Publications by authors named "Sunyoung Kim"

211 Publications

Assessment of therapeutic platelet inhibition in cardiac patients: Comparative study between VerifyNow-P2Y12 and Anysis-P2Y12 assay.

Clin Hemorheol Microcirc 2021 Apr 13. Epub 2021 Apr 13.

Division of Cardiology, Department of Internal Medicine, College of Medicine, Korea University, Seoul, Korea.

Background: Analyzing responsiveness to P2Y12 therapy is vital to preventing thrombotic and hemorrhagic complications in patients with cardiovascular diseases.

Objective: This study evaluates a new Anysis-P2Y12 assay system against VerifyNow-P2Y12 in cardiac patients and analyzes the P2Y12 low-response rates of the two devices with various cutoff values.

Methods: In total, 125 citrated blood samples were collected from cardiac patients referred for a P2Y12 antiplatelet response test. In the Anysis assay, the test result was the migration distance (MD) until the blood flow stops, which is comparable to both P2Y12 reaction units and percent inhibition obtained using VerifyNow.

Results: The MDs without and with P2Y12 were 182±30 and 264±12 mm, respectively (p <  0.0001). Compared to VerifyNow-P2Y12, the sensitivity and specificity of Anysis-200 were 96.8%and 88.7%, respectively. Cohen's kappa coefficient between the two devices was 0.761, indicating a high agreement. However, there was an apparent difference in the low-response rate to P2Y12, which was 36.5%for VerifyNow and 5.9%for Anysis.

Conclusions: The performance of the newly developed platelet function assay, Anysis-P2Y12 was equivalent to that of VerifyNow-P2Y12 in terms of sensitivity and specificity. The Anysis-P2Y12 assay may help screen patients with abnormal P2Y12 non-responsiveness.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3233/CH-211104DOI Listing
April 2021

Residential indoor air quality interventions through a social-ecological systems lens: A systematic review.

Indoor Air 2021 Apr 15. Epub 2021 Apr 15.

School of Communication and Information, Rutgers, the State University of New Jersey, New Brunswick, New Jersy, USA.

Indoor air quality (IAQ) is an important consideration for health and well-being as people spend most of their time indoors. Multi-disciplinary interest in IAQ is growing, resulting in more empirical research, especially in affordable housing settings, given disproportionate impacts on vulnerable populations. Conceptually, there is little coherency among these case studies; they traverse diverse spatial scales, indoor and outdoor environments, and populations, making it difficult to implement research findings in any given setting. We employ a social-ecological systems (SES) framework to review and categorize existing interventions and other literature findings to elucidate relationships among spatially and otherwise diverse IAQ factors. This perspective is highly attentive to the role of agency, highlighting individual, household, and organizational behaviors and constraints in managing IAQ. When combined with scientific knowledge about the effectiveness of IAQ interventions, this approach favors actionable strategies for reducing the presence of indoor pollutants and personal exposures.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/ina.12835DOI Listing
April 2021

Hepatocyte growth factor induces pErk and pSTAT3 (Ser 727) to promote mitochondrial activity and neurite outgrowth in primary dorsal root ganglion cultures.

Neuroreport 2021 Apr;32(6):525-530

Division of Gene Therapy, Helixmith Co Ltd., Seoul, Korea.

Hepatocyte growth factor (HGF) promotes the neurite outgrowth of sensory neurons in developmental stages, but its role in injured peripheral nerves in adult mice remains largely been unexplored. In this study, we investigated the role of HGF in the regeneration of injured peripheral nerves using cultured dorsal root ganglions (DRGs). When cells were treated with HGF protein, the length of the neurite was increased 1.4-fold compared to the untreated control group. HGF greatly increased the level of phosphorylated STAT3 at serine 727 [pSTAT3 (Ser 727)], thereby translocating the protein to the mitochondria. HGF treatment increased the activity of mitochondrial complex I. When DRGs were cultured in the presence of U0126, a pharmacological inhibitor of Erk, the HGF-mediated increase in neurite outgrowth and the level of pSTAT3 (Ser 727) were both suppressed. Taken together, these results suggest that the HGF/c-met pathway might promote neurite outgrowth by controlling mitochondrial activity through the HGF/Erk/STAT3 axis.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/WNR.0000000000001622DOI Listing
April 2021

Hepatocyte growth factor is necessary for efficient outgrowth of injured peripheral axons in culture system and nerve crush mouse model.

Biochem Biophys Rep 2021 Jul 3;26:100973. Epub 2021 Mar 3.

Division of Gene Therapy, Helixmith Co Ltd, Seoul, 07794, South Korea.

Hepatocyte growth factor (HGF) is a neurotrophic factor and its role in peripheral nerves has been relatively unknown. In this study, biological functions of HGF and its receptor c-met have been investigated in the context of regeneration of damaged peripheral nerves. Axotomy of the peripheral branch of sensory neurons from embryonic dorsal root ganglia (DRG) resulted in the increased protein levels of HGF and phosphorylated c-met. When the neuronal cultures were treated with a pharmacological inhibitor of c-met, PHA665752, the length of axotomy-induced outgrowth of neurite was significantly reduced. On the other hand, the addition of recombinant HGF proteins to the neuronal culture facilitated axon outgrowth. In the nerve crush mouse model, the protein level of HGF was increased around the injury site by almost 5.5-fold at 24 h post injury compared to control mice and was maintained at elevated levels for another 6 days. The amount of phosphorylated c-met receptor in sciatic nerve was also observed to be higher than control mice. When PHA665752 was locally applied to the injury site of sciatic nerve, axon outgrowth and injury mediated induction of cJun protein were effectively inhibited, indicating the functional involvement of HGF/c-met pathway in the nerve regeneration process. When extra HGF was exogenously provided by intramuscular injection of plasmid DNA expressing HGF, axon outgrowth from damaged sciatic nerve and cJun expression level were enhanced. Taken together, these results suggested that HGF/c-met pathway plays important roles in axon outgrowth by directly interacting with sensory neurons and thus HGF might be a useful tool for developing therapeutics for peripheral neuropathy.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.bbrep.2021.100973DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7933716PMC
July 2021

Exploring How Older Adults Use a Smart Speaker-Based Voice Assistant in Their First Interactions: Qualitative Study.

Authors:
Sunyoung Kim

JMIR Mhealth Uhealth 2021 01 13;9(1):e20427. Epub 2021 Jan 13.

School of Communication and Information, Rutgers University, New Brunswick, NJ, United States.

Background: Smart speaker-based voice assistants promise support for the aging population, with the advantages of hands-free and eyes-free interaction modalities to handle requests. However, little is known about how older adults perceive the benefits of this type of device.

Objective: This study investigates how older adults experience and respond to a voice assistant when they first interact with it. Because first impressions act as strong predictors of the overall attitude and acceptability of new technologies, it is important to understand the user experiences of first exposure.

Methods: We conducted semistructured interviews with 18 people 74 years and older who had never used a smart speaker before, investigating the patterns of use, usability issues, and perspectives that older adults have when using a voice assistant for the first time.

Results: The overall first response to a voice assistant was positive, thanks to the simplicity of a speech-based interaction. In particular, a positive and polite response to complete the interaction with a voice assistant was prevalent, such as expressing gratitude or giving feedback about the quality of answers. Two predominant topics of commands made in the first interaction include asking health care-related questions and streaming music. However, most of the follow-up reactions were unfavorable because of the difficulty in constructing a structured sentence for a command; misperceptions about how a voice assistant operates; and concerns about privacy, security, and financial burdens. Overall, a speech-based interaction was perceived to be beneficial owing to its efficiency and convenience, but no other benefits were perceived.

Conclusions: On the basis of the findings, we discuss design implications that can positively influence older adults' first experiences with a voice assistant, including helping better understand how a voice assistant works, incorporating mistakes and common interaction patterns into its design, and providing features tailored to the needs of older adults.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2196/20427DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7840274PMC
January 2021

Botanical formulation, TADIOS, alleviates lipopolysaccharide (LPS)-Induced acute lung injury in mice via modulation of the Nrf2-HO-1 signaling pathway.

J Ethnopharmacol 2021 Apr 7;270:113795. Epub 2021 Jan 7.

R&D Center for Innovative Medicines, Helixmith Co., Ltd., Seoul, 07794, South Korea. Electronic address:

Ethnopharmacological Relevance: TADIOS is an herbal formulation prepared from a mixture of Taraxacum officinale (L.) Weber ex F.H.Wigg, Dioscorea batatas Decaisne and Schizonepeta tenuifolia (Benth.) Briquet. These plants have traditionally been used in Asia to treat a variety of respiratory diseases. A bulk of literature on traditional Korean medicine describe their activities and functions for respiratory problems. Therefore, we hypothesized that the combination of these plants might be effective in alleviating respiratory symptoms.

Aim Of The Study: In this study, we investigated whether TADIOS ameliorates LPS-induced acute lung injury via regulation of the Nrf2-HO-1 signaling pathway.

Materials And Methods: The LPS-induced acute lung injury mouse model was used to determine the anti-inflammatory and anti-oxidative stress effects of TADIOS. The amount of marker compounds contained in TADIOS was quantified using high-performance liquid chromatography (HPLC) analysis. The protein level of pro-inflammatory cytokines in culture supernatant was measured by ELISA. Changes in the RNA level of pro-inflammatory cytokines in mice lungs and RAW264.7 cells were measured by quantitative RT-PCR. The relative amounts of reactive oxygen species (ROS) were measured by DCF-DA assay. Western blot analysis was used to evaluate expression of cellular proteins. Effects of TADIOS on antioxidant responsive elements (AREs) were determined by luciferase assay. The severity of acute lung injury was evaluated by Hematoxylin & Eosin (H&E) staining. To test the effects of TADIOS on LPS-induced oxidative stress, myeloperoxidase (MPO) activity and the total antioxidant capacity were measured.

Results: TADIOS was prepared by extraction of a blend of these three plants by ethanol, and quality control was performed through quantification of marker compounds by HPLC and measurement of bioactivities using cell-based bioassays. In the murine macrophage cell line RAW264.7, TADIOS effectively suppressed the production of pro-inflammatory cytokines such as IL-6 and IL-1β, and also ROS induced by LPS. When RAW264.7 cells were transfected with a luciferase reporter plasmid containing nucleotide sequences for AREs, TADIOS treatment increased the level of relative luciferase units in a dose-dependent manner. In the LPS-induced acute lung injury mouse model, orally administered TADIOS alleviated lung damage and neutrophil infiltration induced by LPS. Consistent with the in vitro data, treatment with TADIOS inhibited the LPS-mediated expression of pro-inflammatory cytokines and oxidative stress, and activated the Nrf2-HO-1 axis.

Conclusion: Our data suggest the potential for TADIOS to be developed as a safe and effective therapeutics for the treatment of acute respiratory distress syndrome.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jep.2021.113795DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7832766PMC
April 2021

Memory-Enhancing Effects of Mangosteen Pericarp Water Extract through Antioxidative Neuroprotection and Anti-Apoptotic Action.

Antioxidants (Basel) 2020 Dec 30;10(1). Epub 2020 Dec 30.

College of Pharmacy and Integrated Research Institute for Drug Development, Dongguk University-Seoul, Dongguk-ro 32, Ilsandong-gu, Goyang, Gyeonggi 10326, Korea.

Mangosteen has long been utilized as a traditional medicine in Southeast Asia. Diverse extracts of mangosteen pericarp and its bioactive xanthones exhibit various bioactivities. However, the pharmacological potential of mangosteen pericarp water extract (MPW) has not been reported yet. This study used primary cultured rat cortical cells to investigate the effect of MPW on neurotoxicity. We found that MPW inhibited neurotoxicity and production of reactive oxygen species triggered by Aβ or excitatory amino acids. MPW inhibited caspase 3 activation and DNA fragmentation in Aβ- or N-methyl-D-aspartate-treated cells, suggesting an anti-apoptotic action. Additionally, MPW reduced lipid peroxidation and scavenged 1,1-diphenyl-2-picrylhydrazyl radicals, assuring its antioxidant property. Furthermore, MPW suppressed β-secretase and acetylcholinesterase activities. These findings prompted us to evaluate its effect on memory dysfunction in scopolamine-treated mice using Morris water maze test. Oral administration of MPW at the dosage of 50, 100, or 300 mg/kg for four days significantly decreased the latency time to find the platform and markedly increased the swimming time in the target quadrant. Taken together, our results suggest that MPW exerts memory-enhancing effect through antioxidative neuroprotection and anti-apoptotic action. Accordingly, MPW may have a potential to prevent or treat memory impairment associated with Alzheimer's disease.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/antiox10010034DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7823671PMC
December 2020

Screening Value of Timed Up and Go Test for Frailty and Low Physical Performance in Korean Older Population: The Korean Frailty and Aging Cohort Study (KFACS).

Ann Geriatr Med Res 2020 Dec 10;24(4):259-266. Epub 2020 Dec 10.

Elderly Frailty Research Center, Department of Family Medicine, College of Medicine, Kyung Hee University, Seoul, Korea.

Background: We evaluated the validity of the Timed Up and Go test (TUG) to screen for physical frailty and low physical performance in a nationwide community-dwelling Korean older population.

Methods: We used baseline records of 3,010 ambulatory participants with TUG data from the Korean Frailty Aging Cohort Study from 2016 to 2017. The population-specific distribution of TUG was assessed. Physical frailty was defined as ≥3 positive items in the 5-item Cardiovascular Health Study (CHS) frailty scale, and low physical performance was assessed as Short Physical Performance Battery (SPPB) scores ≤9 (ranging from 0 to 12).

Results: In men (n=1,429) and women (n=1,581), the mean TUG times were 10.3±2.7 seconds and 10.2±3.0 seconds, respectively. The cut-off TUG times for the worst quintile were 11.8 seconds in men and 12.5 seconds in women. The TUG time was correlated with both the CHS frailty scale score (standardized beta [B]=0.36, p<0.001) and SPPB total score (B=-0.22, p<0.001) in the linear regression analysis adjusted for age and sex. In the receiver operating characteristic analysis, the performance of TUG in identifying physical frailty, calculated as the area under the curve (AUC), was 0.87, while the AUC of TUG in identifying low physical performance according to SPPB was 0.86.

Conclusion: In the Korean older population, TUG can be a simple measure to identify physical frailty and low physical performance so as to identify populations that may benefit from in-depth geriatric assessments.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4235/agmr.20.0072DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7781966PMC
December 2020

Comparison of Older and Younger Adults' Attitudes Toward the Adoption and Use of Activity Trackers.

JMIR Mhealth Uhealth 2020 10 22;8(10):e18312. Epub 2020 Oct 22.

School of Communication and Information, Rutgers University, New Brunswick, NJ, United States.

Background: Activity tracking devices have significant potential in assisting older adults' health care and quality of life, but this population lags behind in the adoption of these devices. While theoretical frameworks have been introduced to explain and increase the adoption of this technology by older adults, little effort has been made to validate the frameworks with people in other age groups.

Objective: The goal of this study was to validate the theoretical framework of technology acceptance by older adults that we previously proposed through a direct comparison of the attitudes to and experiences of activity trackers in older and younger users.

Methods: Semistructured interviews were conducted with 2 groups of 15 participants to investigate their experiences of using activity trackers. The recruitment criteria included age (between 18 years and 24 years for the younger participant group or 65 years and older for the older participant group) and prior experiences of using mobile devices or apps for activity tracking for 2 months and longer.

Results: Our findings showed that the phase of perceived ease of learning as a significant influencer of the acceptance of activity trackers existed only in the older participant group, but this phase never emerged in the younger participant group. In addition, this study confirmed that other phases exist in both age groups, but 2 distinct patterns emerged according to age groups: (1) the social influence construct influenced the older participants positively but the younger participants negatively and (2) older participants' exploration in the system experiment phase was purpose-driven by particular needs or benefits but for younger participants, it was a phase to explore a new technology.

Conclusions: This study confirms the validity of the proposed theoretical framework to account for the unique aspect of older adults' technology adoption. This framework can provide theoretical guidelines when designing technology for older adults as well as when generating new investigations and experiments for older adults and technology use.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2196/18312DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7644379PMC
October 2020

Older Men Living with Spouse and Older Women Living with Spouse and Children Have Lower Frailty Prevalence: The Korean Frailty and Aging Cohort Study (KFACS).

Ann Geriatr Med Res 2020 Sep 22;24(3):204-210. Epub 2020 Sep 22.

Department of Family Medicine, Kyung Hee University Medical Center, Seoul, Korea.

Background: In older adults, the risk of frailty is higher among those who are unmarried than among those who are married. However, no study has reported about the relationship between cohabitation status and frailty.

Methods: This cross-sectional study included 2,128 community-dwelling adults aged between 70 and 84 years who underwent interviews and physical function assessments for the Korean Frailty and Aging Cohort Study. The definition of frailty was derived from the Fried frailty phenotype. Cohabitation was categorized as "living alone", "with spouse only", "with children only", and "with spouse and children".

Results: The mean age was 76 years, and 46.3% of the adults were men. After adjusting for age, education, income, nutritional status, alcohol, smoking history, Geriatric Depression Scale, Mini-Mental State Examination, Korean Activities of Daily Living, Korean Instrumental Activities of Daily Living, urinary incontinence, and polypharmacy, the odds ratios of frailty were 0.323 (95% confidence interval [CI], 0.137-0.763; p<0.001) and 1.089 (95% CI, 0.671-1.769; p=0.730) for men and women living with a spouse, respectively. The odds ratios of frailty were 0.329 (95% CI, 0.117-0.927; p=0.035) and 0.332 (95% CI, 0.123-0.891; p=0.029) for men and women living with spouse and children, respectively.

Conclusion: Men living with a spouse or with a spouse and children had a lowered prevalence of frailty, and women living with a spouse and children together had a lowered prevalence of frailty.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4235/agmr.20.0058DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7533199PMC
September 2020

Toxicity of Povidone-iodine to the ocular surface of rabbits.

BMC Ophthalmol 2020 Sep 1;20(1):359. Epub 2020 Sep 1.

College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, Korea.

Background: We evaluated the toxicity of 5% (w/v) povidone-iodine (PI) applied to the ocular surface of rabbits.

Methods: Twenty-three white rabbits were divided into four groups; these were a control group and three study groups in which the ocular surface was exposed to PI for different times. In control group, one drop of phosphate-buffered saline (PBS) was applied once for 10 min. In study groups, one drop of 5% (w/v) PI was topically applied once for 1 min, 3 min, and 10 min, and then the animals were observed for 7 days. The Schirmer test, Rose Bengal staining, corneal fluorescein staining and conjunctival impression cytology were performed on day 0, 3, and 7. After 7 days, the rabbits were sacrificed and conjunctiva and cornea were collected and evaluated by light and electron microscope. Immunofluorescence staining was also performed to detect mucin 5 subtype AC (MUC5AC).

Results: The decrease in goblet cell density, reductions in MUC5AC level and histopathological and ultrastructural changes of conjunctiva and cornea were more prominent in the 5% (w/v) PI groups than the control group (p < 0.05). Moreover, these changes were more prominent when PI was applied for 3 and 10 min rather than 1 min (both p values < 0.05).

Conclusions: 5% (w/v) povidone-iodine caused damages to the ocular surface in a time-dependent manner. Therefore, we should be aware of that excessive PI exposure during ophthalmic procedures could be a pathogenic factor of dry eye syndrome after surgery.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s12886-020-01615-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7466785PMC
September 2020

Urinary cMet as a prognostic marker in immunoglobulin A nephropathy.

J Cell Mol Med 2020 10 21;24(19):11158-11169. Epub 2020 Aug 21.

Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.

The prediction of prognosis in patients with immunoglobulin A nephropathy (IgAN) is challenging. We investigated the correlation between urinary cMet (ucMet) levels and clinical parameters and examined the effects of cMet agonistic antibody (cMet Ab) in an in vitro IgAN model. Patients diagnosed with IgAN (n = 194) were divided into three groups representing undetectable (Group 1), below-median (Group 2) and above-median (Group 3) levels of ucMet/creatinine (ucMet/Cr). Stained kidney biopsy samples were graded according to cMet intensity. Primary-cultured human mesangial cells were stimulated with recombinant tumour necrosis factor (TNF)-α and treated with cMet Ab. Our results showed that ucMet/Cr levels positively correlated with proteinuria (P < .001). During the follow-up, patients in Group 3 showed a significantly lower probability of complete remission (CR; uPCr < 300 mg/g) than those in groups 1 and 2, after adjusting for blood pressure, estimated glomerular filtration rate, and proteinuria, which influence clinical prognosis (HR 0.60, P = .038); moreover, ucMet/Cr levels were also associated with glomerular cMet expression. After TNF-α treatment, the proliferation of mesangial cells and increased interleukin-8 and intercellular adhesion molecule-1 expression were markedly reduced by cMet Ab in vitro. In conclusion, ucMet/Cr levels significantly correlated with proteinuria, glomerular cMet expression, and the probability of CR. Further, cMet Ab treatment alleviated the inflammation and proliferation of mesangial cells. Hence, ucMet could serve as a clinically significant marker for treating IgAN.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/jcmm.15636DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7576300PMC
October 2020

How Can We Evaluate Disability without Bias?

Ann Geriatr Med Res 2020 Jun 24;24(2):152-153. Epub 2020 Jun 24.

Department of Family Medicine, Kyung Hee University Medical Center, Seoul, Korea.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4235/agmr.20.0033DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7370790PMC
June 2020

Effects of Statin Use for Primary Prevention among Adults Aged 75 Years and Older in the National Health Insurance Service Senior Cohort (2002-2015).

Ann Geriatr Med Res 2020 Jun 29;24(2):91-98. Epub 2020 Jun 29.

Elderly Frailty Research Center, Department of Family Medicine, College of Medicine, Kyung Hee University, Seoul, Korea.

Background: This study aimed to identify adverse events and mortality in adults aged 75 years and older who were initially prescribed statins for primary prevention.

Methods: This retrospective study analyzed the data from the National Health Insurance Corporation-Senior Cohort from 2002 to 2015. An exact block matched model was constructed from statin user and statin non-user groups.

Results: The study sample comprised 1,370 older adults (mean age, 78 years), with 685 statin non-users matched to 685 new statin users. Compared to non-users, the adjusted hazard ratios (HRs) of new statin users were 0.83 (p=0.04) for all-cause mortality, 1.24 (p=0.03) for major adverse cardiovascular events, and 1.18 (p=0.06) for new-onset diabetes mellitus. In a sub-analysis of statin use duration, longer statin use (>5 years) was associated with a significantly lower risk of all-cause mortality (HR=0.76, p=0.01) but not with major adverse cardiovascular events (HR=0.88, p=0.36) or new-onset diabetes mellitus (HR=0.95, p=0.78) after adjusting for age, sex, body mass index, diabetes mellitus, hypertension, aspirin use, and antiplatelet use.

Conclusion: Our findings suggested that statins started for primary prevention in older adults aged 75 years and older had an advantageous effect on all-cause mortality only if used for at least 5 years.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4235/agmr.20.0028DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7370796PMC
June 2020

Role of panic appraisal in predicting the severity of panic and agoraphobic symptoms.

J Clin Psychol 2021 Jan 14;77(1):298-311. Epub 2020 Jul 14.

Department of Psychology, University of Hawaii at Hilo, Hilo, Hawaii.

Objective: The present study examined the contribution of panic appraisal (PA) dimensions to the prediction of panic and agoraphobic symptoms, above and beyond anxiety sensitivity (AS), among patients with panic disorder. PA dimensions consist of anticipated panic, perceived panic consequences, and panic coping efficacy.

Method: Panic disorder patients (N = 84, 60.7% female, M = 38 years) completed self-report measures of panic and agoraphobic symptoms, three dimensions of PA, AS, anxiety, and depression symptoms.

Results: PA dimensions significantly contributed to the prediction of overall and all facets of panic and agoraphobic symptoms, as well as anxiety symptoms, but not depressive symptoms, above and beyond AS. Of the three PA dimensions, both anticipated panic and panic coping efficacy uniquely contributed to agoraphobic avoidance after controlling for AS and the other dimensions of PA.

Conclusion: PA dimensions may emerge as an important predictor of panic and agoraphobic or anxiety symptoms.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/jclp.23028DOI Listing
January 2021

Botanical preparation HX109 inhibits macrophage-mediated activation of prostate epithelial cells through the CCL4-STAT3 pathway: implication for the mechanism underlying HX109 suppression of prostate hyperplasia.

Heliyon 2020 Jun 23;6(6):e04267. Epub 2020 Jun 23.

Helixmith Co. Ltd., 21, Magokjungang 8-ro 7-gil, Gangseo-gu, Seoul, 07794, Republic of Korea.

Benign prostatic hyperplasia (BPH) is one of the most frequently observed diseases in the elderly male population worldwide. A variety of factors such as aging, hormonal imbalance, chronic inflammation, and oxidative stress play an important role in its pathogenesis. We have previously shown that HX109, an ethanol extract prepared from 3 plants (, , and ), alleviates prostate hyperplasia in the BPH rat model and suppresses AR signaling by upregulating Ca/CAMKKβ and ATF3. In this study, we used macrophage cell lines to examine the effects of HX109 on inflammation, which is considered an important causative factor in BPH pathogenesis. In the co-culture system involving macrophage-prostate epithelial cells, HX109 inhibited macrophage-induced cell proliferation, migration and epithelial-mesenchymal transition (EMT) by inhibiting the expression of CCL4 and the phosphorylation of STAT3. Furthermore, HX109 inhibited the expression of inflammatory cytokines and the phosphorylation of p65 NF-κB in a concentration dependent manner. Taken together, our results suggested that HX109 could regulate macrophage activation and its crosstalk with prostate cells, thereby inhibiting BPH.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.heliyon.2020.e04267DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7322056PMC
June 2020

Improving prognosis communication for patients facing complex medical treatment: A user-centered design approach.

Int J Med Inform 2020 09 22;141:104147. Epub 2020 May 22.

School of Communication and Information, Rutgers University, United States. Electronic address:

Background: The understanding and processing of numerical prognostic information can be challenging for patients who suffer from disease and the stress of a diagnosis.

Objective: This paper investigates how patients diagnosed with Leukemia respond to different graph representations of prognosis information.

Methods: We conducted a user-centered design process, for which three experimental prototypes (vertical, horizontal, and pie charts) with and without animation were developed. Twelve patients diagnosed with Leukemia were recruited to evaluate the prototypes using a think-aloud interview protocol.

Results: The results showed a preference for vertical bar charts over horizontal and pie charts. In addition, we found that animating the charts to "fill-up" generally conveyed a subtle sense of positivity even when diagnosis information was negative. The value of explicitly indicating numeric values and scale varied but the results suggest that what matters to participants is having control over when such details would be seen. The results also point out that making sense of prognostic information involves balancing the tension between information utility and patient judgments about authenticity and credibility of prognosis information.

Conclusion: Our findings are important for the design and implementation of representations of prognostic information. They suggest that an appropriate visual format can reduce potential negative effects in conveying prognosis information, as well as helping patients stay positive and motivated for cure in the delivery of prognosis information.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.ijmedinf.2020.104147DOI Listing
September 2020

Functional Ambulation Profile (FAP) Score as a Potential Marker of Gait Analysis in Myotonic Dystrophy Type 1.

Front Neurol 2020 19;11:392. Epub 2020 May 19.

Department of Neurology, School of Medicine, Kyungpook National University Chilgok Hospital, Kyungpook National University, Daegu, South Korea.

Recent studies on Myotonic dystrophy type 1 (DM1) have shown profound impairments in gait, leading to falls. We analyzed functional ambulation profile (FAP) score that reflects the temporal and spatial gait characteristics and investigated correlations with the lower limb muscle magnetic resonance imaging (MRI) and 6 min walk test (6MWT). Twenty patients with DM1 and 20 controls participated in this study. The 6MWT and gait analysis including FAP scores via GAITRite were performed in all patients and controls. DM1 patients displayed slower gait, shorter stride length, shorter stance length, and lower FAP score. Among lower extremity muscles, the gastrocnemius, soleus and tibialis anterior showed the most severe fat infiltration and these crural muscles significantly correlated with FAP and 6MWT. Among crural muscles, tibialis anterior was the most important muscle affecting gait speed, whereas the gastrocnemius contributed substantially to gait instability. FAP score correlated with the muscle imaging and 6MWT in DM1. Therefore, FAP score maybe used as an non-invasive marker that reflects deterioration of gait and a possible surrogate biomarker in DM1.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3389/fneur.2020.00392DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7249254PMC
May 2020

Carbohydrate antigen 19-9 elevation without evidence of malignant or pancreatobiliary diseases.

Sci Rep 2020 06 1;10(1):8820. Epub 2020 Jun 1.

Department of Policy Research Affairs, National Health Insurance Service Ilsan Hospital, Goyang, Korea.

Although carbohydrate antigen 19-9 (CA 19-9) may be elevated in benign diseases, elevated CA 19-9 may cause a fear of cancer and unnecessary follow-up studies. Research on how to approach systematically in this case is very limited. The purpose of this study was to analyze the clinical features and the causes of CA 19-9 elevation without evidence of malignant or pancreatobiliary diseases. We retrospectively reviewed the medical records of patients who had CA 19-9 elevation (≥80 U/mL) and were found to be unrelated to cancer after follow-up. After exclusion, 192 patients were included in this study. The median level of CA 19-9 was 136.5 U/mL. The causes of CA 19-9 elevation were determined in 147 (76.6%) patients, and that was unknown in 45 (23.4%). The estimated causative diseases were hepatic diseases in 63 patients, pulmonary diseases in 32, gynecologic diseases in 38, endocrine diseases in 13, and spleen disease in 1. Of 45 patients with unknown cause, 35 had normalization of CA 19-9 and 10 had persistently elevated CA 19-9. In conclusion, CA 19-9 elevation without malignancies or pancreatobiliary diseases should be systematically evaluated and followed up. We suggest an algorithm to investigate the causes and follow up these patients.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1038/s41598-020-65720-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7264353PMC
June 2020

Korean frailty and aging cohort study (KFACS): cohort profile.

BMJ Open 2020 04 22;10(4):e035573. Epub 2020 Apr 22.

Department of Biomedical Science and Technology, College of Medicine, East-West Medical Research Institute, Kyung Hee University, Seoul, Republic of Korea

Purpose: The purpose of the Korean Frailty and Aging Cohort Study (KFACS) is to initiate a nationwide, population-based prospective cohort study of older adults living in the community to assess their frailty status and explore transitions between frailty states over time in Korea.

Participants: The KFACS is a multicentre longitudinal study with the baseline survey conducted from May 2016 to November 2017. Each centre recruited participants using quota sampling stratified by age and sex. The number of participants recruited through 2 years of baseline study from 10 centres was 3014, with each site accounting for approximately 300 participants. The inclusion criteria were: having an age of 70-84 years, currently living in the community, having no plans to move out in the next 2 years, having no problems with communication and no prior dementia diagnosis.

Findings To Date: To define physical frailty, the KFACS used a modified version of the Fried Frailty Phenotype (FFP) consisting of five components of frailty: unintended weight loss, weakness, self-reported exhaustion, slowness and low physical activity. In the baseline study of 2016-2017, 2907 of 3014 individuals fulfilled all five components of FFP. The results indicated that 7.8% of the participants (n=228) were frail, 47.0% (n=1366) were prefrail and 45.2% (n=1313) were robust. The prevalence of frailty increased with age in both sexes; in the group aged 70-74 years, 1.8% of men and 3.7% of women were frail, whereas in the 80-84 years age group, 14.9% of men and 16.7% of women were frail. Women tended to exhibit a higher prevalence of frailty than men in all age groups.

Future Plans: The KFACS plans to identify outcomes and risk factors associated with frailty by conducting a 10-year cohort study, with a follow-up every 2 years, using 3014 baseline participants.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1136/bmjopen-2019-035573DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7204935PMC
April 2020

Validation of the Korean Frailty Index in community-dwelling older adults in a nationwide Korean Frailty and Aging Cohort study.

Korean J Intern Med 2021 03 17;36(2):456-466. Epub 2020 Apr 17.

Elderly Frailty Research Center, Department of Family Medicine, Kyung Hee University School of Medicine, Seoul, Korea.

Background/aims: We aimed to assess validity of the Korean Frailty Index (KFI) and the modified KFI (mKFI) in nationwide Korean population as screening measures for frailty status in older adults.

Methods: Analysis was performed in the records of baseline assessments of 2,886 participants in the Korean Frailty Aging Cohort study from 2016 to 2017. The KFI included eight items on a history of hospitalization, self-reported health status, polypharmacy, weight loss, mood, incontinence, sensory problems, and timed up and go test. In mKFI, timed up and go test was replaced with a question whether a person can walk around a schoolyard. Cardiovascular Health Study (CHS) frailty scale was used as a gold standard.

Results: In study population (mean age, 76; 47.6% men), score of the KFI correlated with the CHS scale. The KFI correlated with common geriatric parameters including Activities of Daily Living, nutritional status, cognitive performance, and mood. As a construct validity, items of KFI correlated with CHS scale. As a criterion validity, sensitivity was 81.6%, specificity was 67.0% to predict frailty by CHS scale with the score of 3 or higher in KFI. The KFI and mKFI correlated with each other (R2 = 0.88), and prediction ability for frailty by CHS scale was not significantly differed between KFI and mKFI.

Conclusion: The KFI and mKFI are valid instruments for frailty screening and might be useful as simple frailty screening tools to identify older adults who might benefit from comprehensive geriatric assessment and integrated, multidisciplinary geriatric care services.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3904/kjim.2019.172DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7969080PMC
March 2021

What are the illnesses associated with frailty in community-dwelling older adults: the Korean Frailty and Aging Cohort Study.

Korean J Intern Med 2020 07 9;35(4):1004-1013. Epub 2020 Apr 9.

Elderly Frailty Research Center, Department of Family Medicine, Kyung Hee University College of Medicine, Seoul, Korea.

Background/aims: Frailty is mainly due to an age-related decrease in the physiological reserves needed to maintain biological homeostasis, but it can also occur as a result of chronic diseases. The purpose of this study was to identify illnesses associated with frailty in Korean community-dwelling older adults.

Methods: This was a cross-sectional study that included 2,936 older adults aged between 70 and 84 years who had completed both interviews and physical function assessments for the Korean Frailty and Aging Cohort Study. Current illnesses diagnosed by physicians were included in the analysis. The definition of frailty was derived from the Fried frailty phenotype.

Results: The prevalence of hypertension, diabetes mellitus (DM), arthritis, osteoporosis, urinary incontinence, and lung disease (including asthma, chronic obstructive pulmonary disease, and chronic bronchitis) was higher in the frail group (p < 0.05). After adjusting for age, sex, physical activity, alcohol, smoking, education, and presence of a spouse, the odds ratios for DM and urinary incontinence in frailty were 1.51 (95% confidence interval [CI], 1.10 to 2.01; p = 0.01) and 1.88 (95% CI, 1.11 to 3.18; p = 0.02).

Conclusion: In Korean community-dwelling older adults, DM and urinary incontinence were associated with frailty after adjusting for various factors. In the future, the list of comorbid diseases that are appropriate for Korean population-specific frailty assessment should be inventoried.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3904/kjim.2019.097DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7373975PMC
July 2020

cMet agonistic antibody attenuates apoptosis in ischaemia-reperfusion-induced kidney injury.

J Cell Mol Med 2020 05 2;24(10):5640-5651. Epub 2020 Apr 2.

Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.

Acute kidney injury (AKI) is a very common complication with high morbidity and mortality rates and no fundamental treatment. In this study, we investigated whether the hepatocyte growth factor (HGF)/cMet pathway is associated with the development of AKI and how the administration of a cMet agonistic antibody (Ab) affects an AKI model. In the analysis using human blood samples, cMet and HGF levels were found to be significantly increased in the AKI group, regardless of underlying renal function. The administration of a cMet agonistic Ab improved the functional and histological changes after bilateral ischaemia-reperfusion injury. TUNEL-positive cells and Bax/Bcl-2 ratio were also reduced by cMet agonistic Ab treatment. In addition, cMet agonistic Ab treatment significantly increased the levels of PI3K, Akt and mTOR. Furthermore, after 24 hours of hypoxia induction in human proximal tubular epithelial cells, treatment with the cMet agonistic Ab also showed dose-dependent antiapoptotic effects similar to those of the recombinant HGF treatment. Even when the HGF axis was blocked with a HGF-blocking Ab, the cMet agonistic Ab showed an independent dose-dependent antiapoptotic effect. In conclusion, cMet expression is associated with the occurrence of AKI. cMet agonistic Ab treatment attenuates the severity of AKI through the PI3K/Akt/mTOR pathway and improves apoptosis. cMet agonistic Ab may have important significance for the treatment of AKI.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/jcmm.15225DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7214182PMC
May 2020

Asian Working Group for Sarcopenia: 2019 Consensus Update on Sarcopenia Diagnosis and Treatment.

J Am Med Dir Assoc 2020 03 4;21(3):300-307.e2. Epub 2020 Feb 4.

National Center for Geriatrics and Gerontology, Obu, Aichi, Japan. Electronic address:

Clinical and research interest in sarcopenia has burgeoned internationally, Asia included. The Asian Working Group for Sarcopenia (AWGS) 2014 consensus defined sarcopenia as "age-related loss of muscle mass, plus low muscle strength, and/or low physical performance" and specified cutoffs for each diagnostic component; research in Asia consequently flourished, prompting this update. AWGS 2019 retains the previous definition of sarcopenia but revises the diagnostic algorithm, protocols, and some criteria: low muscle strength is defined as handgrip strength <28 kg for men and <18 kg for women; criteria for low physical performance are 6-m walk <1.0 m/s, Short Physical Performance Battery score ≤9, or 5-time chair stand test ≥12 seconds. AWGS 2019 retains the original cutoffs for height-adjusted muscle mass: dual-energy X-ray absorptiometry, <7.0 kg/m in men and <5.4 kg/m in women; and bioimpedance, <7.0 kg/m in men and <5.7 kg/m in women. In addition, the AWGS 2019 update proposes separate algorithms for community vs hospital settings, which both begin by screening either calf circumference (<34 cm in men, <33 cm in women), SARC-F (≥4), or SARC-CalF (≥11), to facilitate earlier identification of people at risk for sarcopenia. Although skeletal muscle strength and mass are both still considered fundamental to a definitive clinical diagnosis, AWGS 2019 also introduces "possible sarcopenia," defined by either low muscle strength or low physical performance only, specifically for use in primary health care or community-based health promotion, to enable earlier lifestyle interventions. Although defining sarcopenia by body mass index-adjusted muscle mass instead of height-adjusted muscle mass may predict adverse outcomes better, more evidence is needed before changing current recommendations. Lifestyle interventions, especially exercise and nutritional supplementation, prevail as mainstays of treatment. Further research is needed to investigate potential long-term benefits of lifestyle interventions, nutritional supplements, or pharmacotherapy for sarcopenia in Asians.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jamda.2019.12.012DOI Listing
March 2020

Small molecule allosteric uncoupling of microtubule depolymerase activity from motility in human Kinesin-5 during mitotic spindle assembly.

Sci Rep 2019 12 27;9(1):19900. Epub 2019 Dec 27.

Department of Biochemistry and Molecular Biology, LSU School of Medicine & Health Sciences Center, 1901 Perdido Street, New Orleans, LA, 70112, USA.

Human Kinesin-5 (Eg5) has a large number of known allosteric inhibitors that disrupt its mitotic function. Small-molecule inhibitors of Eg5 are candidate anti-cancer agents and important probes for understanding the cellular function. Here we show that Eg5 is capable of more than one type of microtubule interaction, and these activities can be controlled by allosteric agents. While both monastrol and S-trityl-L-cysteine inhibit Eg5 motility, our data reveal an unexpected ability of these loop5 targeting inhibitors to differentially control a novel Eg5 microtubule depolymerizing activity. Remarkably, small molecule loop5 effectors are able to independently modulate discrete functional interactions between the motor and microtubule track. We establish that motility can be uncoupled from the microtubule depolymerase activity and argue that loop5-targeting inhibitors of Kinesin-5 should not all be considered functionally synonymous. Also, the depolymerizing activity of the motor does not contribute to the genesis of monopolar spindles during allosteric inhibition of motility, but instead reveals a new function. We propose that, in addition to its canonical role in participating in the construction of the three-dimensional mitotic spindle structure, Eg5 also plays a distinct role in regulating the dynamics of individual microtubules, and thereby impacts the density of the mitotic spindle.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1038/s41598-019-56173-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6934681PMC
December 2019

Characteristics of sarcopenia by European consensuses and a phenotype score.

J Cachexia Sarcopenia Muscle 2020 04 21;11(2):497-504. Epub 2019 Dec 21.

Marcus Institute for Aging Research, Hebrew Senior Life, Boston, MA, USA.

Background: We aimed to assess the clinical characteristics of sarcopenia by the original and revised European Working Group on Sarcopenia in Older People (EWGSOP 1 and 2), and to propose a new sarcopenia phenotype score (SPS) to improve relevance of clinical outcomes.

Methods: Analyses were performed in 1408 older adults of the Aging Study of PyeongChang Rural Area, a community-based cohort in Korea. For sarcopenia definitions, we used EWGSOP 1, EWGSOP 2, and SPS, a new index counting number of abnormal domains among components of grip strength, gait speed, or muscle mass. Frailty status by the frailty index and the Cardiovascular Health Study frailty score was compared with sarcopenia measures. Prediction ability for composite outcome combining death and institutionalization due to functional decline was assessed among sarcopenia measures.

Results: Generally, sarcopenia spectrum by both EWGSOP 1 and 2 was associated with worse functional status in parameters of geriatric assessments. However, population who were considered as sarcopenic by EWGSOP 1, but not by EWGSOP 2, showed increased risk of composite outcome and worse frailty status, compared with people who were classified as not sarcopenic by both EWGSOP 1 and 2. With SPS, dose-response relationship was observed with both frailty status and outcome prediction. Prediction for composite outcome was better in SPS than in EWGSOP 2 classification.

Conclusions: A new SPS might be used to classify sarcopenic burden in older adults to resolve possible inconsistencies in phenotype correlation and outcome prediction of EWGSOP 2 criteria.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/jcsm.12507DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7113507PMC
April 2020

Chemical-genetic profiling reveals limited cross-resistance between antimicrobial peptides with different modes of action.

Nat Commun 2019 12 16;10(1):5731. Epub 2019 Dec 16.

Synthetic and Systems Biology Unit, Institute of Biochemistry, Biological Research Centre, Szeged, Hungary.

Antimicrobial peptides (AMPs) are key effectors of the innate immune system and promising therapeutic agents. Yet, knowledge on how to design AMPs with minimal cross-resistance to human host-defense peptides remains limited. Here, we systematically assess the resistance determinants of Escherichia coli against 15 different AMPs using chemical-genetics and compare to the cross-resistance spectra of laboratory-evolved AMP-resistant strains. Although generalizations about AMP resistance are common in the literature, we find that AMPs with different physicochemical properties and cellular targets vary considerably in their resistance determinants. As a consequence, cross-resistance is prevalent only between AMPs with similar modes of action. Finally, our screen reveals several genes that shape susceptibility to membrane- and intracellular-targeting AMPs in an antagonistic manner. We anticipate that chemical-genetic approaches could inform future efforts to minimize cross-resistance between therapeutic and human host AMPs.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1038/s41467-019-13618-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6915728PMC
December 2019

Randomized clinical trial of capnometry-assisted respiratory training in veterans with posttraumatic stress disorder hyperarousal.

Psychol Trauma 2019 Dec 5. Epub 2019 Dec 5.

VA Palo Alto Health Care System.

Objective: To investigate whether capnometry-assisted antihyperventilation respiratory training, successful in treating panic, and sleep hygiene instructions would reduce posttraumatic stress disorder (PTSD) hyperarousal symptoms in U.S. military veterans.

Method: We conducted a parallel, nonblinded clinical trial and randomized 80 veterans with PTSD hyperarousal into treatment or wait list. Primary treatment outcomes from baseline to 1st follow-up were analyzed using mixed modeling. Baseline physiological measures were compared between the PTSD hyperarousal group and a no-PTSD group ( = 68).

Results: Baseline respiration rate but not partial-pressure of end-tidal carbon dioxide (PCO₂) was higher in the PTSD hyperarousal group than in the no-PTSD group during 3 min of quiet sitting, indicating no difference in baseline hyperventilation. There was no significant effect of the intervention on PTSD hyperarousal symptoms or hyperventilation compared to wait list, but treatment did lower respiratory rate.

Conclusion: This intervention did not reduce PTSD hyperarousal symptoms, perhaps due to differences between underlying mechanisms of PTSD hyperarousal and panic disorder or to differences between veteran and civilian populations. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1037/tra0000525DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7272253PMC
December 2019

Estimating quality of life with biomarkers among older Korean adults: A machine-learning approach.

Arch Gerontol Geriatr 2020 Mar - Apr;87:103966. Epub 2019 Nov 9.

Department of Family Medicine, SMG- SNU Boramae Medical Center 20, Boramae-ro 5-gil, Dongjak-gu, Seoul 07061, Republic of Korea. Electronic address:

Background: While health-related quality of life (HRQoL) has clinical value, its determinants, particularly objective health-related measurements, have not been fully explored. This study seeks to identify the biological indicators that relate to HRQoL among a group of older Korean adults using a machine-learning approach.

Methods: We used physical and mental scores from the 36-item Short Form Health Survey (SF-36) to measure HRQoL among older Korean adults who participated in the Korean Longitudinal Study of Aging (KLoSA) biomarker pilot study (N = 385). The variables for the multivariate penalized regression analysis included demographic factors, medical measurements, physical performance, and health-related behaviors.

Results: The multivariate profiles identified several significant biomarkers that relate to quality of life. Among the 20 variables, handgrip strength was the most powerful indicator in both men and women for the SF-36 physical scores, followed by walking speed. Age and total sleep duration exclusively were significantly associated with the SF-36 physical scores only in women, whereas body mass index, blood pressure, and sit-to-stand times were unique elements in men.

Conclusions: The present study suggests significant physical indicators that explain quality of life in elderly populations, using a data-driven approach. Based on these findings, maintaining a good level of physical performance is considered a key element of successful aging.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.archger.2019.103966DOI Listing
September 2020

Association of Intestinal Alkaline Phosphatase With Necrotizing Enterocolitis Among Premature Infants.

JAMA Netw Open 2019 11 1;2(11):e1914996. Epub 2019 Nov 1.

Department of Biochemistry and Molecular Biology, Louisiana State University School of Medicine and Health Sciences Center, New Orleans.

Importance: Necrotizing enterocolitis (NEC) in preterm infants is an often-fatal gastrointestinal tract emergency. A robust NEC biomarker that is not confounded by sepsis could improve bedside management, lead to lower morbidity and mortality, and permit patient selection in randomized clinical trials of possible therapeutic approaches.

Objective: To evaluate whether aberrant intestinal alkaline phosphatase (IAP) biochemistry in infant stool is a molecular biomarker for NEC and not associated with sepsis.

Design, Setting, And Participants: This multicenter diagnostic study enrolled 136 premature infants (gestational age, <37 weeks) in 2 hospitals in Louisiana and 1 hospital in Missouri. Data were collected and analyzed from May 2015 to November 2018.

Exposures: Infant stool samples were collected between 24 and 40 or more weeks postconceptual age. Enrolled infants underwent abdominal radiography at physician and hospital site discretion.

Main Outcomes And Measures: Enzyme activity and relative abundance of IAP were measured using fluorometric detection and immunoassays, respectively. After measurements were performed, biochemical data were evaluated against clinical entries from infants' hospital stay.

Results: Of 136 infants, 68 (50.0%) were male infants, median (interquartile range [IQR]) birth weight was 1050 (790-1350) g, and median (IQR) gestational age was 28.4 (26.0-30.9) weeks. A total of 25 infants (18.4%) were diagnosed with severe NEC, 19 (14.0%) were suspected of having NEC, and 92 (66.9%) did not have NEC; 26 patients (19.1%) were diagnosed with late-onset sepsis, and 14 (10.3%) had other non-gastrointestinal tract infections. For severe NEC, suspected NEC, and no NEC samples, median (IQR) fecal IAP content, relative to the amount of IAP in human small intestinal lysate, was 99.0% (51.0%-187.8%) (95% CI, 54.0%-163.0%), 123.0% (31.0%-224.0%) (95% CI, 31.0%-224.0%), and 4.8% (2.4%-9.8%) (95% CI, 3.4%-5.9%), respectively. For severe NEC, suspected NEC, and no NEC samples, median (IQR) enzyme activity was 183 (56-507) μmol/min/g (95% CI, 63-478 μmol/min/g) of stool protein, 355 (172-608) μmol/min/g (95% CI, 172-608 μmol/min/g) of stool protein, and 613 (210-1465) μmol/min/g (95% CI, 386-723 μmol/min/g) of stool protein, respectively. Mean (SE) area under the receiver operating characteristic curve values for IAP content measurements were 0.97 (0.02) (95% CI, 0.93-1.00; P < .001) at time of severe NEC, 0.97 (0.02) (95% CI, 0.93-1.00; P < .001) at time of suspected NEC, 0.52 (0.07) (95% CI, 0.38-0.66; P = .75) at time of sepsis, and 0.58 (0.08) (95% CI, 0.42-0.75; P = .06) at time of other non-gastrointestinal tract infections. Mean (SE) area under the receiver operating characteristic curve values for IAP activity were 0.76 (0.06) (95% CI, 0.64-0.86; P < .001), 0.62 (0.07) (95% CI, 0.48-0.77; P = .13), 0.52 (0.07) (95% CI, 0.39-0.67; P = .68), and 0.57 (0.08) (95% CI, 0.39-0.69; P = .66), respectively.

Conclusions And Relevance: In this diagnostic study, high amounts of IAP protein in stool and low IAP enzyme activity were associated with diagnosis of NEC and may serve as useful biomarkers for NEC. Our findings indicated that IAP biochemistry was uniquely able to distinguish NEC from sepsis.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1001/jamanetworkopen.2019.14996DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6902776PMC
November 2019