedure. As an application, we consider the well-known Pima Indian Diabetes data. We explore the relationship among the diabetes risk and several important variables including the plasma glucose concentration, body mass index and age.

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<![CDATA[Longitudinal Study of the Dynamics of Vaginal Microflora during Two Consecutive Menstrual Cycles]]> https://www.researchpad.co/article/5989da6cab0ee8fa60b9351d

Background

Although the vaginal microflora (VMF) has been well studied, information on the fluctuation of the different bacterial species throughout the menstrual cycle and the information on events preceding the presence of disturbed VMF is still very limited. Documenting the dynamics of the VMF during the menstrual cycle might provide better insights. In this study, we assessed the presence of different Lactobacillus species in relation to the BV associated species during the menstrual cycle, assessed the influence of the menstrual cycle on the different categories of vaginal microflora and assessed possible causes, such as menstruation and sexual intercourse, of VMF disturbance. To our knowledge, this is the first longitudinal study in which swabs and Gram stains were available for each day of two consecutive menstrual cycles, whereby 8 grades of VMF were distinguished by Gram stain analysis, and whereby the swabs were cultured every 7th day and identification of the bacterial isolates was carried out with a molecular technique.

Methods

Self-collected vaginal swabs were obtained daily from 17 non pregnant, menarchal volunteers, and used for daily Gram staining and weekly culture. Bacterial isolates were identified with tDNA-PCR and 16 S rRNA gene sequencing.

Results

Nine women presented with predominantly normal VMF and the 8 others had predominantly disturbed VMF. The overall VMF of each volunteer was characteristic and rather stable. Menses and antimicrobials were the major disturbing factors of the VMF. Disturbances were always accompanied by a rise in Gram positive cocci, which also appeared to be a significant group within the VMF in general.

Conclusions

We observed a huge interindividual variability of predominantly stable VMF types. The importance of Gram positive cocci in VMF is underestimated. L. crispatus was the species that was most negatively affected by the menses, whereas the presence of the other lactobacilli was less variable.

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<![CDATA[Toll-Like Receptor (TLR2 and TLR4) Polymorphisms and Chronic Obstructive Pulmonary Disease]]> https://www.researchpad.co/article/5989db4bab0ee8fa60bda2d8

Toll-like receptors (TLRs) participate in the defence against bacterial infections that are common in patients with Chronic Obstructive Pulmonary Disease (COPD). We studied all tagging SNPs in TLR2 and TLR4 and their associations with the level and change over time of both FEV1 and sputum inflammatory cells in moderate-to-severe COPD. Nine TLR2 SNPs and 17 TLR4 SNPs were genotyped in 110 COPD patients. Associations of SNPs with lung function and inflammatory cells in induced sputum were analyzed cross-sectionally with linear regression and longitudinally with linear mixed-effect models. Two SNPs in TLR2 (rs1898830 and rs11938228) were associated with a lower level of FEV1 and accelerated decline of FEV1 and higher numbers of sputum inflammatory cells. None of the TLR4 SNPs was associated with FEV1 level. Eleven out of 17 SNPs were associated with FEV1 decline, including rs12377632 and rs10759931, which were additionally associated with higher numbers of sputum inflammatory cells at baseline and with increase over time. This is the first longitudinal study showing that tagging SNPs in TLR2 and TLR4 are associated with the level and decline of lung function as well as with inflammatory cell numbers in induced sputum in COPD patients, suggesting a role in the severity and progression of COPD.

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<![CDATA[The Risk Behaviors and Mental Health of Detained Adolescents: A Controlled, Prospective Longitudinal Study]]> https://www.researchpad.co/article/5989db0aab0ee8fa60bc9da1

Background

To assess the behavioral risk factors and mental health needs of adolescents in juvenile detention centers (JDC).

Method

A total of 238 boys aged 12–17 years was surveyed who had been admitted to a detention center and compared them with boys from the community (n = 238) matched for sex and age. We assessed behavioral risk factors and mental health problems by using the Youth Risk Behavior Survey questionnaire (YRBS) and the Youth Self-Report questionnaire (YSR).

Results

Young offenders had significantly higher YRBS scores than controls for drug use (odds ratio (OR) 5.16, 95% CI 2.27–7.84), sexual intercourse (OR, 2.51; 95% CI 1.55–2.90), irregular diet (4.78, 2.11–7.51), suicide attempts (1.96, 1.32–5.85), and physical fighting behavior (3.49, 1.60–7.07), but not for tobacco use, alcohol use, and high–risk cycling. Young offenders at the time of admission (6.61, 2.58–15.2), at 6 months (3.12, 1.81–10.1), and at 12 months (5.29, 1.98–13.3) reported statistically higher levels of total mental health problems than adolescents in a community sample.

Conclusions

Young offenders have a high rate of mental and behavioral disorders. In the detention period, aggressive behavior, self–destructive/identity, and externalizing of problems improved while withdrawn, anxious or depressed, and internalizing of problems worsened.

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<![CDATA[Developmental Trajectories of Body Mass Index Among Japanese Children and Impact of Maternal Factors during Pregnancy]]> https://www.researchpad.co/article/5989db15ab0ee8fa60bcced6

Background

The aims of this study were to 1) determine the distinct patterns of body mass index (BMI) trajectories in Japanese children, and 2) elucidate the maternal factors during pregnancy, which contribute to the determination of those patterns.

Methodology/Principal Findings

All of the children (1,644 individuals) born in Koshu City, Japan, between 1991 and 1998 were followed in a longitudinal study exploring the subjects’ BMI. The BMI was calculated 11 times for each child between birth and 12 years of age. Exploratory latent class growth analyses were conducted to identify trajectory patterns of the BMI z-scores. The distribution of BMI trajectories were best characterized by a five-group model for boys and a six-group model for girls. The groups were named “stable thin,” “stable average,” “stable high average,” “progressive overweight,” and “progressive obesity” in both sexes; girls were allocated to an additional group called “progressive average.” Multinomial logistic regression found that maternal weight, smoking, and skipping breakfast during pregnancy were associated with children included in the progressive obesity pattern rather than the stable average pattern. These associations were stronger for boys than for girls.

Conclusions/Significance

Multiple developmental patterns in Japanese boys and girls were identified, some of which have not been identified in Western countries. Maternal BMI and some unfavorable behaviors during early pregnancy may impact a child’s pattern of body mass development. Further studies to explain the gender and regional differences that were identified are warranted, as these may be important for early life prevention of weight-associated health problems.

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<![CDATA[The Effectiveness of an Online Support Group for Members of the Community with Depression: A Randomised Controlled Trial]]> https://www.researchpad.co/article/5989da85ab0ee8fa60b9c140

Background

Internet support groups (ISGs) are popular, particularly among people with depression, but there is little high quality evidence concerning their effectiveness.

Aim

The study aimed to evaluate the efficacy of an ISG for reducing depressive symptoms among community members when used alone and in combination with an automated Internet-based psychotherapy training program.

Method

Volunteers with elevated psychological distress were identified using a community-based screening postal survey. Participants were randomised to one of four 12-week conditions: depression Internet Support Group (ISG), automated depression Internet Training Program (ITP), combination of the two (ITP+ISG), or a control website with delayed access to e-couch at 6 months. Assessments were conducted at baseline, post-intervention, 6 and 12 months.

Results

There was no change in depressive symptoms relative to control after 3 months of exposure to the ISG. However, both the ISG alone and the combined ISG+ITP group showed significantly greater reduction in depressive symptoms at 6 and 12 months follow-up than the control group. The ITP program was effective relative to control at post-intervention but not at 6 months.

Conclusions

ISGs for depression are promising and warrant further empirical investigation.

Trial Registration

Controlled-Trials.com ISRCTN65657330

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<![CDATA[Sustained low peritoneal effluent CCL18 levels are associated with preservation of peritoneal membrane function in peritoneal dialysis]]> https://www.researchpad.co/article/5989db52ab0ee8fa60bdc850

Peritoneal membrane failure (PMF) and, ultimately, encapsulating peritoneal sclerosis (EPS) are the most serious peritoneal dialysis (PD) complications. Combining clinical and peritoneal transport data with the measurement of molecular biomarkers, such as the chemokine CCL18, would improve the complex diagnosis and management of PMF. We measured CCL18 levels in 43 patients’ effluent and serum at baseline and after 1, 2, and 3 years of PD treatment by retrospective longitudinal study, and evaluated their association with PMF/EPS development and peritoneal risk factors. To confirm the trends observed in the longitudinal study, a cross-sectional study was performed on 61 isolated samples from long-term (more than 3 years) patients treated with PD. We observed that the patients with no membrane dysfunction showed sustained low CCL18 levels in peritoneal effluent over time. An increase in CCL18 levels at any time was predictive of PMF development (final CCL18 increase over baseline, p = .014; and maximum CCL18 increase, p = .039). At year 3 of PD, CCL18 values in effluent under 3.15 ng/ml showed an 89.5% negative predictive value, and higher levels were associated with later PMF (odds ratio 4.3; 95% CI 0.90–20.89; p = .067). Moreover, CCL18 levels in effluent at year 3 of PD were independently associated with a risk of PMF development, adjusted for the classical (water and creatinine) peritoneal transport parameters. These trends were confirmed in a cross-sectional study of 61 long-term patients treated with PD. In conclusion, our study shows the diagnostic capacity of chemokine CCL18 levels in peritoneal effluent to predict PMF and suggests CCL18 as a new marker and mediator of this serious condition as well as a new potential therapeutic target.

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<![CDATA[Effects of Short-Term Continuous Subcutaneous Insulin Infusion on Fasting Plasma Fibroblast Growth Factor-21 Levels in Patients with Newly Diagnosed Type 2 Diabetes Mellitus]]> https://www.researchpad.co/article/5989daa8ab0ee8fa60ba84b9

Background

To investigate the effects of short-term continuous subcutaneous insulin infusion (CSII) on plasma fibroblast growth factor-21 (FGF-21) levels in patients with newly diagnosed type 2 diabetes mellitus (nT2DM).

Method

Sixty-eight patients with nT2DM (nT2DM group), and 52 gender-, age- and body mass index (BMI) -matched normal glucose tolerance (NGT group) controls participated in the study. 30 nT2DM patients with FBG≥14.0 mmol/L were treated with CSII for 2 weeks, and were underwent a euglycemic–hyperinsulinemic clamp pre- and post-treatment. Plasma FGF-21 concentrations were measured with a commercial ELISA kit. The relationship between plasma FGF-21 levels and metabolic parameters was also analyzed.

Results

Fasting plasma FGF-21 levels were higher in the nT2DM group than in NGT groups (1.60±0.08 vs. 1.13±0.26 µg/L, P<0.01). In nT2DM patients, fasting plasma FGF-21 concentrations were significantly decreased after CSII treatment for 2 weeks (1.60±0.08 vs.1.30±0.05 µg/L, P<0.05), accompanied by a significant increase in the whole body glucose uptake (M value) and blood glucose control. The changes in plasma FGF-21 levels (ΔFGF-21) were positively associated with the amelioration of insulin resistance shown by the changes in M value.

Conclusion

Plasma FGF-21 level is associated with whole body insulin sensitivity and significantly reduced following short-term CSII treatment.

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<![CDATA[Application of Diffusion Tensor Imaging Parameters to Detect Change in Longitudinal Studies in Cerebral Small Vessel Disease]]> https://www.researchpad.co/article/5989da6bab0ee8fa60b92ed1

Cerebral small vessel disease (SVD) is the major cause of vascular cognitive impairment, resulting in significant disability and reduced quality of life. Cognitive tests have been shown to be insensitive to change in longitudinal studies and, therefore, sensitive surrogate markers are needed to monitor disease progression and assess treatment effects in clinical trials. Diffusion tensor imaging (DTI) is thought to offer great potential in this regard. Sensitivity of the various parameters that can be derived from DTI is however unknown. We aimed to evaluate the differential sensitivity of DTI markers to detect SVD progression, and to estimate sample sizes required to assess therapeutic interventions aimed at halting decline based on DTI data. We investigated 99 patients with symptomatic SVD, defined as clinical lacunar syndrome with MRI confirmation of a corresponding infarct as well as confluent white matter hyperintensities over a 3 year follow-up period. We evaluated change in DTI histogram parameters using linear mixed effect models and calculated sample size estimates. Over a three-year follow-up period we observed a decline in fractional anisotropy and increase in diffusivity in white matter tissue and most parameters changed significantly. Mean diffusivity peak height was the most sensitive marker for SVD progression as it had the smallest sample size estimate. This suggests disease progression can be monitored sensitively using DTI histogram analysis and confirms DTI’s potential as surrogate marker for SVD.

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