Uncontrolled Diabetes as an Associated Factor with Dynapenia in Adults Aged 50 Years or Older: Sex Differences

BACKGROUND: Epidemiological studies demonstrate an association between diabetes and low neuromuscular strength (NMS). However, none have grouped participants into non-diabetics (ND), undiagnosed diabetics (UDD), controlled diabetics (CD) and uncontrolled diabetics (UCD) or investigated what glycated hemoglobin levels (HbA1c) are associated with low NMS (dynapenia) by sex. METHODS: We analyzed the association between UDD, CD and UCD and dynapenia, the extent to which the different groupings of these individuals modifies this association and the association between HbA1c levels and NMS, by sex, in a cross-sectional study involving 5,290 participants ≥ 50 years from the ELSA study. In the first two analyses, logistic regression models were used with dynapenia (grip strength < 26kg in men and < 16kg in women) as outcome and diabetes [ND, UDD, CD and UCD] as exposure. Next, linear regression was performed with grip strength as outcome and the participants classified based on HbA1c level as exposure. The models were adjusted by sociodemographic, behavioral and clinical characteristics. RESULTS: Compared to ND only UCD was associated with dynapenia (men OR=2.37 95% CI 1.36-4.14; women OR=1.67 95% CI 1.01-2.79). This association was less clear, particularly in women, when CD and UCD groups were merged. HbA1c ≥ 6.5% in men and ≥ 8.0% in women were associated with lower NMS. CONCLUSIONS: UCD increases the chance of dynapenia in both sexes. The different groupings based on diabetes status modify the association between UCD and dynapenia. The threshold of HbA1c associated with reduced NMS is lower in men compared to women

Source Classification in Atrial Fibrillation Using a Machine Learning Approach

International audienceA precise analysis of the atrial activity (AA) signal in electrocardiogram (ECG) recordings is necessary for a better understanding of the mechanisms behind atrial fibrillation (AF). Blind source separation (BSS) techniques have proven useful in extracting the AA source from ECG recordings. However, the automated selection of the AA source among the other sources after BSS is still an issue. In this scenario, the present work proposes two contributions: i) the use of the normalized mean square error of the TQ segment (NMSE-TQ) as a new feature to quantify the AA content of a source, and ii) an automated classification of AA and non-AA sources using three well-known machine learning algorithms. The tested classifiers outperform the techniques present in literature. A pattern in the mean and standard deviation of the used features, for AA and non-AA sources, is also observed

Dynapenia, abdominal obesity or both: which accelerates the gait speed decline most?

OBJECTIVE: to investigate whether the combination of dynapenia and abdominal obesity is worse than these two conditions separately regarding gait speed decline over time. METHODS: a longitudinal study was conducted involving 2,294 individuals aged 60 years or older free of mobility limitation at baseline (gait speed >0.8 m/s) who participated in the English Longitudinal Study of Ageing. Dynapenia was determined as a grip strength 102 cm for men and >88 cm for women. The participants were divided into four groups: non-dynapenic/non-abdominal obese (ND/NAO); only abdominal obese (AO); only dynapenic (D) and dynapenic/abdominal obese (D/AO). Generalised linear mixed models were used to analyse gait speed decline (m/s) as a function of dynapenia and abdominal obesity status over an 8-year follow-up period. RESULTS: over time, only the D/AO individuals had a greater gait speed decline (-0.013 m/s per year, 95% CI: -0.024 to -0.002; P < 0.05) compared to ND/NAO individuals. Neither dynapenia nor abdominal obesity only was associated with gait speed decline. CONCLUSION: dynapenic abdominal obesity is associated with accelerated gait speed decline and is, therefore, an important modifiable condition that should be addressed in clinical practice through aerobic and strength training for the prevention of physical disability in older adults

Association of radio polar cap brightening with bright patches and coronal holes

Radio-bright regions near the solar poles are frequently observed in Nobeyama Radioheliograph (NoRH) maps at 17 GHz, and often in association with coronal holes. However, the origin of these polar brightening has not been established yet. We propose that small magnetic loops are the source of these bright patches, and present modeling results that reproduce the main observational characteristics of the polar brightening within coronal holes at 17 GHz. The simulations were carried out by calculating the radio emission of the small loops, with several temperature and density profiles, within a 2D coronal hole atmospheric model. If located at high latitudes, the size of the simulated bright patches are much smaller than the beam size and they present the instrument beam size when observed. The larger bright patches can be generated by a great number of small magnetic loops unresolved by the NoRH beam. Loop models that reproduce bright patches contain denser and hotter plasma near the upper chromosphere and lower corona. On the other hand, loops with increased plasma density and temperature only in the corona do not contribute to the emission at 17 GHz. This could explain the absence of a one-to-one association between the 17 GHz bright patches and those observed in extreme ultraviolet. Moreover, the emission arising from small magnetic loops located close to the limb may merge with the usual limb brightening profile, increasing its brightness temperature and width.Comment: 8 pages, 6 figures, 1 table. Accepted for publication in The Astrophysical Journa

Association of Serum 25-Hydroxyvitamin D Deficiency with Risk of Incidence of Disability in Basic Activities of Daily Living in Adults >50 Years of Age.

BACKGROUND: Vitamin D deficiency compromises muscle function and is related to the etiology of several clinical conditions that can contribute to the development of disability. However, there are few epidemiological studies investigating the association between vitamin D deficiency and the incidence of disability. OBJECTIVES: We aimed to assess whether vitamin D deficiency is associated with the incidence of disability in basic activities of daily living (BADL) and to verify whether there are sex differences in this association. METHODS: A 4-y follow-up study was conducted involving individuals aged 50 y or older who participated in ELSA (English Longitudinal Study of Ageing). The sample consisted of 4814 participants free of disability at baseline according to the modified Katz Index. Vitamin D was assessed by serum 25-hydroxyvitamin D [25(OH)D] concentrations and the participants were classified as sufficient (>50 nmol/L), insufficient (>30 to ≤50 nmol/L), or deficient (≤30 nmol/L). Sociodemographic, behavioral, and clinical characteristics were also investigated. BADL were re-evaluated after 2 and 4 y of follow-up. The report of any difficulty to perform ≥1 BADL was considered as an incident case of disability. Poisson models stratified by sex and controlled for sociodemographic, behavioral, and clinical characteristics were carried out. RESULTS: After 4-y follow-up, deficient serum 25(OH)D was a risk factor for the incidence of BADL disability in both women (IRR: 1.53; 95% CI: 1.16, 2.03) and men (IRR: 1.44; 95% CI: 1.02, 2.02). However, insufficient serum 25(OH)D was not a risk factor for the incidence of BADL disability in either men or women. CONCLUSIONS: Independently of sex, deficient serum 25(OH)D concentrations were associated with increased risk of incidence of BADL disability in adults >50 y old and should be an additional target of clinical strategies to prevent disability in these populations

DMC-GRASP: A continuous GRASP hybridized with data mining

The hybridization of metaheuristics with data mining techniques has been successfully applied to combinatorial optimization problems. Examples of this type of strategy are DM-GRASP and MDM-GRASP, hybrid versions of the Greedy Randomized Adaptive Search Procedure (GRASP) metaheuristic, which incorporate data mining techniques. This type of hybrid method is called Data-Driven Metaheuristics and aims at extracting useful knowledge from the data generated by metaheuristics in their search process. Despite success in combinatorial problems like the set packing problem and maximum diversity problem, proposals of this type to solve continuous optimization problems are still scarce in the literature. This work presents a data mining hybrid version of C-GRASP, an adaptation of GRASP for problems with continuous variables. We call this new version DMC-GRASP, which identifies patterns in high-quality solutions and generates new solutions guided by these patterns. We performed computational experiments with DMC-GRASP on a set of well-known mathematical benchmark functions, and the results showed that metaheuristics for continuous optimization could also benefit from using patterns to guide the search for better solutions

Combined Effect of Dynapenia (Muscle Weakness) and Low Vitamin D Status on Incident Disability

BACKGROUND AND OBJECTIVE: There is little epidemiologic evidence considering the combined effect of dynapenia and low 25-hydroxyvitamin D [25 (OH) D] on incident disability. Our aim was to investigate whether the combination of dynapenia and low 25 (OH) D serum levels increases the risk of activities of daily living (ADL) incident disability. DESIGN: Prospective cohort study. SETTINGS: English Longitudinal Study of Aging. PARTICIPANTS: A total of 4630 community-dwelling adults aged 50 years and older without ADL disability at baseline. MEASUREMENTS: The baseline sample was categorized into 4 groups (ie, nondynapenic/normal 25 (OH) D, low 25 (OH) D only, dynapenic only, and dynapenic/low 25 (OH) D according to their handgrip strength (<26 kg for men and <16 kg for women) and 25 (OH) D (≤50 nmol/L). The outcome was the presence of any ADL disability 2 years after baseline according to the modified Katz Index. Incidence rate ratios (IRRs) adjusted by sociodemographic, behavioral, and clinical characteristics were estimated using Poisson regression. RESULTS: The fully adjusted model showed that older adults with dynapenia only and those with lower serum levels of 25 (OH) D combined with dynapenia had higher incident ADL disability risk compared with nondynapenic and those with normal serum levels of 25 (OH) D. The IRRs for lower 25 (OH) D serum levels combined with dynapenia were higher than for dynapenia only, however, the confidence intervals (CIs) showed similar effect for these 2 groups. The IRRs were 1.31 for low 25(OH) D only (95% CI 0.99-1.74), 1.77 for dynapenia only (95% CI 1.08-2.88), and 1.94 for combined dynapenia and low 25(OH)D (95% CI 1.28-2.94). CONCLUSIONS: Dynapenia only and dynapenia combined with low 25 (OH) D serum levels were important risk factors for ADL disability in middle-aged individuals and older adults in 2 years of follow-up

Differences in the prevalence of prediabetes, undiagnosed diabetes and diagnosed diabetes and associated factors in cohorts of Brazilian and English older adults

OBJECTIVE: To analyse differences in the prevalence of prediabetes (PD), undiagnosed diabetes (UDD) and diagnosed diabetes (DD) and associated factors between Brazilian and English older adults. DESIGN: Cross-sectional study. SETTING: England and Brazil. PARTICIPANTS: 5301 participants of the English Longitudinal Study of Ageing study and 1947 participants of the Brazilian Longitudinal Study of Aging study classified as non-diabetics, PD, UDD and DD. RESULTS: The prevalence of PD, UDD and DD was 48·6, 3 and 9·6 % in England and 33, 6 and 20 % in Brazil. In England, the increase in age, non-white skin colour, smoking, general obesity and abdominal obesity were associated with PD, UDD and DD, whereas hypertriglyceridaemia, low HDL levels, hypertension and stroke were associated with UDD and DD. In Brazil, the increase in age was associated with DD and UDD, non-white skin colour and smoking were associated with UDD and abdominal obesity and hypertriglyceridaemia were associated with all three conditions. CVD in England and schooling in Brazil were associated with PD and DD. A sedentary lifestyle was associated with DD in both samples. CONCLUSIONS: The prevalence of diabetes was higher in the Brazilian sample. Different associated factors were found in the two samples, which may be related to differences in nutritional transition, access to healthcare services and the use of such services

Regeneração medular: a ação do neurotrophin-3 sobre a lesão medular de ratos

OBJECTIVE: For many years, it was believed that medullary regeneration could not occur, although currently there are many trials using neurotrophic factors, stem cells, fetal medulla grafts, peripheral nerve grafts, and antibodies against myelin-associated proteins that demonstrate the existence of the possibility of spinal cord regeneration. The purpose of this study was to investigate the action of neurotrophin-3, a novel neurotrophic factor. METHODS: The New York University impactor, a standardized device for delivery of spinal cord injuries was used on 33 rats, which were divided into 2 groups: a control group receiving distilled water intraperitoneally and a treatment group receiving neurotrophin-3 intraperitoneally. RESULTS: Using the Basso, Beattie, and Bresnahan scale, the locomotor recovery curve for the neurotrophin-3 treated group was superior to that of the control group (P < 0.05); the administration of neurotrophin-3 was associated with the absence of deaths, while the control group showed a 28.5% (P = 0.026) mortality rate. Other parameters (hematuria rate and histological analysis) showed no significant differences. CONCLUSIONS: Based on these results, it appears that a strong relationship exists between the use of neurotrophin-3 in rats with spinal cord injury and better functional recovery.OBJETIVO: Por muitos anos acreditou-se que a regeneração medular não fosse factível. Atualmente porém, existem várias experiências utilizando fatores neurotróficos, células troncos, enxerto de medula fetal, enxerto de nervo periférico e anticorpos contra proteínas associadas a mielina que sugerem o contrário. Esta pesquisa estudou a ação de um dos mais novos neurotróficos, o Neurotrophin-3. MÉTODOS: As lesões medulares foram realizadas através do New York University impator, método experimental de produção de lesão medular padronizada. Foram utilizados 33 ratos divididos em 2 grupos. Um grupo controle com administração intraperitoneal de água destilada e um grupo tratamento, tratado com Neurotrophin-3 por via intraperitoneal. RESULTADOS: Observamos que a curva de recuperação locomotora, segundo a escala de Basso, Beattie e Bresnahan, do grupo Neurotrophin-3 foi superior à do grupo controle (p < 0,05); a administração de Neurotrophin-3 determinou ausência de mortes no grupo tratamento, enquanto o grupo controle apresentou taxa de mortalidade de 28,5% (p = 0,026). Os outros parâmetros (taxa de hematúria e análise histológica) não apresentaram diferenças estatisticamente significantes. CONCLUSÕES: Existe forte relação entre a aplicação de Neurotrophin-3 em ratos com lesão medular e melhor recuperação funcional