Screening strategies for dysglycaemia in relation to cardiovascular risk

Background: Dysglycaemia, defined as type 2 diabetes (T2DM) or impaired glucose tolerance (IGT), is a major risk factor for cardiovascular disease (CVD). Dysglycaemia and CVD together account for more than half of worldwide mortality. Despite abundant evidence stressing the need for early detection and improved cardiovascular prevention in patients with dysglycaemia, approximately 50% of people with T2DM are undiagnosed. The early identification of dysglycaemia is key to initiating lifestyle changes and pharmacological interventions successfully to prevent cardiovascular complications. Aims: The general aim of this thesis was to evaluate different screening strategies for dysglycaemia with respect to CVD. There were four specific goals: 1) Compare the prognostic value of fasting plasma glucose (FPG), 2h postload glucose (2hPG) and HbA1c in patients with coronary artery disease (CAD) (Study I) 2) Study the prevalence of dysglycaemia in people treated for hypertension and/or dyslipidaemia but without CVD and examine whether using the Finnish Diabetes Risk Score (FINDRISC) decreases the need for blood tests in this patient population (Study II) 3) Examine the effectiveness of different outreach strategies to detect people at high risk of T2DM and/or CVD using FINDRISC (Study III) 4) Study the accuracy of a point-of-care technique used for glucose measurement compared with laboratory-based methods (Study IV). Methods: Studies I and II were based on data from the EUROASPIRE IV survey, a multicentre study of two large cohorts of patients, providing both questionnaire data and blood samples: one patient cohort with established CVD and one with hypertension and/or dyslipidaemia but without established CVD. In Study III, FINDRISC questionnaire data were collected through several outreach channels in the municipality of Södertälje. Response rate, risk level and cost effectiveness were compared across channels. In Study IV, glucose measurement data from the same patients using different laboratory methods were obtained from the EUROASPIRE V survey. Results: In Study I, 4,004 patients with CAD but no history of dysglycaemia at baseline were followed for a median of 2.03 years. The 2hPG was a significant predictor of future cardiovascular events (p=0.01) in contrast to FPG (p=0.45) or HbA1c (p=0.36). In Study II, of 2,395 patients with hypertension and/or dyslipidaemia but no history of dysglycaemia, 19% had undetected T2DM and 20% IGT. Contrary to the hypothesis, a relatively large proportion of patients with low FINDRISC scores had dysglycaemia. In Study III, the highest response rate to the FINDRISC was obtained through workplaces. The largest proportion of individuals at high risk (≥15/26 points) were outreached through the Syrian Orthodox church. The cost of identifying a person at high risk varied greatly depending on the choice of outreach strategy. Finally, in Study IV, glucose values obtained from the HemoCue® point-of-care system correlated well with gold standard hospital laboratory measurements (FPG r=0.94 and 2hPG r=0.96; p<0.05) in CAD patients in the EUROASPIRE V survey. Conclusions: Future cardiovascular events were only predicted by 2hPG in the present cohort of CAD patients. A large proportion of patients with CVD risk factors but without established CVD had undetected dysglycaemia. The use of the FINDRISC did not reduce the need for blood testing in patients with hypertension and/or dyslipidaemia. The outreach strategy affected participation rate, risk level and cost in a large-scale dysglycaemia screening. The HemoCue® point-of-care system is accurate for dysglycaemia screening, which should save time and costs when performing OGTT

18 selesai, dua belum

KUALA LUMPUR: Hanya tinggal dua universiti yang belum membentuk Majlis Perwakilan Pelajar (MPP) bagi tempoh 2012/2013, manakala 18 institusi pengajian tinggi awam (IPTA) lain sudah melangkah ke proses bantahan serta rayuan

Neurochemical markers of traumatic brain injury – relevance to acute diagnostics, disease monitoring, and neuropsychiatric outcome prediction

Considerable advancements have been made in the quantification of biofluid-based biomarkers for traumatic brain injury (TBI), which provide a clinically accessible window to investigate disease mechanisms and progression. Methods with improved analytical sensitivity compared with standard immunoassays are increasingly utilized, which has opened for the use of blood tests in the diagnosis, monitoring, and outcome prediction of TBI. Most work to date has focused on acute TBI diagnostics, whilst the literature on biomarkers for long-term sequelae is relatively scarce. In this review, we give an update on the latest developments in biofluid-based biomarker research in TBI and discuss how acute and prolonged biomarker changes can be used to detect and quantify brain injury and predict clinical outcome and neuropsychiatric sequelae

Welcome to WillowTree: Come take a closer look

The demand for more workers in tech related fields has given students the opportunity of choosing between multiple job offers and students can now be more deliberate about the jobs that they accept. Because of this employers also need to set themselves apart from other companies. Many companies do this is by sending out brochures, PDFs, and other information that may be outdated by the time it goes out. Our solution to this problem was to make an application which would provide relevant data to the user as well as provide insight into the company. The end result is a beautiful, well-made app which allows users to experience Charlottesville through the eyes of WillowTree. Constraints we faced were limited access to photos for use in the applications due to copyright issues as well as keeping consideration of easily maintainable and malleable data. We started with basic information provided to us by WillowTree then worked with them to establish goals and expectations. The end result is a mobile application which can be downloaded through the Apple App Store by anyone new to WillowTree and Charlottesville. Remaining issues are that the app is completely one-sided and does not currently collect data from the user. If this were possible then user data could be passed along to recruiters. Overall, this app will prove to be an invaluable recruiting tool for WillowTree and set WillowTree apart from other employers.https://scholarscompass.vcu.edu/capstone/1091/thumbnail.jp

Relationship between Willingness to Communicate (WTC) and Writing Ability among Afghanistan EFL Learners

The notion of willingness to communicate (WTC) is a state of readiness to speak freely, without fear at a particular time with a specific person or group of people using a foreign language. Writing ability is, therefore, defined as the ability to initiate and evolve ideas and then use certain revising and editing practices to develop them to maturity in a given context. This study aimed to investigate the relationship between Afghanistan EFL learners’ WTC and their writing ability. To perform this, 25 male learners who studied in senior English language class were selected to participate in this study. At the beginning of the research, they were asked to complete the Willingness to communicate questionnaire. Having answered the questionnaire, the participants were supposed to write a 200-word essay on a topic to show the learners’ writing ability. In the end, in order to explore the relationship between WTC and writing ability of the EFL learners, a descriptive correlational design used to achieve its objectives. The study used a descriptive correlational design to achieve its objectives. The results of the present study indicated that there was a positive significant relationship between the participants’ WTC and their writing ability

A hybrid localization method for Wireless Capsule Endoscopy (WCE)

Wireless capsule endoscopy (WCE) is a well-established diagnostic tool for visualizing the Gastrointestinal (GI) tract. WCE provides a unique view of the GI system with minimum discomfort for patients. Doctors can determine the type and severity of abnormality by analyzing the taken images. Early diagnosis helps them act and treat the disease in its earlier stages. However, the location information is missing in the frames. Pictures labeled by their location assist doctors in prescribing suitable medicines. The disease progress can be monitored, and the best treatment can be advised for the patients. Furthermore, at the time of surgery, it indicates the correct position for operation. Several attempts have been performed to localize the WCE accurately. Methods such as Radio frequency (RF), magnetic, image processing, ultrasound, and radiative imaging techniques have been investigated. Each one has its strengths and weaknesses. RF-based and magnetic-based localization methods need an external reference point, such as a belt or box around the patient, which limits their activities and causes discomfort. Computing the location solely based on an external reference could not distinguish between GI motion from capsule motion. Hence, this relative motion causes errors in position estimation. The GI system can move inside the body, while the capsule is stationary inside the intestine. This proposal presents two pose fusion methods, Method 1 and Method 2, that compensate for the relative motion of the GI tract with respect to the body. Method 1 is based on the data fusion from the Inertial measurement unit (IMU) sensor and side wall cameras. The IMU sensor consists of 9 Degree-Of-Freedom (DOF), including a gyroscope, an accelerometer, and a magnetometer to monitor the capsule’s orientation and its heading vector (the heading vector is a three-dimensional vector pointing to the direction of the capsule's head). Four monochromic cameras are placed at the side of the capsule to measure the displacement. The proposed method computes the heading vector using IMU data. Then, the heading vector is fused with displacements to estimate the 3D trajectory. This method has high accuracy in the short term. Meanwhile, due to the accumulation of errors from side wall cameras, the estimated trajectory tends to drift over time. Method 2 was developed to resolve the drifting issue while keeping the same positioning error. The capsule is equipped with four side wall cameras and a magnet. Magnetic localization acquires the capsule’s global position using 9 three-axis Hall effect sensors. However, magnetic localization alone cannot distinguish between the capsule’s and GI tract’s motions. To overcome this issue and increase tracking accuracy, side wall cameras are utilized, which are responsible for measuring the capsule’s movement, not the involuntary motion of the GI system. A complete setup is designed to test the capsule and perform the experiments. The results show that Method 2 has an average position error of only 3.5 mm and can compensate for the GI tract’s relative movements. Furthermore, environmental parameters such as magnetic interference and the nonhomogeneous structure of the GI tract have little influence on our system compared to the available magnetic localization methods. The experiment showed that Method 2 is suitable for localizing the WCE inside the body

Early synaptic hippocampal deficits in the Q175FDN mouse model of Huntington Disease

Huntington Disease (HD) is an inherited neurodegenerative disease caused by a CAG repeat expansion in the gene encoding the huntingtin protein. The resultant mutant huntingtin triggers numerous and severe neuronal abnormalities. Although motor deficits manifest during midlife, subtle cognitive aberrations can be detected prior to the onset of an overt behavioural phenotype. However, knowledge surrounding the cognitive deficits in the early stages of HD is scarce. Here, we studied hippocampal synaptic properties, including activity-dependent plasticity and nanoscale architecture in a mouse model of HD prior to the onset of motor symptoms. We focused on the hippocampus due to its involvement in cognitive function and the debilitating cognitive symptoms described by HD patients. Multi-electrode array recordings of synaptic activities revealed impairments in plasticity, while super-resolution microscopy elucidated clear alterations in synaptic nanoarchitecture of the hippocampus. Our data demonstrate detrimental effects of mHtt expression on hippocampal structure and function in presymptomatic HD

Neurofilament light and tau as blood biomarkers for sports-related concussion

OBJECTIVE: To compare neurofilament light (NfL) and tau as blood-based biomarkers for acute sports-related concussion (SRC) and determine whether their concentrations at different time points after the injury are associated with prolonged time to return to play (RTP).METHODS: A total of 288 professional hockey players were followed longitudinally from September 1, 2012, to April 30, 2015. Data collection and biomarker analyses were conducted between 2015 and 2017. Associations were tested between blood concentrations of NfL and tau, and RTP time. Serum concentrations of S100B and neuron-specific enolase (NSE) were also measured for comparison.RESULTS: Of 288 players, 105 sustained an SRC. Of these, 87 underwent blood sampling 1, 12, 36, and 144 hours after SRC and at the RTP time point. Serum NfL concentrations 1, 12, 36, and 144 hours after SRC were related to prolonged RTP time, and could separate players with RTP >10 days from those with RTP ≤10 days (area under the receiver operating characteristic curve [AUROC] 0.82). Also, serum NfL 144 hours after SRC discriminated players who resigned from the game due to persistent postconcussion symptoms (PCS) from those who returned to play (AUROC 0.89). Plasma tau 1 hour after SRC was related to RTP but less strongly than NfL, while S100B and NSE showed no such associations.CONCLUSION: Serum NfL outperformed tau, S100B, and NSE as a biomarker for SRC. From a clinical standpoint, serum NfL may be useful to identify individuals at risk of prolonged PCS, and may aid in biomarker-informed decisions with regard to when RTP should be considered