Associations entre les caractéristiques physiques et nutritionnelles et les concentrations circulantes de caroténoïdes chez les hommes et les femmes

L'adhésion aux recommandations nutritionnelles est un élément important d'un mode de vie sain aidant à la prévention de maladies chroniques. Cependant, les professionnels de la santé considèrent que l'évaluation des habitudes alimentaires constitue un défi compte tenu des biais potentiels des questionnaires alimentaires qui sont souvent fondés sur des données auto-déclarées. Les concentrations circulantes de caroténoïdes sont souvent utilisées dans la validation des outils d'évaluation diététique notamment parce qu’elles sont considérées comme des biomarqueurs fiables de la consommation de caroténoïdes alimentaires ainsi que de celle de légumes et fruits (L&F). Cependant, nous avons préalablement rapporté une différence sexuelle dans les concentrations plasmatiques de caroténoïdes, les femmes affichant des concentrations plus élevées par rapport aux hommes. Le but de mon travail de maîtrise était d'identifier les déterminants des concentrations plasmatiques de caroténoïdes. Nous avons donc compilé des données de participants d’une série d'interventions nutritionnelles entièrement contrôlées et effectuées par notre groupe au cours des dernières années. Ces données nous ont permis d’évaluer les déterminants physiques et métaboliques qui, au-delà des apports en L&F, prédisaient les concentrations de caroténoïdes circulants chez l’homme et la femme. Nos résultats suggèrent que le poids corporel et les concentrations circulantes de cholestérol des lipoprotéines de densité élevée (high-density lipoproteins, HDL) contribuent à la différence des concentrations plasmatiques de caroténoïdes observée entre les hommes et les femmes. Nos travaux suggèrent que l’adiposité de même que le profil lipidique devraient être pris en compte lorsque les concentrations plasmatiques de caroténoïdes sont utilisées comme biomarqueurs de la consommation de caroténoïdes (ou des aliments qui en contiennent) chez les hommes et les femmes.Adherence to nutritional recommendations is an important part of leading a healthy lifestyle and preventing chronic diseases. However, health professionals consider the evaluation of eating habits to be a challenge given the potential biases of dietary questionnaires which are frequently based on self-reported data. Circulating carotenoid concentrations, which are considered reliable biomarkers of dietary carotenoid intake as well as of fruits and vegetables consumption, are often used in the validation of dietary assessment tools. However, our group demonstrated the presence of a sex difference in circulating carotenoids as women have been reported to display higher concentrations compared to men. Therefore, the aim of our study was to identify determinants of plasma carotenoid concentrations. We compiled data from men and women enrolled in a series of fully-controlled dietary interventions we conducted in recent years. This data allowed us to evaluate the physical and metabolic determinants, beyond fruit and vegetable intake, which predicted circulating carotenoid concentrations in men and women. and determined the contribution of various physical and metabolic determinants to circulating carotenoids in men and women. We found that body weight and circulating high-density lipoprotein cholesterol concentrations contribute to the difference in circulating carotenoid concentrations noted between men and women. Our results suggest that variations in physical characteristics and the plasma lipid profile should be taken into account when using plasma carotenoids as biomarkers of food intake in men and women

Under-Display Fingerprint Sensor System

This publication describes techniques for embedding an under-display fingerprint sensor (UDFPS) system, without increasing the thickness of an electronic device (e.g., smartphone) and/or decreasing the storage capacity of a battery of the smartphone. The described techniques allow a manufacturer to embed the UDFPS system outside the planar footprint of the battery of the smartphone. Also, these techniques enhance user experience by assembling the UDFPS system closer to the bottom edge of the smartphone, may enable the removal of a display flex support (backer), and may decrease the shear stress of a display bend of a display screen of the smartphone, increasing the mechanical strength the display screen

Adaptive User Interface for a Camera Aperture within an Active Display Area

This publication describes systems and techniques to account for an active display area around a camera aperture in a “hole-punch” style display of an electronic device to reduce a light-leaking effect caused by pixels surrounding the camera aperture. Illuminated pixels that are proximate to the camera aperture can degrade a quality of an image captured by a camera sensor by preventing the sensor from properly detecting light from a targeted image, such as a user’s face. To counteract this image degradation, techniques described herein override the illumination control for pixels surrounding the hole in the display. For example, responsive to the camera being engaged, one or more rings of pixels around the display hole can be controlled to have a decreased illumination level based on ambient brightness. The decreased illumination can involve being commanded to be turned off or being commanded to illuminate at a lower level. With less light emanating from pixels that are proximate to the display hole, there is less light pollution funneled into the camera aperture to affect the camera sensor

Individualized Absolute Risk Calculations for Persons with Multiple Chronic Conditions: Embracing Heterogeneity, Causality, and Competing Events

Approximately 75% of adults over the age of 65 years are affected by two or more chronic medical conditions. We provide a conceptual justification for individualized absolute risk calculators for competing patient-centered outcomes (PCO) (i.e. outcomes deemed important by patients) and patient reported outcomes (PRO) (i.e. outcomes patients report instead of physiologic test results). The absolute risk of an outcome is the probability that a person receiving a given treatment will experience that outcome within a pre-defined interval of time, during which they are simultaneously at risk for other competing outcomes. This allows for determination of the likelihood of a given outcome with and without a treatment. We posit that there are heterogeneity of treatment effects among patients with multiple chronic conditions (MCC) largely depends on those coexisting conditions. We outline the development of an individualized absolute risk calculator for competing outcomes using propensity score methods that strengthen causal inference for specific treatments. Innovations include the key concept that any given outcome may or may not concur with any other outcome and that these competing outcomes do not necessarily preclude other outcomes. Patient characteristics and MCC will be the primary explanatory factors used in estimating the heterogeneity of treatment effects on PCO and PRO. This innovative method may have wide-spread application for determining individualized absolute risk calculations for competing outcomes. Knowing the probabilities of outcomes in absolute terms may help the burgeoning population of patients with MCC who face complex treatment decisions

Accounting for the Hierarchical Structure in Veterans Health Administration Data: Differences in Healthcare Utilization between Men and Women Veterans

Women currently constitute 15% of active United States of America military service personnel, and this proportion is expected to double in the next 5 years. Previous research has shown that healthcare utilization and costs differ in women US Veterans Health Administration (VA) patients compared to men. However, none have accounted for the potential effects of clustering on their estimates of healthcare utilization. US Women Veterans are more likely to serve in specific military branches (e.g. Army), components (e.g. National Guard), and ranks (e.g. officer) than men. These factors may confer different risk and protection that can affect subsequent healthcare needs. Our study investigates the effects of accounting for the hierarchical structure of data on estimates of the association between gender and VA healthcare utilization. The sample consisted of data on 406,406 Veterans obtained from VA's Operation Enduring Freedom/ Operation Iraqi Freedom roster provided by Defense Manpower Data Center - Contingency Tracking System Deployment File. We compared three statistical models, ordinary, fixed and random effects hierarchical logistic regression, in order to assess the association of gender with healthcare utilization, controlling for branch of service, component, rank, age, race, and marital status. Gender was associated with utilization in ordinary logistic and, but not in fixed effects hierarchical logistic or random effects hierarchical logistic regression models. This points out that incomplete inference could be drawn by ignoring the military structure that may influence combat exposure and subsequent healthcare needs. Researchers should consider modeling VA data using methods that account for the potential clustering effect of hierarchy

Longitudinal Patterns of Potentially Inappropriate Medication Use Following Incident Dementia Diagnosis

Introduction: Potentially inappropriate medication (PIM) use in older adults with dementia is an understudied area. We assessed longitudinal changes in PIM exposure by dementia type following dementia diagnosis. Methods: We followed 2448 participants aged ≥ 65 years (52% women, 85.5% Caucasian, mean age 80.9 ± 7.5 years) diagnosed with dementia after enrollment in the National Alzheimer\u27s Coordinating Center (2005-2014). We estimated the association between dementia type and PIM annually for 2 years after diagnosis, using Generalized Estimating Equations. Results:Participants with Lewy body dementia had more PIM use, and participants with frontotemporal dementia had less PIM use than participants with Alzheimer\u27s disease. In the first year following diagnosis, total number of medications increased, on average, by 10% for Alzheimer\u27s disease and 15% for Lewy body dementia (P \u3c .05 for both). Discussion: A tailored approach aimed at optimizing drug therapy is needed to mitigate PIM exposure to improve medical care for individuals with dementia

Associations between home deaths and end-of-life nursing care trajectories for community-dwelling people: a population-based registry study

Background: Few studies have estimated planned home deaths compared to actual place of death in a general population or the longitudinal course of home nursing services and associations with place of death. We aimed to investigate trajectories of nursing services, potentially planned home deaths regardless of place of death; and associations of place of death with potentially planned home deaths and nursing service trajectories, by analyzing data from the last 90 days of life. Methods: A retrospective longitudinal study with data from the Norwegian Cause of Death Registry and National registry for statistics on municipal healthcare services included all community-dwelling people who died in Norway 2012–2013 (n = 53,396). We used a group-based trajectory model to identify joint trajectories of home nursing (hours per week) and probability of a skilled nursing facility (SNF) stay, each of the 13 weeks leading up to death. An algorithm estimated potentially planned home deaths. We used a multinomial logistic regression model to estimate associations of place of death with potentially planned home deaths, trajectories of home nursing and short-term SNF. Results: We identified four home nursing service trajectories: no (46.5%), accelerating (7.6%), decreasing (22.1%), and high (23.5%) home nursing; and four trajectories of the probability of a SNF stay: low (69.0%), intermediate (6.7%), escalating (15.9%), and increasing (8.4%) SNF. An estimated 24.0% of all deaths were potentially planned home deaths, of which a third occurred at home. Only high home nursing was associated with increased likelihood of a home death (adjusted relative risk ratio (aRRR) 1.29; CI 1.21–1.38). Following any trajectory with elevated probability of a SNF stay reduced the likelihood of a home death. Conclusions: We estimated few potentially planned home deaths. Trajectories of home nursing hours and probability of SNF stays indicated possible effective palliative home nursing for some, but also missed opportunities of staying at home longer at the end-of-life. Continuity of care seems to be an important factor in palliative home care and home death.publishedVersio

Correlates of the difference in plasma carotenoid concentrations between men and women

Health professionals consider the evaluation of eating habits to be challenging, given the potential biases of dietary questionnaires based on self-reported data. Circulating carotenoid concentrations are reliable biomarkers of dietary carotenoid intake and could be useful in the validation of dietary assessment tools. However, there is a sex difference in circulating carotenoids, with women displaying higher concentrations compared with men independent of intake. The aim of the present study was to identify the correlates of plasma carotenoid concentrations among men (n 155) and women (n 110) enrolled in six fully controlled dietary interventions with varying dietary carotenoid intakes. We looked at the associations of post-intervention fasting plasma carotenoid concentrations (α-carotene, β-carotene, β-cryptoxanthin, lutein, lycopene and zeaxanthin) with physical and metabolic characteristics. We found that increased body weight (r –0·47, P<0·0001) and waist circumference (r –0·46, P <0·0001) were associated with lower plasma total carotenoid concentrations, while elevated plasma LDLcholesterol (r 0·49, P<0·0001) and HDL-cholesterol (r 0·50, P<0·0001) concentrations were correlated with higher total carotenoids in plasma. Women had significantly higher plasma total carotenoid concentrations compared with men, despite significantly lower dietary carotenoid intake. Adjustment of circulating carotenoid concentrations for plasma HDL-cholesterol eliminated sex difference in plasma carotenoid concentrations. Our results suggest that physical characteristics as well as plasma lipids are associated with circulating carotenoid concentrations and that these variables should be taken into account when using plasma carotenoids as biomarkers for food intake in men and women

Sequence Analysis of Cardiometabolic Multimorbidity and Association with Subsequent Dementia

Sequence analysis is used in the social sciences to examine patterns of events occurring across the life course, but there are few examples of its use in multimorbidity research among older adults. We used sequence analysis to identify longitudinal patterns of cardiometabolic multimorbidity over a five-year period among participants in the National Health and Aging Trends Study (N=5,218). Multimorbidity sequences were constructed using self-reported diagnosis of diabetes, heart disease, stroke, and myocardial infarction (MI) assessed annually. Death was included as an absorbing state, yielding a total of 281 distinct sequences. We calculated sequence dissimilarity using optimal matching then used hierarchical clustering to identify seven distinct sequence clusters. The largest cluster (46.2%) was characterized by no baseline cardiometabolic disease and minimal incident disease across the 5-year period. Three clusters were characterized by stable sequences: diabetes (13.1%), heart disease (7.5%), and MI or stroke (7.3%) across the 5-year period. Two clusters exhibited a high rate of incident cardiometabolic disease during the 5-year period, one among persons with no baseline disease (9.6%) and one with rapid accumulation of cardiometabolic multimorbidity (5.3%). Finally, one cluster largely contained persons who died during the study period (11.0%). Compared to those with no baseline and minimal incident cardiometabolic disease, the odds of subsequent dementia were significantly higher among the cluster without prior disease who developed incident cardiometabolic disease (OR= 1.61, 95% CI:1.07,2.43) and the cluster with high cardiometabolic multimorbidity (OR=2.77, 95% CI:1.84,4.18). These findings contribute to our understanding of the impact of cardiometabolic multimorbidity on cognitive health

Impact of Anticholinergic Burden on Cognitive Performance: A Cohort Study of Community-Dwelling Older Adults

Older people are susceptible to the adverse effects of anticholinergic medications, including cognitive impairment. A systematic review of observational studies reported mixed associations between high anticholinergic burden, a cumulative measure of anticholinergic medications, and cognitive performance in older people. Observational studies may have biased estimates of the impact of exposures, as the exposed and unexposed may systematically differ in covariates associated with the outcomes