Group Of Individuals Research Articles

Utilizing the Banana S-Adenosyl-L-Homocysteine Hydrolase Allergen to Identify Cross-Reactive IgE in Ryegrass-, Latex-, and Kiwifruit-Allergic Individuals.

Food allergies mediated by specific IgE (sIgE) have a significant socioeconomic impact on society. Evaluating the IgE cross-reactivity between allergens from different allergen sources can enable the better management of these potentially life-threatening adverse reactions to food proteins and enhance food safety. A novel banana fruit allergen, S-adenosyl-L-homocysteine hydrolase (SAHH), has been recently identified and its recombinant homolog was heterologously overproduced in E. coli. In this study, we performed a search in the NCBI (National Center for Biotechnology Information) for SAHH homologs in ryegrass, latex, and kiwifruit, all of which are commonly associated with pollen-latex-fruit syndrome. In addition, Western immunoblot analysis was utilized to identify the cross-reactive IgE to banana SAHH in the sera of patients with a latex allergy, kiwifruit allergy, and ryegrass allergy. ClustalOmega analysis showed more than 92% amino acid sequence identity among the banana SAHH homologs in ryegrass, latex, and kiwifruit. In addition to five B-cell epitopes, in silico analysis predicted eleven T-cell epitopes in banana SAHH, seventeen in kiwifruit SAHH, twelve in ryegrass SAHH, and eight in latex SAHH, which were related to the seven-allele HLA reference set (HLA-DRB1*03:01, HLA-DRB1*07:01, HLA-DRB1*15:01, HLA-DRB3*01:01, HLA-DRB3*02:02, HLA-DRB4*01:01, HLA-DRB5*01:01). Four T-cell epitopes were identical in banana and kiwifruit SAHH (positions 328, 278, 142, 341), as well as banana and ryegrass SAHH (positions 278, 142, 96, and 341). All four SAHHs shared two T-cell epitopes (positions 278 and 341). In line with the high amino acid sequence identity and B-cell epitope homology among the analyzed proteins, the cross-reactive IgE to banana SAHH was detected in three of three latex-allergic patients, five of six ryegrass-allergic patients, and two of three kiwifruit-allergic patients. Although banana SAHH has only been studied in a small group of allergic individuals, it is a novel cross-reactive food allergen that should be considered when testing for pollen-latex-fruit syndrome.

Clinical efficacy of titanium prepared platelet rich fibrin in periodontal regeneration: A systematic review and meta-analysis

Background Periodontal regeneration therapies frequently involve autologous platelet concentrates (APCs). They can be used in sinus lift surgeries and socket preservation, among other clinical settings. Platelet rich fibrin (PRF) membrane has been used to treat gingival recession in individuals or groups of individuals using a coronally progressed or lateral pedicle flap. In the treatment of mixed periodontic endodontic lesion/furcation defect, PRF functions as a healing and interpositional biomaterial, filling a cystic cavity. PRF is known to help the bone regeneration process. In the last few years, efforts have been made to enhance the PRFs characteristics and quality. One of them is titanium platelet rich fibrin (T-PRF). Third-generation platelet concentrate no longer contains silica, and its preparation in glass vacuum containers, that no longer creates any known concerns. The effectiveness PRF’s has been evaluated in connective tissue and bone repair. The aim of this study is to compare T-PRF to other platelet concentrates and different treatment modalities for periodontal regenerative procedures. Methods A protocol of this systematic review have been registered in prospero (CRD42022293545). The online database searched were PUBMED, COCHRANE for published articles up to November 2022 without language restrictions. Studies in trial registers, handsearching, bibliographic references of relevant articles were also checked. Data collection and analysis was done by individual authors. Independent eligibility assessments were conducted by four review authors. Then, using the standard Cochrane methodology, four review authors extracted the data and evaluated the risk of bias for individual studies. We developed “Summary of findings” tables and used GRADE to evaluate the evidence. Results Three studies were included for meta-analysis. Results of meta-analysis supported that T-PRF is effective for correction of both hard and soft tissue defects. Conclusions The overall qualitative and quantitative analysis suggest that T-PRF has superior structural properties and thicker fibrin network for ensuring predictable success periodontal regenerative procedures.

Public Education Investment, Economic Growth and Welfare: A Political Economy Analysis with Preference Heterogeneity

This study examines the politics of public education policy and its impact on economic growth and welfare under intergenerational altruism. The study considers an endogenous growth model with altruistic overlapping generations. Due to its significant role in promoting long-term economic expansion, we consider investment in public education to be an effective tool of productive government intervention. Nonetheless, public educational investment has been the subject of political disputes owing to its inherent intergenerational redistributive implications. Backed by the tendency of democratically elected governments to maintain their political power, the preferences of some particular individuals or group of individuals become more dominant in the political process of determining the level of public investment in education. In particular, governments are more concerned with the preferences of the median voter, or the current generation at large, because they, as electors, have the ability to determine the next government. This reality leads governments to exhibit a bias toward the desires of these people. As a result, such political considerations divert the economy from its optimal path of economic growth and reduce the welfare of future generations. This effect becomes more pronounced when individuals with lower levels of altruism toward their offspring assume a more influential position in the political decision-making process over the allocation of public funds for education. Our theoretical analyses demonstrate the implications for economic growth and welfare resulting from policy decisions made by democratically elected governments with inherent biases, as opposed to decisions made by an unbiased social planner.

Ethical and Medicolegal Issues: When Obstetric Patients Who Refuse Blood Products Change Their Minds

(Anesth Analg. 2024;138(1):89–95) Patients with postpartum hemorrhage (PPH) often need blood transfusions, but there are groups of individuals who are morally or religiously against receiving transfused blood products. The most prominent religious group to refuse transfusions are Jehovah’s witnesses (JW); some may accept minor blood components such as albumin or cell salvage, but many refuse at least major blood components. The preferences and beliefs of these patients must be considered, along with ethical and legal implications surrounding the medical decisions during PPH. This article examines the implications, ethically and legally, of patients who are awake and able to participate in conversations about blood transfusions and change their minds about wanting to proceed, arguing that it is ethically necessary in specific circumstances for a physician to reassess a patient’s wishes mid-crisis and follow through with those decisions.

Uncovering the digital payment divide: Understanding the importance of cash for groups at risk

AbstractThe transition to digital payments is an ongoing trend, yet cash remains important for a substantial and diverse group of individuals. This emerges from a study using rich payment diary data of Dutch consumers. A total of 7% of the respondents report always using cash at points of sale and 28% indicate they cannot do without cash. Cash is especially important for people with low digital literacy, people who are blind or visually impaired, people with limited or no hand function, people with a mild intellectual disability and people who find it difficult to make ends meet on their income. Even though many parties involved in the payment industry are developing their payment solutions to enhance accessibility for a broader audience, there will continue to be people for whom the use of digital payments poses significant challenges. It is therefore essential that cash remains accessible and available.

#2293 Cardiac autonomic neuropathy: an independent risk factor for renal decline in diabetic kidney disease

Abstract Background and Aims Diabetic kidney disease (DKD) is the leading cause of chronic kidney disease (CKD) and end stage kidney disease (ESKD) in the UK and worldwide. Due to its unpredictability and incurable nature, novel risk factors associated with incidence and progression of DKD need to be identified. One such factor is cardiac autonomic neuropathy (CAN). Many studies over last 30 years had demonstrated a significant relationship between CAN and incidence and progression of DKD using estimated glomerular filtration rate (eGFR) and urinary albumin creatinine ratio (UACR) as end points. However, no prospective studies have looked into relationship between CAN diagnosed by gold standard cardiac autonomic reflex tests (CARTs) and DKD with different prognostic risks as per KDIGO classification. The aim of the study is to examine this relationship further. Method Data from 91 participants (type 1 and type 2 DM) with eGFR >30 ml/min/1.73 m2 who underwent assessment for CAN using CARTs as per O'Brien's and Ewing's criteria during baseline visits performed between 2007 and 2010 were collected. Additional participants (n = 113) were also recruited in 2021 as part of iBEAt study which is an EU-funded, multi-centre renal imaging study to identify novel biomarkers for DKD. Data analysis for 204 participants in total was performed for this study. CAN was defined as 2 or more abnormal CARTs out of 5 (Table 1). The level of prognostic risk was calculated based on eGFR (G1-G5) and UACR (A1-A3), following KDIGO risk table from 2012 CKD guidelines. eGFR was calculated by chronic kidney disease epidemiology collaboration (CKD-EPI) equation and UACR was assessed by early morning urine sample. Participants were categorised as follow: low risk, moderate risk and high risk. Due to limited numbers of participants with G3 in eGFR, we have combined ‘high risk’ and ‘very high risk’ into one group. CAN was divided into 2 groups—with and without CAN. Differences in proportions were examined using chi-square test. The association between baseline CAN and risk of renal decline was assessed using multinominal logistic regression adjusted for baseline age, HbA1c, ACEi/ARBs use, retinopathy status, total cholesterol and triglyceride. If significant differences were found, individual groups were compared by Bonferroni post hoc test. All analyses were performed in SPSS (version 29.0) and correlations were considered significant if p < 0.05. Results We analysed data of 204 participants (130 T1DM, 74 T2DM), 44.6% (n = 91) of them were women, mean (SD) age at baseline visit was 51 (15.7) years, eGFR 82.6 (13) ml/min/1.73 m2, UACR 5.2 (21.8) mg/mmol, duration of diabetes at baseline 19.7 (12.3) years and 36.8% had hypertension. Baseline eGFR and UACR were available for 198 and 193 participants respectively. Of these, 42.9% (85/198) had G1, 47.5 (94/198) had G2 and 9.6 (19/198) had G3. For UACR, 80.8% (156/193) had A1, 15.5% (30/193) had A2 and 3.6% (7/193) had A3. 53.4% (103/204) of participants had CAN and 46.6% (101/204) had no CAN. A higher proportion of participants was in low prognostic risk category 77.8% (154/198), followed by 13.1% (26/198) with moderate risk and 9.8% (18/198) with high risk for CKD progression. The risk of DKD progression was significantly associated with presence of CAN in multinominal logistic regression analysis (p = 0.020). The presence of CAN was closely related to low risk (95% CI: 1.44 to 22.04, p = 0.013) and moderately increased risk (95% CI: 1.03 to 24.7, p = 0.04). The participants with moderate and high risk had lower eGFR (p < 0.001) and higher UACR with increased risk (p < 0.001) (Table 2). This finding was independent of baseline age, HbA1C, retinopathy, ACEI/ARB use, type of diabetes, cholesterol and triglyceride levels at baseline as measured by logistic regression. Conclusion To our knowledge, this is one of the first studies to examine the relationship between presence of CAN in three stages of prognostic risk in DKD. We demonstrated that presence of CAN was an independent risk factor for decline in renal function in DKD. Further large prospective studies are required to confirm the findings of this study and examine the underlying mechanisms how CAN leads to greater risk of DKD.

#2247 Influence of the diagnosis of atopic dermatitis in childhood on the course of kidney function in young adulthood: a single-center study

Abstract Background and Aims Several studies demonstrated non-osmotic sodium-storage, especially in the skin. Patients with chronic kidney disease often suffer from skin symptoms and furthermore an association of advanced CKD-stages with inflammatory skin diseases has been shown. Additionally, in inflammatory skin disease atopic dermatitis an increased salt content was found in the affected skin areas. Thus we hypothesized that atopic dermatitis might have a detrimental effect on kidney function later in life. Method The retrospective case-control study using the patient files of a general medical practice included a randomly selected sample with a 2:1 matching technique. Initially, data of 114 patients who underwent J1-screening exam for adolescents (age 12-14) and also a follow-up examination in adulthood (over the age of 18) between January 1980 and April 2022 have been examined. By the time of inclusion they had to be over 18 years old and did not suffer knowingly from a kidney disease. Over the course of the study, patients for whom no creatinine value was recorded during the following examinations were excluded. Serum creatinine levels and eGFR were compared between the two groups at two assessment times (J1 in adolescence and Follow-Up in young adulthood) and within each group using a one-tailed t-test. A point-biserial correlation analysis was then performed. Results Biometric characteristics, gender distribution and kidney function for J1 as the first measurement point and for follow-up in young adulthood as the second one for both atopic dermatitis and control group are shown in Table 1. The statistical analysis showed that the two groups did not differ significantly in terms of gender distribution at both the first (X²(89) = 0.4918, p = 0.483103) and the second measuring point (X²(73) = 0.45, p = 0.50), therefore a gender bias in the results is unlikely. Furthermore, it was shown by a one-tailed, unpaired t-test for serum creatinine levels ​​at time J1 did not differ from those in the control group (t = 0.60, p = 0.28). This applies too for the corresponding eGFR according to Schwartz-Bedside (t = -0.47, p = 0.32). At the time of follow-up, 16 patients, 8 per group, were excluded due to a lack of creatinine values ​​- in this study using a hypothesis test, no significant difference in the creatinine values ​​was found between the two groups (t = 0.91, p = 0.18), consequently also not in the comparison of eGFR after CKD-Epi (t = -1.28, p = 0.10). Only when comparing creatinine values ​​and eGFR over time within the individual groups, a significant difference for each group was found. In the atopic dermatitis group, the creatinine levels and the eGFR differed significantly in between J1 and the follow-up examination (creatinin: t = 4.29, p = 0.00015, eGFR: t = 1.83, p = 0.042). Likewise did the creatinine levels and the eGFR differ significantly over time in the control group (creatinine: t = 4.77, p < 0.00001 and eGFR: t = 5.72, p < 0.0001). In the point-biserial correlation analysis, no connection between the presence of atopic dermatitis and the level of the serum creatinine value could be confirmed (t = 0.6, df = 89, p = 0.55, 95% CI [-0.14, 0.27], r = 0.063). Conclusion In our study, the diagnosis of atopic dermatitis in childhood does not seem to be a determinant risk factor for a decline in kidney function in young adulthood.

#2213 APOL1 high-risk genotype in in a Dutch multi-ethnic population

Abstract Background and Aims The presence of 2 APOL1 high-risk alleles (high-risk APOL1 genotype) is associated with an increased risk of ESKD. In the USA, the prevalence of these high-risk alleles is high in people of West African descent and almost absent in patients from European descent. In Amsterdam, there is a significant number of people from Surinam, and (West-) Africa. A big group of Surinamese individuals have a West African heritage. The prevalence, however, of high-risk APOL1 genotype in the Netherlands and thereby the significance is unknown. The aim of this research was to investigate the prevalence of the APOL1 risk alleles in a multi-ethnic cohort of the Amsterdam general population consisting of individuals of African Surinamese, Ghanaian, Moroccan and Dutch origin. Second we correlate the presence of these risk alleles to blood pressure, kidney function and proteinuria. Method HELIUS is a multi-ethnic prospective cohort study including people aged 18-70 who were randomly selected, stratified by ethnic origin, from the Amsterdam general population. Baseline examination took place tween 2011 and 2015. We analysed a population of 5971 individuals with available genotype data, of whom 1287 were of Dutch, 3048 of Moroccan, 1156 of African Suriname and 480 of Ghanaian descent. APOL1 risk was determined by genotyping two APOL1 missense variants, rs73885319A>G, S342G; rs60910145T>G, I384M, together constitute the G1 high-risk allele and the 6-base pair deletion allele, rs71785313 RRRATAA/−, N388Y399/−−, is the G2 high risk allele. Logistic regression analyses were performed to determine correlation between creatinine, eGFR, and systolic blood pressure and apol1 high risk genotype, with additional adjustments for age, sex, and BMI. Results The prevalence of high-risk APOL1 genotype was 4.17% in the total sample, in African Surinamese 9.5%, and in the Ghanaian 29.0%. There were no individuals with high risk genotype in the Moroccan or Dutch descent population. The presence of high risk APOL1 genotype was associated with an elevated creatinine level of 10.68 µmol/L (SD 0.91) in the whole cohort. Also, in the Surinamese and Ghanaian populations population the presence of the high-risk APOL1 genotype was associated with an increased creatinine of 2.6 µmol/L (SD 1.00) as compared to the black population with low-risk APOL1 genotype. People with high-risk APOL1 genotype had significantly higher systolic blood pressure 10.69 mmHg (SD 0.091) than those without. Nevertheless, there was no significant difference in systolic blood pressure in the black population with high-risk APOL1 genotype in comparison with the black population with low-risk APOL1 genotype 1.38 mmHg (SD 1.17). Also, there was no significant difference in eGFR (CKD CKD-EPI 2009) in any analysis and no differences in proteinuria was seen, between those with and without the high-risk APOL1 genotype. Conclusion In this population, the overall prevalence of the APOL1 risk alleles seems to conform to the African American population in the USA. There is however a much higher prevalence of high-risk APOL1 genotype in the Ghanaian in comparison to the African Surinamese. The group with high-risk APOL1 genotype had significantly higher creatinine levels and higher systolic blood pressure. However there was no significant difference in blood pressure within the black population between APOL1 high-risk genotype and low-risk genotype. There was no significant difference in eGFR, possibly because the CKD-EPI 2009 formula was used which overestimates the eGFR in the black population. Better calculation with cysteine C possibly gives different outcomes. In conclusion, this is the first study in Europe investigating the prevalence of APOL1 high-risk genotype in a large population-based cohort. APOL1 risk alleles, and high-risk genotype, are prevalent in our population of African descent. More analysis in this cohort are pending and also longitudinal data will follow.

Transforming ghosts into ancestors: A call to action

AbstractThe psychological case for reparations offers a framework for understanding the emotional complexity inherent in the centuries‐long resistance to granting reparations to African Americans for its three hundred years of chattel slavery and its legacies—Jim Crow, redlining, mass incarceration, extrajudicial killings, and voter suppression. A central component of the resistance is moral injury, which Bryan Nichols and I maintain is the primary reason why the concept of reparations is so emotionally charged. The disavowal of the collective trauma for both the formerly enslaved and former slave owners creates moral wounds which show up as metaphorical ghosts that haunt US culture. Behavioral scientists who understand the complexity of both individual and large group dynamics are called upon to acknowledge and repair the intergenerational moral wounds of chattel slavery and assume leadership in the reparative process—to “transform ghosts into ancestors.”

#2291 ANCA negative vasculitis—the unmet need within small vessel vasculitis

Abstract Background and Aims ANCA negative small vessel vasculitis with renal involvement has been described in a number of cohorts. Though comprehensive studies comparing these individuals to ANCA positive patients are lacking and they are routinely excluded from clinical trials. Whilst the numbers are smaller than those with ANCA positivity, they still make up a large proportion of small vessel vasculitidies (Fig. 1). The absence of detectable circulating ANCA is thought to indicate a distinct spectrum of the disease. There remains unanswered questions regarding the pathophysiology, diagnosis and management of patients with seronegative AAGN. We present data from Croatian referral center. Method Study included 106 AAV patients with biopsy proven renal involvement in the period from 2007-2017. Category variables were analysed with Fisher Exact test and continuous with Kruskal-Wallis test. Statistical difference was then analysed post hoc with Chi-square test. Kaplan Meyer survival analysis and multivariate Cox proportional hazard regression analysis were used to explore difference between clinical phenotypes and finding significant predictors regarding outcomes which were defined as combined outcome end-stage renal disease and death (ESRDD), ESRD alone, the death outcome alone and relapse rate. Results 106 AAV patients with renal involvement were included: 66 (61.1%) MPA, 20 (18.5%) GPA, 20 (18.5%) RLV. 14 (13%) were PR3-ANCA positive, 57 (52.8%) MPO ANCA positive, 5 (4.6%) PR3-ANCA+MPO-ANCA and 32 (29.6%) ANCA negative patients. ANCA negative patients were comparatively younger (p = 0.02) and presented with more renal limited vasculitis (RLV; p < 0.001), lower BVAS (p = 0.003) and lower CRP (p = 0.001). ANCA negative patients usually presented with nephrotic syndrome compared to positive ones which presented with rapid progressive nephritic syndrome or acute nephritic syndrome (p = 0.027). 24-hour proteinuria levels were higher in ANCA negative group (p = 0.003). Though statistical difference was not reached, there was tendency for ANCA negatives to receive less plasmapheresis (p = 0.074). Histologically there were no differences between ANCA positive and ANCA-negative patients. On sub analysis ANCA negatives versus individual seropositive groups, there was tendency that ANCA negatives and MPO-ANCA patients had lower percentage of glomerular crescents (p = 0.092) but more acute tubular damage (p = 0.087). There were no differences in clinical outcomes between the groups. Conclusion ANCA negative vasculitis form a large proportion of small vessel vasculitidies and present with different clinical laboratory and histological (renal) characteristics than ANCA positive ones. More often than not disease seems to be renal limited and patients tend to be younger. Due to the rarity of the disease, there remains unanswered questions regarding the pathophysiology, diagnosis and management of these patients. This study highlights noteworthy distinctions between the two groups. Whether these differences warrant adjustments in treatment algorithms or a reconsideration of the classification of small vessel vasculitis remains to be determined. Further investigation into the pathogenetic mechanisms of seronegative AAVs is essential.

Influence of Pre-treatment of Withania somnifera Root Extract and Cow Urine on Hemato-biochemical Parameters in Acetaminophen-induced Toxicity in Swiss Albino Male Mice

Background: The present study was undertaken to investigate protective activity of W. somnifera root extract (W.S.R.E.), cow urine (C.U.) and their combination against acetaminophen (APAP) induced toxicity in male mice. APAP also known as paracetamol, is a well-known drug used for its analgesic and antipyretic effects. However, outside of the therapeutic window, the toxicity may result. W.S. and C.U. are from indigenous sources of plant and animal origins, respectively with several therapeutic activities. Methods: Sixty adult swiss albino male mice were randomly divided into six groups, comprising of ten mice in each group. Group I (control group) received 2% gum acacia suspension for 14 days orally and on day 14, 0.9% NaCl (@300 mg/kg b.wt.) intraperitoneally was administered after 30 min of prior treatment of various agents. Group II, III, IV, V and VI received 2% gum acacia, silymarin (@25 mg/kg b.wt.), W.S.R.E. (@100 mg/kg b.wt.), C.U. (@7.8 mL/kg b.wt.) and W.S.R.E. (@100 mg/kg b.wt.) and C.U. (@7.8 mL/kg b.wt.) co-treatment orally for 14 days and on day 14, APAP (@300 mg/kg b.wt.) intraperitoneally was administered after 30 min of prior treatment of various agents as mentioned. On 15th day, the animals were sacrificed and samples were collected to study various hematobiochemical and growth related parameters. Result: The treatment of acetaminophen caused significant decrease in haemoglobin, total erythrocyte count whereas increase in total leucocyte and prothrombine time. There were significant (p£0.05) decreases in plasma total protein, albumin and globulin values in group II (APAP), as compared to control (group I). Treatment with W.S. +C.U attenuates these alterations. W.S.R.E., C.U. and their combination pre-treatment mildly restored the changes to normal observed following APAP exposure in mice. However, the results of co-treatment group were more pronounced as compared to individual treatment groups. Thus, it was concluded that treatment with W.S.R.E. and C.U. curtailed the toxic effect of APAP, however, co-administration of both potentiated the protective effect.

Synergistic Amelioration of Letrozole-induced Polycystic Ovary Syndrome in Rats: A Therapeutic Approach with Apple Cider Vinegar and Metformin Combination.

The present study was conducted to evaluate the combination effect of apple cider vinegar (ACV) and metformin against letrozole-induced polycystic ovary syndrome (PCOS).Female Wistar rats were administered letrozole (1mg/kg/day, p.o) for 21 days, except for the control group of animals. On the 22nd day, PCOS-induced animals were segregated into 4 groups and administered with CMC, ACV, metformin, and a combination of ACV and metformin, respectively. The treatments were continued for 15 days, and on the 36th day, all the animals were sacrificed for biochemical (blood glucose, lipid profile), hormonal (sex hormones and adiponectin), and pro-inflammatory mediator estimations in blood samples. The ovarian tissue samples were used for oxidative stress parameters and histological alterations.The PCOS control animals showed a significant alteration in the estrous cycle. The administration of letrozole resulted in the alteration of hormonal balance and elevation of body weights, glycemic state, lipid profile, pro-inflammatory mediators in serum, and oxidative stress in ovarian samples. Individual treatment groups and combination treatment groups reversed the letrozole-induced alterations in PCOS animals, and more promising results were observed with combination therapy than with individual treatment groups. Further, the therapeutic potential of the combination treatment group was also confirmed by the histological observations in the ovarian samples.The study showed that the combination of ACV and metformin significantly alleviated letrozole-induced PCOS complications in rats. This might have been achieved by mitigating the hormonal imbalance, pro-inflammatory, hyperglycemic, and hyperlipidemic states in serum, and oxidative stress in the ovary samples.

Walking on a Balance Beam as a New Measure of Dynamic Balance to Predict Falls in Older Adults and Patients with Neurological Conditions.

Beam walking is a new test to estimate dynamic balance. We characterized dynamic balance measured by the distance walked on beams of different widths in five age groups of healthy adults (20, 30, 40, 50, 60years) and individuals with neurological conditions (i.e., Parkinson, multiple sclerosis, stroke, age: 66.9years) and determined if beam walking distance predicted prospective falls over 12months. Individuals with (n = 97) and without neurological conditions (n = 99, healthy adults, age 20-60) participated in this prospective longitudinal study. Falls analyses over 12months were conducted. The summed distance walked under single (walking only) and dual-task conditions (walking and serial subtraction by 7 between 300 to 900) on three beams (4, 8, and 12-cm wide) was used in the analyses. Additional functional tests comprised grip strength and the Short Physical Performance Battery. Beam walking distance was unaffected on the 12-cm-wide beam in the healthy adult groups. The distance walked on the 8-cm-wide beam decreased by 0.34m in the 20-year-old group. This reduction was ~ 3 × greater, 1.1m, in the 60-year-old group. In patients, beam walking distances decreased sharply by 0.8m on the 8 versus 12cm beam and by additional 1.6m on the 4 versus 8cm beam. Beam walking distance under single and dual-task conditions was linearly but weakly associated with age (R2 = 0.21 for single task, R2 = 0.27 for dual-task). Age, disease, and beam width affected distance walked on the beam. Beam walking distance predicted future falls in the combined population of healthy adults and patients with neurological conditions. Based on receiver operating characteristic curve analyses using data from the entire study population, walking ~ 8.0 of the 12m maximum on low-lying beams predicted future fallers with reasonable accuracy. Balance beam walking is a new but worthwhile measure of dynamic balance to predict falls in the combined population of healthy adults and patients with neurological conditions. Future studies are needed to evaluate the predictive capability of beam walking separately in more homogenous populations. Clinical Trial Registration Number NCT03532984.

‘I didn't know it was you’: The impersonal grounds of relational normativity

AbstractA notable feature of our moral and legal practices is the recognition of privileges, powers, and entitlements belonging to a select group of individuals in virtue of their status as victims of wrongful conduct. A philosophical literature on relational normativity purports to account for this status in terms of such notions as interests, rights, and attitudes of disregard. This paper argues that such individualistic notions cannot account for prevailing and intuitive ways of demarcating the class of victims. The paper is focused on the wrongful infliction of harm, and centers on the mediating role played by impersonal “danger‐making properties” in the determination of the class of victims. The paper begins with an analysis of one of the most well‐ known discussions of negligently‐inflicted harm — from the most famous case of the American common law tradition, Palsgraf v. Long Island Railroad Co. — and the analysis is then extended to the morality of harm‐doing more broadly, negligent and intentional alike. The paper's chief targets are interest theories of rights — including contractualist theories of moral claim‐rights of the kind defended by R. Jay Wallace — and neo‐Strawsonian Quality of Will theories of “moral injury”.

Sepsis risk in diabetic patients with urinary tract infection.

Urinary tract infections (UTI) is a prevalent condition in those with diabetes, and in severe cases, it may escalate to sepsis. Therefore, it is important to analyze the risk variables associated with sepsis in diabetes individuals with UTI. This research was a retrospective cross-sectional analysis. From January 2011 to June 2022, a group of individuals with diabetes were identified as having UTI at a tertiary hospital situated in Southeastern China. Patient data, including information on urine culture, was collected retrospectively from a clinical record database. The participants were categorized into the sepsis and non-sepsis groups. The risk variables were derived using both uni-and multiple- variable regression analysis. The research included 1919 patients, of whom 1106 cases (57.63%) had positive urine cultures. In total, 445 blood culture samples were tested, identifying 186 positive cases (41.80%). The prevalence of bacteria in urine and blood samples was highest for Escherichia coli and Klebsiella pneumoniae, respectively. Moreover, 268 individuals (13.97%) exhibited sepsis. The regression analysis indicated a positive correlation between sepsis and albumin (ALB)<34.35 g/L, C-reactive protein (CRP)>55.84 mg/L and white blood cell count (WBC) >8.485 X 109/L in diabetic cases with UTIs. By integrating the three aforementioned parameters, the area under the receiver operating characteristic curve was 0.809. The early detection of sepsis in diabetic individuals with UTI may be achieved using a comprehensive analysis of CRP, WBC, and ALB test findings.

A Procedure for Revising Data-Based Priors in a Group

A group of individuals is interested in predicting the outcome of a current problem. Each individual has access to private data that are used to form a prior probability over possible outcomes. While individuals may be reluctant or unable to disclose their private data, they are willing to publish their priors. We characterize a procedure for revising the individuals’ prior probabilities based on the published priors of others and discuss its implications regarding the formation of a common prior in the group, both in the short and long run. This paper was accepted by Manel Baucells, behavioral economics and decision analysis. Funding: G. Gayer gratefully acknowledges support from ISF [Grant 1443/20].

Adherence to Healthy and Unhealthy Plant-Based Diets and the Risk of Gout

Plant-based diets are increasing in popularity due, in part, to their health benefits for selected cardiometabolic diseases as well as favorable environmental impact. Little is known about how such a diet is related to gout risk. To examine associations between adherence to a plant-based diet (including healthy and unhealthy versions of this diet), as well as its 18 individual food groups, and incident gout. This prospective cohort study used data from population-based cohorts of US men and women enrolled in the Health Professionals Follow-Up Study (1986-2012) and Nurses' Health Study (1984-2010). Participants were men and women free of gout at baseline. Statistical analyses were performed over March 2020 to August 2023. An overall plant-based diet index (PDI), as well as healthy (hPDI) and unhealthy (uPDI) versions of this index that emphasize healthy and less healthy plant-based foods, respectively. These diet indices were comprised of 18 food groups, assessed using a validated semiquantitative food frequency questionnaire. Incident cases of gout that were confirmed with a supplementary questionnaire to meet the preliminary American College of Rheumatology survey criteria for gout. Cox proportional hazards regression models were used to evaluate multivariable-adjusted associations of all 3 PDIs with incident gout using quintiles (Q) of adherence. Among a total of 122 679 participants (mean [SD] age, 53.8 [9.8] years among 43 703 men; mean [SD] age, 50.9 [7.2] years among 78 976 women) over 2 704 899 person-years of follow-up, 2709 participants experienced incident gout. The overall PDI was not significantly associated with gout in either cohort (Q5 vs Q1 pooled hazard ratio [HR], 1.02 [95% CI, 0.89-1.17]; P for trend = .63). In the pooled analysis, hPDI was significantly inversely associated with risk of gout (Q5 vs Q1 HR, 0.79 [95% CI, 0.69-0.91]; P for trend = .002), while the uPDI was positively associated with risk of gout (Q5 vs Q1 HR, 1.17 [95% CI, 1.03-1.33]; P for trend = .02), particularly in women (Q5 vs Q1 HR, 1.31 [95% CI, 1.05-1.62]; P for trend = .01). In analysis of individual food groups, higher intakes of certain healthy plant foods, such as whole grains (pooled HR per 1 serving/d, 0.93 [95% CI, 0.89-0.97]) and tea and coffee (pooled HR per 1 serving/d, 0.95 [95% CI, 0.92-0.97]), as well as dairy (pooled HR per 1 serving/d, 0.86 [95% CI, 0.82-0.90]), were independently associated with a lower risk of gout, while selected unhealthy plant foods, such as fruit juice (pooled HR per 1 serving/d, 1.06 [95% CI, 1.00-1.13]) and sugar-sweetened beverages (pooled HR per 1 serving/d, 1.16 [95% CI, 1.07-1.26]) were associated with increased risk of gout. The findings of this prospective cohort study of PDIs and gout support current dietary recommendations to increase consumption of healthy plant foods while lowering intake of unhealthy plant foods to mitigate gout risk.

Solution to the cocktail party problem: A time-reversal active metasurface for multipoint focusing

The cocktail party effect is the capability to focus one’s auditory attention on particular audio sources while ignoring other audio sources. We propose an experimental strategy to reproduce this ability by designing a time-dependent metasurface composed of independent active mirrors. Each active mirror is a programmable acoustic unit cell capable of hearing, computing, and re-emitting acoustic signals: each of them acts as a convolution filter. The proper configuration of the metasurface temporal filters allows one to establish an acoustic communication link between groups of individuals immersed in the noisy environment: a multiple-user multiple-input, multiple-output acoustic system is built. Published by the American Physical Society 2024

Learning Decision-Making Functions Given Cardinal and Ordinal Consensus Data

Decision-making and reaching consensus are an integral part of everyday life, and studying how individuals reach these decisions is an important problem in psychology, economics, and social choice theory. Our work develops methods and theory for learning the nature of decisions reached upon by individual decision makers or groups of individuals using data. We consider two tasks, where we have access to data on: 1) Cardinal utilities for d individuals with cardinal consensus values that the group or decision maker arrives at, 2) Cardinal utilities for d individuals for pairs of actions, with ordinal information about the consensus, i.e., which action is better according to the consensus. Under some axioms of social choice theory, the set of possible decision functions reduces to the set of weighted power means, M(u, w, p) = (∑ᵢ₌₁ᵈ wᵢ uᵢᵖ)¹ᐟᵖ, where uᵢ indicate the d utilities, w ∈ ∆_{d - 1} denotes the weights assigned to the d individuals, and p ∈ ℝ (Cousins 2023). For instance, p = 1 corresponds to a weighted utilitiarian function, and p = -∞ is the egalitarian welfare function. Our goal is to learn w ∈ ∆_{d - 1} and p ∈ ℝ for the two tasks given data. The first task is analogous to regression, and we show that owing to the monotonicity in w and p (Qi 2000}, learning these parameters given cardinal utilities and social welfare values is a PAC-learnable task. For the second task, we wish to learn w, p such that, given pairs of actions u, v ∈ ℝ₊ᵈ, the preference is given as C((u, v), w, p) = sign(ln(M(u, w, p)) - ln(M(v, w, p))). This is analogous to classification; however, convexity of the loss function in w and p is not guaranteed. We analyze two related cases - one in which the weights w are known, and another in which the weights are unknown. We prove that both cases are PAC-learnable given positive u, v by giving an O(log d) bound on the VC dimension for the known weights case, and an O(d log d) bound for the unknown weights case. We also establish PAC-learnability for noisy data under IID (Natarajan 2013) and logistic noise models for this task. Finally, we demonstrate how simple algorithms can be useful to learn w and p up to moderately high d through experiments on simulated data.

The Clinical Management of Electrical Stimulation Therapies in the Rehabilitation of Individuals with Spinal Cord Injuries.

Background: People with spinal cord injuries (SCIs) often have trouble remaining active because of paralysis. In the past, exercise recommendations focused on the non-paralyzed muscles in the arms, which provides limited benefits. However, recent studies show that electrical stimulation can help engage the paralyzed extremities, expanding the available muscle mass for exercise. Methods: The authors provide an evidence-based approach using expertise from diverse fields, supplemented by evidence from key studies toward the management of electrical stimulation therapies in individuals with SCIs. Literature searches were performed separately using the PubMed, Medline, and Google Scholar search engines. The keywords used for the searches included functional electrical stimulation cycling, hybrid cycling, neuromuscular electrical stimulation exercise, spinal cord injury, cardiovascular health, metabolic health, muscle strength, muscle mass, bone mass, upper limb treatment, diagnostic and prognostic use of functional electrical stimulation, tetraplegic hands, and hand deformities after SCI. The authors recently presented this information in a workshop at a major rehabilitation conference. Additional information beyond what was presented at the workshop was added for the writing of this paper. Results: Functional electrical stimulation (FES) cycling can improve aerobic fitness and reduce the risk of cardiovascular and metabolic diseases. The evidence indicates that while both FES leg cycling and neuromuscular electrical stimulation (NMES) resistance training can increase muscle strength and mass, NMES resistance training has been shown to be more effective for producing muscle hypertrophy in individual muscle groups. The response to the electrical stimulation of muscles can also help in the diagnosis and prognosis of hand dysfunction after tetraplegia. Conclusions: Electrical stimulation activities are safe and effective methods for exercise and testing for motor neuron lesions in individuals with SCIs and other paralytic or paretic conditions. They should be considered part of a comprehensive rehabilitation program in diagnosing, prognosing, and treating individuals with SCIs to improve function, physical activity, and overall health.