203 research outputs found

    PCN91 PROVISION OF QUALITY OF LIFE INFORMATION AND PHYSICIAN TRUST AMONG FAMILIES OF CHILDREN WITH LIFE-LIMITED CONDITIONS

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    Various Jobs of Proteolytic Enzymes in Skeletal Muscle during Unloading: Facts and Speculations

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    Skeletal muscles, namely, postural muscles, as soleus, suffer from atrophy under disuse. Muscle atrophy development caused by unloading differs from that induced by denervation or other stimuli. Disuse atrophy is supposed to be the result of shift of protein synthesis/proteolysis balance towards protein degradation increase. Maintaining of the balance involves many systems of synthesis and proteolysis, whose activation leads to muscle adaptation to disuse rather than muscle degeneration. Here, we review recent data on activity of signaling systems involved in muscle atrophy development under unloading and muscle adaptation to the lack of support

    Longitudinal associations among asthma control, sleep problems, and health-related quality of life in children with asthma: a report from the PROMIS® Pediatric Asthma Study

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    Few studies have investigated the complex relationship among asthma control, sleep problems, and health-related quality of life (HRQOL) among children with asthma. This study aimed to test the longitudinal effect of asthma control status on asthma-specific HRQOL through the mechanism of nighttime sleep quality and daytime sleepiness

    Comparing and Contrasting A Priori and A Posteriori Generalizability Assessment of Clinical Trials on Type 2 Diabetes Mellitus

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    Clinical trials are indispensable tools for evidence-based medicine. However, they are often criticized for poor generalizability. Traditional trial generalizability assessment can only be done after the trial results are published, which compares the enrolled patients with a convenience sample of real-world patients. However, the proliferation of electronic data in clinical trial registries and clinical data warehouses offer a great opportunity to assess the generalizability during the design phase of a new trial. In this work, we compared and contrasted a priori (based on eligibility criteria) and a posteriori (based on enrolled patients) generalizability of Type 2 diabetes clinical trials. Further, we showed that comparing the study population selected by the clinical trial eligibility criteria to the real- world patient population is a good indicator of the generalizability of trials. Our findings demonstrate that the a priori generalizability of a trial is comparable to its a posteriori generalizability in identifying restrictive quantitative eligibility criteria

    Cultural differences in daily coupling of subjective views of aging and negative affect

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    Objectives The established link between subjective views of aging (VoA) and well-being shows variations across different cultures. Although VoA show daily fluctuations, little is known about cultural differences in such fluctuations and the daily coupling of VoA and well-being. We compared Israeli Arabs to Israeli Jews in the daily coupling of VoA and negative affect (NA). Methods Community-dwelling older adults (N=76, Mage=66.71) completed measures of subjective age, subjective accelerated aging, ageist attitudes, and NA over 14 consecutive days. Results Respondents reported higher daily NA when they felt older, reported to be aging faster, or had more ageist attitudes. The daily coupling between subjective age/subjective accelerated aging and NA was stronger among Israeli Arabs compared to Israeli Jews. There was no such interaction with ageist attitudes. Discussion It is important to adopt a cultural perspective when investigating daily fluctuations in VoA and their correlates. In applied contexts, this might help to identify cultural groups that are particularly sensitive to the effects of VoA

    The impact of CHIP premium increases on insurance outcomes among CHIP eligible children

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    Background: Within the United States, public insurance premiums are used both to discourage private health policy holders from dropping coverage and to reduce state budget costs. Prior research suggests that the odds of having private coverage and being uninsured increase with increases in public insurance premiums. The aim of this paper is to test effects of Children's Health Insurance Program (CHIP) premium increases on public insurance, private insurance, and uninsurance rates. Methods: The fact that families just below and above a state-specific income cut-off are likely very similar in terms of observable and unobservable characteristics except the premium contribution provides a natural experiment for estimating the effect of premium increases. Using 2003 Medical Expenditure Panel Survey (MEPS) merged with CHIP premiums, we compare health insurance outcomes for CHIP eligible children as of January 2003 in states with a two-tier premium structure using a cross-sectional regression discontinuity methodology. We use difference-in-differences analysis to compare longitudinal insurance outcomes by December 2003. Results: Higher CHIP premiums are associated with higher likelihood of private insurance. Disenrollment from CHIP in response to premium increases over time does not increase the uninsurance rate. Conclusions: When faced with higher CHIP premiums, private health insurance may be a preferable alternative for CHIP eligible families with higher incomes. Therefore, competition in the insurance exchanges being formed under the Affordable Care Act could enhance choice

    A Study of Generative Large Language Model for Medical Research and Healthcare

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    There is enormous enthusiasm and concerns in using large language models (LLMs) in healthcare, yet current assumptions are all based on general-purpose LLMs such as ChatGPT. This study develops a clinical generative LLM, GatorTronGPT, using 277 billion words of mixed clinical and English text with a GPT-3 architecture of 20 billion parameters. GatorTronGPT improves biomedical natural language processing for medical research. Synthetic NLP models trained using GatorTronGPT generated text outperform NLP models trained using real-world clinical text. Physicians Turing test using 1 (worst) to 9 (best) scale shows that there is no significant difference in linguistic readability (p = 0.22; 6.57 of GatorTronGPT compared with 6.93 of human) and clinical relevance (p = 0.91; 7.0 of GatorTronGPT compared with 6.97 of human) and that physicians cannot differentiate them (p < 0.001). This study provides insights on the opportunities and challenges of LLMs for medical research and healthcare

    Вопросы диагностики и патогенеза хронической алкогольной миопатии

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    Peripheral neuromuscular apparatus lesion is a common complication of chronic alcohol intoxication. Alcohol-induced skeletal muscle diseaseis least studied now. A comprehensive clinical, neurophysiological, and morphological examination was made in 42 patients with chronic alcoholintoxication during this study. All the patients underwent skeletal muscle biopsy followed by muscle fiber morphometry. There was both selective type 2 muscle fiber atrophy and diffuse types 1 and 2 muscle fiber atrophic changes. The clinical manifestations of skeletal muscle disease corresponded to the degree of an atrophic process. There was impairment in the main components of protein synthesis at both intracellular and systemic regulation levels.Поражение периферического нервно-мышечного аппарата – частое осложнение хронической алкогольной интоксикации. Наименее изучено в настоящее время поражение скелетных мышц алкогольного генеза. В ходе настоящего исследования проведено комплексное клиническое, нейрофизиологическое, морфологическое обследование 42 пациентов с хронической алкогольной интоксикацией. Всем пациентам проводилась биопсия скелетной мышцы с последующей морфометрией мышечных волокон. Отмечались как селективная атрофия мышечных волокон 2-го типа, так и диффузные атрофические изменения мышечных волокон 1-го и 2-го типов. Клинические проявления поражения скелетных мышц соответствовали выраженности атрофического процесса. Выявлено нарушение основных звеньев синтеза белка как на внутриклеточном, так и на системном уровне регуляции
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