Objective Markers Research Articles

Perceptions or behavior? An evaluation of CFPB's financial well‐being scale using household financial ratios

AbstractThis article creates a typology to assess four categories of financial well‐being based on a combination of household financial ratios. Most financial well‐being scales are based on subjective measures (i.e., perceptions), as objective markers have not reliably encapsulated financial well‐being. We define a conceptual model, the equilibrium model of the household (EMH), and use discriminant analysis to extract categories of financial well‐being. The continuum of these categories is financially distressed (lowest), financially fragile, financially stable, and financially flourishing (highest). Our results demonstrate these categories are consistent with the Consumer Financial Protection Bureau's (CFPB) Financial Well‐Being Scale, a subjective scale. Higher CFPB scores were associated with higher category ranks. Our results provide additional evidence to support construct validity of the CFPB scale and may offer more actionability to the CFPB scores because specific financial outcomes/behaviors associated with our categories of financial well‐being correspond to ranges of the CFPB scale. However, we argue that the claim whereby the CFPB scale measures a concept beyond traditional financial measures is imprecise and may even reflect the existence of noise in the CFPB's data, raising questions about its reliability.

From Tissue to System: What Constitutes an Appropriate Response to Loading?

Optimal loading involves the prescription of an exercise stimulus that promotes positive tissue adaptation, restoring function in patients undergoing rehabilitation and improving performance in healthy athletes. Implicit in optimal loading is the need to monitor the response to load, but what constitutes a normal response to loading? And does it differ among tissues (e.g., muscle, tendon, bone, cartilage) and systems? In this paper, we discuss the "normal" tissue response to loading schema and demonstrate the complex interaction among training intensity, volume, and frequency, as well as the impact of these training variables on the recovery of specific tissues and systems. Although the response to training stress follows a predictable time course, the recovery of individual tissues to training load (defined herein as the readiness to receive a similar training stimulus without deleterious local and/or systemic effects) varies markedly, with as little as 30min (e.g., cartilage reformation after walking and running) or 72h or longer (e.g., eccentric exercise-induced muscle damage) required between loading sessions of similar magnitude. Hyperhydrated and reactive tendons that have undergone high stretch-shorten cycle activity benefit from a 48-h refractory period before receiving a similar training dose. In contrast, bone cells desensitize quickly to repetitive loading, with almost all mechanosensitivity lost after as few as 20 loading cycles. To optimize loading, an additional dose (≤ 60 loading cycles) of bone-centric exercise (e.g., plyometrics) can be performed following a 4-8h refractory period. Low-stress (i.e., predominantly aerobic) activity can be repeated following a short (≤ 24h) refractory period, while greater recovery is needed (≥ 72h) between repeated doses of high stress (i.e., predominantly anaerobic) activity. The response of specific tissues and systems to training load is complex; at any time, it is possible that practitioners may be optimally loading one tissue or system while suboptimally loading another. The consideration of recovery timeframes of different tissues and systems allows practitioners to determine the "normal" response to load. Importantly, we encourage practitioners to interpret training within an athlete monitoring framework that considers external and internal load, athlete-reported responses, and objective markers, to contextualize load-response data.

CYSTATIN C AS A MARKER OF EARLY KIDNEY DAMAGE UNDER ARTERIAL HYPERTENSION (LITERATURE REVIEW)

The purpose of this study is to determine kidney functional activity in relation to cystatin C levels, as reported in recent literature. Materials and Methods. A bibliographic-semantic method was employed to assess the current state of research on this topic, analyzing findings from previous scientific studies using both literature sources and electronic resources. Results. Chronic kidney disease (CKD) is as prevalent as hypertension. It is well-known that arterial hypertension exacerbates kidney function, making the assessment of renal functional activity critical. Glomerular filtration rate (GFR) is commonly used to evaluate kidney function, relying on established indicators as well as newer, more objective markers. Among these, cystatin C has emerged as one of the most accurate and sensitive indicators for assessing kidney function. Its concentration in serum negatively correlates with GFR and is particularly valuable for detecting renal pathology even when creatinine levels remain unchanged. This insight has led to the development of an estimated GFR (eGFR) formula that incorporates cystatin C levels. Research suggests that cystatin C levels increase with hypertension, although studies on the specific relationship between cystatin C and hypertension remain limited. Some findings propose that serum cystatin C could serve as a predictor of disease severity, particularly in elderly hypertensive patients with coronary heart disease. The literature supports the utility of cystatin C as a reliable marker for assessing GFR, which facilitates early detection of CKD even when albumin excretion is normal, thus identifying kidney damage at an early stage. Ppotential mechanisms by which elevated cystatin C may contribute to cardiovascular damage are under investigation. As a highly informative endogenous marker of GFR, serum cystatin C not only aids in staging CKD but is especially valuable in identifying early renal dysfunction. Conclusion. The measurement of cystatin C enables a highly accurate assessment of kidney function and aids in evaluating cardiovascular risk, especially when hypertension coexists with chronic kidney disease. Further research is needed to improve predictions of chronic kidney progression at various stages and in the presence of comorbidities. Such insights will support more effective preventive strategies to slow the progression of this pathology.

Changes in spinal curve during dentistry studies measured with a Spinal Mouse device: A five-year prospective study.

Musculoskeletal disorders (MSDs) often arise and develop during dentistry studies. The most affected regions are related to the spine. Possible associations between spinal curve parameters and MSDs have not yet been investigated amongst dentistry students. This longitudinal observational study aimed to determine whether spinal curve changes during dentistry studies, analyse the relationship between objective findings and subjectively declared MSDs and compare spinal curve parameters with those published in the literature. Seventy-three dentistry students answered a questionnaire on MSDs, and were examined using the Spinal Mouse® device at the beginning, in the middle, and at the end of their 5-year study. The spinal curve exhibited a gender diversity in the lumbar lordosis angle, sacrum inclination, and thoracolumbar ratio. From the first to fifth study year, we observed an increase in the range of motions in the sagittal and frontal planes, an increase in the maximal extent of right lateral inclination, and a decrease in maximal left lateral inclination. Whole-spine backward inclination increased only in women, and forward sacral inclination decreased. No statistically significant relationships were found between the objective findings and subjectively declared MSDs. The spinal curve shape differed between men and women and changed during dentistry studies. No objective markers or predictors of MSDs were found amongst the dentistry students. These findings can serve as a benchmark for further studies on the association between MSDs and objective findings.

Predictive ability of the Cancer and Aging Research Group chemotherapy toxicity calculator in hematologic malignancy

IntroductionChemotherapy toxicity tools are rarely studied in patients with hematologic malignancy (HM). The primary aim of this pilot study was to determine the predictive ability of the Cancer and Aging Research Group (CARG) chemo-toxicity calculator in estimating grade 3–5 toxicity in patients with HM. Materials and MethodsPatients 60 years and older with HM were prospectively evaluated using the CARG chemo-toxicity calculator. Discrimination and calibration were checked by applying the published model in our data. Additionally, a full geriatric assessment (GA), the Short Physical Performance Battery (SPPB), and health related quality of life (HRQoL) were captured longitudinally at the start of treatment and at end of study. Secondary aims explored the association of GA metrics with chemo-related toxicities and survival. ResultsOne hundred forty-five patients were approached, 118 patients consented, and 97 patients were evaluable. Most patients were newly diagnosed (n = 91). The median CARG score was 9 (range 4–18). The CARG score was not validated in our cohort of older patients with HM, with area under the receiver operation characteristic curve being 0.53 (95 % CI: 0.41–0.65). In multivariable analysis, after controlling for disease type, risk factors associated with grade 3–5 toxicity included living alone (hazard ratio [HR] 4.24, 95 %CI: 2.07–8.68, p < 0.001), increase in body mass index (HR 1.06, 95 %CI: 1.01–1.12, p = 0.03) and a higher social activities score (HR 1.27, 95 %CI: 1.06–1.51, p = 0.01). In multivariable analysis of overall survival, the only prognostic factor was an objective marker of physical function (SPPB score HR = 0.85, 95 %CI:0.78–0.93, p < 0.001). DiscussionThe CARG chemo-toxicity calculator was not predictive of grade 3–5 toxicity in patients with hematologic malignancy. The SPPB was associated with overall survival in multivariable analysis, suggesting future use as an objective biomarker in HM. We also report a comprehensive trajectory of function, QoL, psychosocial well-being, and cognition among older adults with HM. The predictive accuracy of the CARG chemo-toxicity calculator may be affected by the diverse range of HM treatment options that are not traditional chemotherapy.

Measuring up: Ensuring Intra- and Interobserver Reliability in Stretched Penile Length with the SPLINT Technique

ABSTRACT Background: A discrepancy between the true and measured value of stretched penile length (SPL) may be a result of errors that can either be systematic or random. Hence, it becomes important to focus on the quality of measurements to prevent any iatrogenic harm to the patients. Objective: The objective of this study was to assess the magnitude of intra- and interobserver variations in the measurement of SPL with the SPLINT technique. Materials and Methods: SPL was measured prospectively in a cohort of 449 boys aged 0–14 years including 68 infants (substratified into Group I: &gt;4 years, Group II: 4–8 years, and Group III: &gt;8 years) with the SPLINT technique by expert (E: E1 and E2) and trainee (T: T1 and T2) surgeons after completing a three-tiered training module. Intra- and interobserver variability was assessed through descriptive statistics, intraclass correlation (ICC), relative technical error of measurement (rTEM), and reliability or R (%). Results: Intraobserver variability: the mean difference between the two readings (E1 and E2) is 0.08 cm (95% confidence interval [CI]: 0.073–0.087), ICC was 0.998 (95% CI: 0.997–0.998), and intraobserver variability ≤0.1 cm in 85% of the participants (n = 370 of 433). The rTEM and reliability (%) were 1.82% and 98.1% (Group I), 1.65% and 98.9% (Group II), and 1.09% and 99.7% (Group III), respectively. The intraobserver variability was observed to be inversely proportional to the age of the participants (correlation coefficient = −0.56). Interobserver variability was calculated separately for expert versus trainee and trainee versus trainee (T-vs-T) measurements. For expert versus expert, ICC, rTEM, and reliability (%) were 0.984, 2.4%, and 96.8% (Group 1), 0.992, 2.07%, and 98.3% (Group 2), and 0.997, 1.38%, and 99.05% (Group 3), respectively. A similar pattern of variability was observed for T-vs-T measurements. The reliability (%) of the SPL by experts is consistently more than that of trainees across all age groups; however, the difference ameliorates with the age of participant. Conclusions: The study has validated the SPLINT technique by demonstrating a high level of intra- and interobserver reliability. The adequacy of the training modules for SPL measurements described in this study has also been established. Evidence that the SPL can be used as an objective marker of penile dimensions is herewith furnished.

Probing Neurophysiological Processes Related to Self-Referential Processing to Predict Improvement for Depressed Adolescents Receiving Cognitive Behavioral Therapy

BACKGROUNDCognitive Behavior Therapy (CBT) is a gold standard approach for treating major depressive disorder (MDD) among adolescents. However, nearly half of adolescents receiving CBT do not improve. In order to personalize treatment, it is essential to identify objective markers that predict treatment responsiveness. Toward addressing this aim, this study investigated neurophysiological processes related to self-referential processing that predicted CBT response among depressed, female adolescents. METHODSAt baseline, female adolescents ages 13-18-years-old (N=80) completed a comprehensive clinical assessment, and a self-referential encoding task was administered while electroencephalogram (EEG) data were recorded. Baseline EEG data were utilized to identify oscillatory differences between healthy (HC, n=38) and depressed (MDD, n=42) adolescents. Following the baseline assessment, depressed youth received up to 12-weeks of CBT. Baseline differences in EEG oscillations between healthy and depressed youth were used to guide CBT prediction analysis. Cluster-based event-related spectral perturbation analysis (ERSP) probed theta and alpha event-related synchronization/desynchronization (ERS/ERD) response to negative and positive words. RESULTSBaseline analyses showed that, relative to the healthy adolescents, depressed youth exhibited higher levels of frontal theta ERS and a greater posterior alpha ERD. Multilevel modeling identified primary neural pre-treatment predictors of treatment response: greater theta ERS in the right prefrontal cortex (PFC) after the onset of negative words and lower alpha ERD in both the right PFC and posterior cingulate cortex (PCC). ERS and ERD associations with treatment response remained significant, with baseline depressive and anxiety symptoms included as covariates in all analyses. CONCLUSIONSConsistent with prior research, results highlighted that relative to healthy youth, depressed adolescents are characterized by prominent theta synchronization and alpha desynchronization over PFC and PCC, respectively. Cluster-based ERSP analysis also identified key mechanisms underlying depression-related self-referential processing that predicted improved symptoms during the CBT course. Ultimately, a better characterization of the neural underpinnings of adolescent depression and its treatment may lead to more personalized interventions.

Balancing Objective Markers and Subjective Experience in Eating Disorder Diagnoses: Commentary on Dang et al. (2024).

The results of Dang et al.'s recent systematic review and meta-analysis suggested that individuals diagnosed with other specified feeding or eating disorder (OSFED) and those diagnosed with specified eating disorders (EDs, such as bulimia nervosa) endorse similar, elevated levels of ED-related cognitions (but not behaviors). The DSM has traditionally conceptualized EDs primarily as disturbances in eating behavior, and the diagnostic boundaries for EDs are based on objective markers, such as behavioral frequencies and weight. Although focusing on objective markers for ED diagnoses and severity indices has advantages (e.g., clinical communication, measurement), pitfalls include diagnostic migration and low emphasis on ED cognitions. Dang et al.'s findings provide a basis for rethinking DSM's conceptualization of EDs as primarily behavioral. This commentary discusses the potential merits and challenges of emphasizing subjective cognitions when assigning ED diagnoses. We explore how objective markers (e.g., behavioral frequency, weight) and subjective experience (e.g., fear of weight gain) may be balanced to improve the clinical utility of ED diagnoses. In all, research that more deeply phenotypes the subjective experiences of people with EDs across contexts, identities, and cultures will enrich our understanding of eating pathology and may inform diagnostic revisions.

Spectral Dynamics Prior to Motor Events Differ Between NREM Sleep Parasomnias and Healthy Sleepers.

The umbrella term "Disorders of Arousal" (DoA), encompassing sleepwalking, confusional arousals, and sleep terrors, refers to parasomnias manifesting during non-rapid eye movement (NREM) sleep, commonly thought to arise from an aberrant arousal process. While previous studies have detailed EEG changes linked to DoA episodes, it remains uncertain how these alterations differ from a physiological arousal process. This study directly compared brain activity between DoA episodes and arousals associated with physiological movements (motor arousal) in individuals with DoA and healthy sleepers. Fifty-three adult patients with DoA (25 males, 32.2±15.5years) and 33 control subjects (14 males, 31.4±11.4years) underwent one or more home-EEG recordings. A semiparametric regression model was employed to elucidate the complex relationship between EEG activity across channels, within and across different groups, including motor arousals in DoA (n=169), parasomnia episodes in DoA (n=361), and motor arousals in healthy sleepers (n=137). Parasomnia episodes and motor arousals in both groups were preceded by a diffuse increase in slow-wave activity (SWA) and beta power, and a widespread decrease in sigma power. However, motor arousals in DoA displayed lower beta and central sigma than in healthy sleepers. Within DoA patients, episodes were preceded by lower beta, frontal sigma, and higher SWA than motor arousals. Our findings suggest that the arousal process is altered in DOA patients, and that specific EEG patterns are required for DOA episodes to emerge. These insights will help guide future research into the underlying circuits and objective markers of DOA.

Catching Mind Wandering With Pupillometry: Conceptual and Methodological Challenges.

Mind-wandering (MW) refers to the shift of attention away from an ongoing task and/or external environment towards mental contents (e.g., memories, prospective thoughts) unrelated to the task. Physiological measures (e.g., pupil size, EEG, and fMRI) have often been acquired as objective markers for MW states, which has greatly helped their study as well as triangulation with other measures. Pupillometry in particular has been used as a covert biomarker of MW because it is reliably modulated by several distinct processes spanning arousal, emotion, and attention, and it signals attentional lapses. Yet, coupling MW and the measurement of pupil size has led to seemingly contrasting results. We argue that, common to the studies reviewed here, one reason is resolving to the measurement of tonic pupil size, which reflects low-frequency, slow changes in one's physiological state, and thus implicitly assumes that MW is a static, long-lasting process. We then additionally focus on three major axes of variability in the reviewed studies: (i) the definition and measurement of MW; (ii) the impact of contextual aspects, such as task demands and individual arousal levels; (iii) the identification and tracking of MW in combination with pupillary measures. We provide an overview of these differences and put forward recommendations for using physiological measures-including, but not limited to, pupil size-in MW research effectively. In conclusion, pupillometry can be a very informative tool for MW research, provided that it is used with the due methodological caution.

Humoral serotonin and neuropsychological status of patients with dizziness

Dizziness is often accompanied by affective disorders such as anxiety and depression, in the occurrence of which the role of the serotonergic system is discussed.Objective: to investigate the serotonin content in blood serum and neuropsychological status in patients with vestibular and non-vestibular dizziness.Material and methods. The study included 97 patients. Two observation groups were formed according to the type of dizziness complaints. The first group (n=47) comprised patients with vestibular (systemic) dizziness against a background of peripheral vestibulopathy, the second group (n=35) comprised patients with non-vestibular (non-systemic) dizziness with a diagnosis of probable persistent postural-perceptual dizziness (PPPD). The control group (n=15) consisted of patients without complaints of dizziness. Neurological and otoneurological status, psychoemotional parameters (level of anxiety and depression) and cognitive functions were analyzed, and the quantitative level of serotonin in blood serum was determined by enzyme immunoassay.Results. The study revealed a significant decrease in the serum serotonin levels in vestibular and non-vestibular dizziness; a lower serotonin level was found in non-vestibular dizziness (p&lt;0.05). The presence of affective disorders did not correlate with a decrease in serotonin levels in vestibular dizziness against a background of peripheral vestibulopathy. It is assumed that a decrease in serotonin content plays a role in pathogenesis of vestibular dizziness on the background of peripheral part of vestibular system involvement.Conclusion. We demonstrated possibility of using the level of serotonin in peripheral blood as an objective laboratory marker of vestibular and non-vestibular dizziness in general clinical medical practice.

An IoT-enabled EEG headphones with customized music for chronic tinnitus assessment and symptom management

Chronic tinnitus often affects elderly or hearing-impaired individuals, which can disturb their daily lives by disrupting concentration and limiting communication. Clinically, sound masking using external sounds like white noise (WN) aims to mask tinnitus and relieve secondary symptoms. Even when symptoms are relieved, tinnitus often requires long-term management, and for patients to visit healthcare professionals regularly. Generally, it could make maintaining symptom management challenging due to the time and effort required for consistent follow-ups. EEG is considered as one of the objective marker for assessing tinnitus symptoms. In this study, we designed IoT-enabled EEG sensing (IEES) headphones, an innovative IoT device that provided customized music (CM) and EEG measurement. The headphones employed a pitch-matching (PM) method to create CM tailored to each patient at specific frequencies for tinnitus patients. To collect EEG measurements, the device incorporated OpenBCI electrodes and a sensing chip to monitor brain waves and evaluate the outcomes.. After 30 days of experiment, participants showed significant reductions in both tinnitus handicap inventory (THI) scores and visual analog scale for annoyance (VAS-A) scores. In comparison, tinnitus frequency showed a slight reduction. EEG measurements demonstrated an increase in alpha band activity. In questionnaires, patients reported high satisfaction with their experiences. These findings highlight the potential of the proposed method for chronic tinnitus assessment and symptom management.

Candidate Molecular Biomarkers of Traumatic Brain Injury: A Systematic Review.

Traumatic brain injury (TBI) is one of the leading causes of mortality and disability among young and middle-aged individuals. Adequate and timely diagnosis of primary brain injuries, as well as the prompt prevention and treatment of secondary injury mechanisms, significantly determine the potential for reducing mortality and severe disabling consequences. Therefore, it is crucial to have objective markers that indicate the severity of the injury. A number of molecular factors-proteins and metabolites-detected in the blood immediately after trauma and associated with the development and severity of TBI can serve in this role. TBI is a heterogeneous condition with respect to its etiology, clinical form, and genesis, being accompanied by brain cell damage and disruption of blood-brain barrier permeability. Two oppositely directed flows of substances and signals are observed: one is the flow of metabolites, proteins, and nucleic acids from damaged brain cells into the bloodstream through the damaged blood-brain barrier; the other is the infiltration of immune cells (neutrophils and macrophages) and serological proteins. Both flows aggravate brain tissue damage after TBI. Therefore, it is extremely important to study the key signaling events that regulate these flows and repair the damaged tissues, as well as to enhance the effectiveness of treatments for patients after TBI.

Epigenetic landscape reorganisation and reactivation of embryonic development genes are associated with malignancy in IDH-mutant astrocytoma

Accurate grading of IDH-mutant gliomas defines patient prognosis and guides the treatment path. Histological grading is challenging, and aside from CDKN2A/B homozygous deletions in IDH-mutant astrocytomas, there are no other objective molecular markers used for grading. RNA-sequencing was conducted on primary IDH-mutant astrocytomas (n = 138) included in the prospective CATNON trial, which was performed to assess the prognostic effect of adjuvant and concurrent temozolomide. We integrated the RNA-sequencing data with matched DNA-methylation and NGS data. We also used multi-omics data from IDH-mutant astrocytomas included in the TCGA dataset and validated results on matched primary and recurrent samples from the GLASS-NL study. Since discrete classes do not adequately capture grading of these tumours, we utilised DNA-methylation profiles to generate a Continuous Grading Coefficient (CGC) based on classification scores from a CNS-tumour classifier. CGC was an independent predictor of survival outperforming current WHO-CNS5 and methylation-based classification. Our RNA-sequencing analysis revealed four distinct transcription clusters that were associated with (i) upregulation of cell cycling genes; (ii) downregulation of glial differentiation genes; (iii) upregulation of embryonic development genes (e.g. HOX, PAX, and TBX) and (iv) upregulation of extracellular matrix genes. The upregulation of embryonic development genes was associated with a specific increase of CpG island methylation near these genes. Higher grade IDH-mutant astrocytomas have DNA-methylation signatures that, on the RNA level, are associated with increased cell cycling, tumour cell de-differentiation and extracellular matrix remodelling. These combined molecular signatures can serve as an objective marker for grading of IDH-mutant astrocytomas.

Identification of texture MRI brain abnormalities on Fibromyalgia syndrome using interpretable machine learning models

To provide objective diagnostic markers for fibromyalgia symptoms (FMS) diagnosis, we have created interpretable extreme gradient boosting (XGBoost) models using radiomics to aid in the diagnosis of chronic pain (CP) and to develop nomogram models for diagnosing subgroups of FMS. A group of 54 patients with CP and 71 healthy controls was randomly separated into training and validation groups, using a 7:3 ratio. Radiomics features were extracted from grey-matter and white-matter in the filtered mwp0* image. The Mann-Whitney U test, Spearman’s rank correlation test, and least absolute shrinkage and selection operator (LASSO) were utilized to select features. An XGBoost model was created based on these features, and Shapley Additive exPlanations (SHAP) was used for personalization and visual interpretation. A nomogram was developed for the diagnosis of FMS subgroups, utilizing radiomics scores and clinical predictors. The efficacy of the nomogram was evaluated using the area under the receiver operating characteristic curve, while decision curve analysis was employed to evaluate its clinical efficacy. The XGBoost model displays stability in the training validation group, indicating lower overfitting of CP model. The nomogram model combined with the rad-score has a greater ability to distinguish between typical and sub-clinical than the clinical factor model alone. We developed and validated a CP diagnosis model by XGBoost and realized model visualization through SHAP. The rad-score obtained by machine learning was used to build a nomogram model that combines clinical scales to distinguish patients with typical and sub-clinical fibromyalgia.

A mental health monitoring system based on intelligent algorithms and biosensors: Algorithm behaviour analysis and intervention strategies

Introduction: Mental health monitoring encompasses the systematic observation and assessment of an individual’s psychological well-being, aiming to detect, understand and manage mental health conditions. It involves various techniques and interventions tailored to support individuals in achieving and maintaining optimal mental wellness. Recent advancements include the use of biosensors and biomechanics to analyze physiological signals that correlate with mental states, providing a more comprehensive understanding of psychological well-being. Aim: The aim of this research is to construct an innovative mental health monitoring system established on intelligent algorithms and biomechanical data through behaviour analysis and intervention strategies. Methodology: We propose a novel Snow Ablation-driven Bi-directional Fine-tuned Recurrent Neural Network (SA-BFRNN) to identify the state of mental health. In addition to behavioural data, biosensors are employed to collect real-time physiological signals such as heart rate variability, skin conductance, and muscle tension, offering objective markers of mental stress and anxiety. These biomechanical inputs are integrated into the system for multi-modal analysis. We employ the SA algorithm, iteratively removing less influential connections and nodes based on their impact on model performance. This process enhances network efficiency and generalization capabilities, refining the BFRNN for mental health state identification. Utilizing a questionnaire with 25 questions, administered to a selected group of 756 individuals, we validate our proposed model. Biosensor data is synchronized with questionnaire responses to improve the precision of mental state identification. Clustering-derived labels are validated with mean opinion score. These labels inform classifiers for individual mental health prediction, aligning with our objective of robust mental health assessment through data-driven approaches. SA-BFRNN integrates both forward and backward temporal information, enhancing its ability to discern subtle patterns in behaviour. Through iterative fine-tuning, our network learns to adapt to diverse datasets, enabling precise identification of mental health states. Research findings: In the result evaluation phase, we thoroughly examine how well our proposed SA-BFRNN model recognizes various states of mental health across different parameters. Our findings also highlight the significance of incorporating biomechanics, where biosensor data showed a strong correlation with mental health indicators, thereby augmenting the accuracy of the system. Our findings emphasize the efficacy of the SA-BFRNN technique, as demonstrated by its overall performance in terms of recall (92.56%), accuracy (90.13%), F1-score (88.16%) and precision (89.23%). Our experimental results unequivocally demonstrate that our proposed model performed better than other traditional approaches in classifying contents from multimodal data, showing notable enhancements in accuracy and robustness, particularly under dynamic conditions.

Outcome measures and their importance for effective equine back pain rehabilitation

Effective rehabilitation for equine back pain is required due to the frequency of dysfunction effecting performance and welfare. Reliable and valid measures should be used establish a baseline in pain and dysfunction levels, and used to monitor change during rehabilitation, as well as support future research assessing the efficacy of treatment interventions. Such measures are collectively known as outcome measures and can include specific objective markers of impairments such as reduced range of motion, or pain on palpation. The aim of this narrative review is to discuss the options and tools available to use as outcome measures in relation to the treatment and rehabilitation of back pain in the horse. In this paper outcome measures critically discussed relate to conformation and standing posture, muscle dimensions, palpation, range of motion, objective gait analysis, functional analysis, owner reported outcome measures and pain scales. Recommendations are made to assist with selection of a suitable outcome measure. In conclusion, complex laboratory-based analysis systems are available to be gold-standard truly objective systems, although realism for clinical practitioners working in the field limits their use. There is a requirement for new outcome measures that are not subject to observer bias nor time or financially consuming, however it is possible to use those available currently with assist in clinical decision making for the benefit of the horse.

Castration Levels of Testosterone Results in Atrophy of Androgen-Sensitive Perineal Muscles: A Potential Biomarker for Male Hypogonadism

ObjectivesTo evaluate MRI-based measurements of androgen-sensitive perineal/pelvic muscles in men with prostate cancer before and after androgen deprivation therapy (ADT) as a novel imaging marker for end-organ effects of hypogonadism. Diagnosing hypogonadism or testosterone deficiency (TD) requires both low serum testosterone and clinical symptoms, such as erectile dysfunction and reduced libido. However, the non-specific nature of many TD symptoms makes it challenging to initiate therapy. Objective markers of TD help to better identify patients who may benefit from testosterone supplementation; however, current markers, such as low bone mineral density, lack sensitivity. Previous studies suggest that decreased bulbocavernosus-muscle (BCM) thickness may be associated with TD, although it remains unclear if this is a correlative relationship. MethodsData was prospectively collected for patients with intermediate/high-risk localized prostate cancer enrolled in a phase II trial (NCT02430480). Patients received ADT before prostatectomy and underwent prostate MRI pre-/post-ADT. BCM, ischiocavernosus-muscle (ICM), and levator-ani-muscle (LAM) measurements were made using T2W-MRI. Paired t-tests evaluated changes in BCM/ICM/LAM width, and linear regression analyses evaluated relationships between changes in testosterone and muscle width. ResultsThirty-eight consecutive patients with pre-/post-ADT MRIs were analyzed. Baseline testosterone was 286.5ng/dl, and 36/38 patients had post-ADT testosterone <50ng/dL. Pre-ADT and post-ADT measurements of the bilateral BCM/ICM/LAM width were 7.16mm/7.95mm/5.53mm and 5.68mm/6.71mm/4.89mm, respectively (p<0.001). Decreases in testosterone predicted reduction in combined perineal muscle (BCM+ICM) width (p=0.032). ConclusionsAndrogen deprivation led to significant and relatively rapid decreases in BCM/ICM/LAM thickness. This objective biomarker of low testosterone states may help identify patients who will potentially benefit from testosterone replacement.

S1146 Inflammatory Bowel Disease (IBD)-Associated Peripheral Arthritis is Not Associated With Objective Markers of Luminal IBD Disease Activity - Results From the CHASE Cohort

S1146 Inflammatory Bowel Disease (IBD)-Associated Peripheral Arthritis is Not Associated With Objective Markers of Luminal IBD Disease Activity - Results From the CHASE Cohort

Longitudinal Fatigue Symptoms and Inflammatory Markers in African American Adults With Hypertension and Obstructive Sleep Apnea.

There is a dearth of research inclusive of African Americans living with obstructive sleep apnea (OSA) despite differences in symptom presentations compared to non-Hispanic White patient populations. Less is known regarding the potential effect of comorbidities, such as hypertension, on commonly reported symptoms, such as fatigue, and their association with inflammatory biomarkers. This longitudinal pilot study aimed to characterize fatigue symptom presentations among African Americans newly diagnosed with OSA and discern peripheral blood analytes linked to symptoms while accounting for co-occurring hypertension. Adult African Americans newly diagnosed with OSA with and without co-occurring hypertension were approached by study staff and recruited following their diagnostic visit with sleep medicine clinicians at two health systems and followed over 6 months after commencing continuous positive airway pressure treatment. Patient-Reported Outcomes Measurement Information System Fatigue surveys and plasma were collected every 3 months from 29 participants. Mixed effects models examined changes in fatigue symptom presentations over time while accounting for plasma-based analytes and hypertension status. Despite higher fatigue symptom severity upon diagnosis, participants with co-occurring hypertension reported greater improvements in fatigue scores after commencing continuous positive airway pressure treatment for up to 6 months than those without hypertension. Inverse correlations were observed between fatigue scores, C-reactive protein, matrix-metalloproteinase-8, and osteoprotegerin analyte levels among participants with/without hypertension. Across all participants, changes in interleukin-6 were associated with changes in fatigue scores in the first three months after diagnosis. Findings indicate that hypertension is linked to increased fatigue upon diagnosis of OSA in this sample of African Americans. Fatigue in persons with hypertension improved after treatment. These hypothesis-generating findings can inform future interventional studies aimed at improving fatigue among persons with OSA while leveraging markers linked to fatigue symptom severity as potential objective markers of improvements. Further research on the role of inflammatory markers, such as IL-6, on fatigue symptom presentations is warranted in those with OSA regardless of hypertension status.