Search

Objective: This cross-sectional study aimed to observe the occurrence of metabolic syndrome in untreated individuals with bipolar disorders. Methods: A total of 125 untreated individuals with bipolar disorders were collected as the study group, and 201 cases from the health examination centre of our hospital were selected as the control group. The participants enrolled were assessed for general demographic data, case characteristics, and metabolic indexes including body mass index (BMI), blood pressure, triglyceride, high-density lipoprotein-cholesterol, cholesterol, low-density lipoprotein-cholesterol, and fasting plasma glucose. Results: The incidence of metabolic syndrome in the bipolar disorders group was higher compared to the control group (9.6% VS. 8.5%). After calibrating sex and age data, a significant difference between the two groups was observed (P < 0.05). Diastolic and systolic blood pressure were higher in the bipolar disorders group compared to the control group (P < 0.01). Men with bipolar disorders had a higher risk of developing metabolic syndrome than women (14.5% vs. 5.8%). Bipolar disorders, sex, age, and BMI were identified as independent risk factors for metabolic syndrome. No significant difference was found in terms of metabolic index and incidence of metabolic syndrome between individuals with depressive episodes (n = 37) and manic episodes (n = 75). Conclusion: Patients with bipolar disorders were found to have a higher risk of developing metabolic syndrome than healthy individuals. Bipolar disorders, male sex, age, and BMI may contribute to an increased risk of developing metabolic syndrome. [ABSTRACT FROM AUTHOR]

Simple Summary: This study investigates predictors influencing the growth of untreated vestibular schwannomas, a common benign brain tumor. We aim to identify predictors of tumor growth, which is crucial for making informed treatment decisions. We reviewed numerous studies and analyzed variables such as age, gender, tumor size, location, symptoms, and MRI signal characteristics. The findings reveal that larger tumor size, extra-canalicular location, cystic components, and vestibular symptoms are associated with tumor growth. These insights can guide clinicians in identifying patients who may benefit from more aggressive monitoring or intervention, potentially improving outcomes for individuals with this condition. This research contributes to better understanding the variability in vestibular schwannoma (VS) growth and emphasizes the importance of personalized treatment strategies. The growth rate of sporadic VS varies considerably, posing challenges for consistent clinical management. This systematic review examines data on factors associated with VS growth, following a protocol registered in the PROSPERO database. The analysis reveals that key predictors of tumor growth include tumor location, initial size, and specific clinical symptoms such as hearing loss and imbalance. Additionally, several studies suggest that growth observed within the first year may serve as an indicator of subsequent progression, enabling the earlier identification of high-risk cases. Emerging factors such as the posture swing test and MRI signal intensity have also been identified as novel predictors that could further refine growth assessments. Our meta-analysis confirms that tumor location, initial size, cystic components, and vestibular symptoms are closely linked to the likelihood of VS growth. This review provides valuable guidance for clinicians in identifying patients who may require closer monitoring or early intervention. By integrating these predictive factors into clinical practice, this review supports more personalized treatment and contributes to the development of more accurate prognostic models for managing untreated sporadic VS. [ABSTRACT FROM AUTHOR]

Abstract Our objectives were to ascertain the following: (1) the prevalence and socioeconomic distribution of hypertension (HTN), undiagnosed for HTN, and untreated cases of HTN‐diagnosed individuals; (2) the relationship between SES and the prevalence of HTN, undiagnosed for HTN, and untreated for HTN; and (3) whether sex moderate this association. Data from the 2017–18 Bangladesh Demographic Health Survey were used. 11,776 participants who were 18 years of age or older responded to our analysis. The age‐adjusted prevalence of HTN, undiagnosed for HTN, and untreated cases was 25.1%, 57.2%, and 12.3%. Compared to females, males were less likely to have HTN but more likely to have undiagnosed HTN. People in the rich SES groups had a higher odd of (adjusted odds ratio [aoR] 1.25; 95% confidence interval [CI] 1.08–3.45) of having HTN compared to those in the poor SES group. When compared to individuals in the poor SES group, those in the rich SES group had lower odds of undiagnosed (aoR 0.57; 95% CI 0.44–0.74) and untreated (aoR 0.56; 95% CI 0.31–0.98) for HTN. Sex moderated the association between SES and HTN prevalence, which showed that men from rich SES were more likely to suffer from HTN than men from poor SES. According to this study, the government and other pertinent stakeholders should concentrate more on developing suitable policy measures to reduce the risk of HTN, particularly for men in rich socioeconomic groups. They should also concentrate on screening and diagnosing HTN in socioeconomically disadvantaged populations, regardless of sex.

Purpose: The impact of untreated medial meniscus posterior root (MMPR) tear (MMPRT) during opening‐wedge high tibial osteotomy (OWHTO) on patient‐reported outcomes (PROs) remains poorly understood. This retrospective cohort study aimed to investigate the association between the presence of MMPRT and post‐operative PROs in patients who underwent OWHTO. Methods: A total of 83 knees that underwent OWHTO that were followed up for 6.6 years were included. Post‐operative PROs were assessed using the knee injury and osteoarthritis outcome score (KOOS) subscales. Medial meniscus extrusion (MME) was measured by magnetic resonance imaging (MRI). MMPRT was diagnosed based on preoperative MRI and intraoperative arthroscopy findings. The participants were categorized into the MMPRT and MMPR intact (MMPRI) groups, and their KOOS subscales were compared. Additionally, logistic regression analysis was conducted to explore the correlation between KOOS and MMPRT presence. Results: In total, 29 out of 80 (36.3%) knees were classified into the MMPRT group, while three knees underwent total knee arthroplasty. Preoperative MME was 3.5 ± 1.9 (range 0–8.9) mm, showing correlation with the presence of MMPRT (p = 0.004) by regression analysis. The post‐operative KOOS subscales of the MMPRT group were lower than the MMPRI group for pain (p = 0.017), activities of daily living (ADLs) (p = 0.001), sports (p < 0.001) and quality of life (QOL) (p < 0.001). Additionally, regression analysis showed the presence of MMPRT was correlated with lower KOOS subscale scores for pain (p = 0.041), ADLs (p = 0.011), sports (p < 0.001) and QOL (p = 0.002). Conclusion: Preoperative MMPRT correlated with a reduction in mid‐term post‐operative PROs, as assessed using the KOOS, among patients who underwent OWHTO. Surgeons should consider addressing an MMPRT at the time of OWHTO. Level of Evidence: Level IV. [ABSTRACT FROM AUTHOR]

Our objectives were to ascertain the following: (1) the prevalence and socioeconomic distribution of hypertension (HTN), undiagnosed for HTN, and untreated cases of HTN‐diagnosed individuals; (2) the relationship between SES and the prevalence of HTN, undiagnosed for HTN, and untreated for HTN; and (3) whether sex moderate this association. Data from the 2017–18 Bangladesh Demographic Health Survey were used. 11,776 participants who were 18 years of age or older responded to our analysis. The age‐adjusted prevalence of HTN, undiagnosed for HTN, and untreated cases was 25.1%, 57.2%, and 12.3%. Compared to females, males were less likely to have HTN but more likely to have undiagnosed HTN. People in the rich SES groups had a higher odd of (adjusted odds ratio [aoR] 1.25; 95% confidence interval [CI] 1.08–3.45) of having HTN compared to those in the poor SES group. When compared to individuals in the poor SES group, those in the rich SES group had lower odds of undiagnosed (aoR 0.57; 95% CI 0.44–0.74) and untreated (aoR 0.56; 95% CI 0.31–0.98) for HTN. Sex moderated the association between SES and HTN prevalence, which showed that men from rich SES were more likely to suffer from HTN than men from poor SES. According to this study, the government and other pertinent stakeholders should concentrate more on developing suitable policy measures to reduce the risk of HTN, particularly for men in rich socioeconomic groups. They should also concentrate on screening and diagnosing HTN in socioeconomically disadvantaged populations, regardless of sex. [ABSTRACT FROM AUTHOR]

The watch and wait (WW) approach consists of regular ultrasound follow-up without interventions on the cyst, in the absence of reactivation or complications. In most centers with a high number of patients treated, this approach is currently the approach of choice for uncomplicated inactive CE4 and CE5 cysts. The approach of placing Cystic Echinococcosis (CE) in a specific stage of the ultrasonographic (US) classification, a position defended by the WHO-IWGE experts, aims to optimize the treatment of patients with cystic echinococcosis, avoiding overtreatment, its impact on daily life and associated costs¹. In this context, the watch-and-wait approach, for asymptomatic and uncomplicated CE4 and CE5 cysts, is safe and supported by increasing evidence. However, the watch-and-wait approach for asymptomatic and uncomplicated inactive EC cysts is still poorly adopted and therefore inadequate treatment of inactive cysts continues to occur, which exposes patients to unnecessary risks derived from overtreatment and high costs to the public health system. For this reason was mentioned above that it is important to bring this behavior to the table, since in our country it is little known and, if put into practice, it would avoid at least 15-20% of unnecessary surgeries. [ABSTRACT FROM AUTHOR]

Abstract Purpose The impact of untreated medial meniscus posterior root (MMPR) tear (MMPRT) during opening‐wedge high tibial osteotomy (OWHTO) on patient‐reported outcomes (PROs) remains poorly understood. This retrospective cohort study aimed to investigate the association between the presence of MMPRT and post‐operative PROs in patients who underwent OWHTO. Methods A total of 83 knees that underwent OWHTO that were followed up for 6.6 years were included. Post‐operative PROs were assessed using the knee injury and osteoarthritis outcome score (KOOS) subscales. Medial meniscus extrusion (MME) was measured by magnetic resonance imaging (MRI). MMPRT was diagnosed based on preoperative MRI and intraoperative arthroscopy findings. The participants were categorized into the MMPRT and MMPR intact (MMPRI) groups, and their KOOS subscales were compared. Additionally, logistic regression analysis was conducted to explore the correlation between KOOS and MMPRT presence. Results In total, 29 out of 80 (36.3%) knees were classified into the MMPRT group, while three knees underwent total knee arthroplasty. Preoperative MME was 3.5 ± 1.9 (range 0–8.9) mm, showing correlation with the presence of MMPRT (p = 0.004) by regression analysis. The post‐operative KOOS subscales of the MMPRT group were lower than the MMPRI group for pain (p = 0.017), activities of daily living (ADLs) (p = 0.001), sports (p

Objectives: Our objectives were to ascertain: the prevalence and socio-economic distribution of hypertension, as well as the rates of undiagnosed and untreated hypertension; the association between socioeconomic status (SES) and the occurrence of hypertension, as well as the rates of undiagnosed and untreated hypertension; and the factors influencing the poor-non-poor gap in terms of the prevalence, diagnosis, and treatment of hypertension. Design: Cross-sectional nationally representative study. Methods: Data from the 2017–18 Bangladesh Demographic Health Survey were used. 11,776 participants who were 18 years of age or older responded to our analysis. We used the wealth index as a proxy for SES. The prevalence of hypertension, both diagnosed and undiagnosed, as well as its untreated states, were the outcome variables. Results: The age-adjusted prevalence of hypertension, undiagnosed as having hypertension, and untreated cases were 25.1%, 57.2%, and 12.3%, respectively. People in the poor SES groups had a 0.88 times (95% confidence interval [CI] 0.77–0.99) lower likelihood of having hypertension compared to those in the non-poor SES group. Individuals belonging to the poor SES group exhibited a likelihood of 1.68 and 1.53 times greater for having untreated hypertension and being undiagnosed with the condition, respectively, compared to those in the non-poor SES group. The results indicated that BMI played a role in increasing the disparity between the poor and non-poor populations concerning hypertension risk. Additionally, factors such as age, gender, and education were found to exacerbate the gap in the risk of undiagnosed hypertension between these two groups. Conclusion: The results of this study suggest that appropriate policy measures be developed for ongoing care and early identification, especially for older adults, men, and individuals with low levels of education from low socioeconomic backgrounds. Additionally, efforts must be made to reduce the prevalence of overweight and obesity among people in the non-poor SES category.

This article explores the use of microbial methods to remove heavy metals from industrial effluent in the pharmaceutical industry. The effluent contains metallic cations that can contaminate the soil and food chain. Traditional treatments for metal-containing waste have limitations, so researchers are investigating alternative biological methods involving bacteria and bio surfactants. The article also presents a study on the effects of microbial treated and untreated tannery effluent on the growth of green gram. The study concludes that bacteria are effective in removing heavy metals from pharmaceutical effluent. [Extracted from the article]

Background: Most people with alcohol use disorder (AUD) do not use treatment services, yet the majority ultimately resolve their AUD. As the phenomenon of untreated recovery remains poorly understood, we investigated the strategies used for recovery without treatment. Methods: We conducted semi-structured interviews with 65 adults (27 women, 37 White) with resolved AUD and no history of using specialty services (e.g., inpatient or outpatient rehabilitation, medication-assisted treatment). Using both inductive and deductive coding, we identified and elaborated themes and meanings. We verified our findings through nine member-check sessions with interviewers and interview participants. Results: Majorities of interview participants met criteria for severe lifetime AUD (84.6%), were in long-term recovery (>5 years; 81.5%), and indicated abstinence was their recovery goal (56.9%). Close to half (41.5%) had attended mutual-help groups (e.g., Alcoholics Anonymous). We identified five active strategies (Changing Contexts, Social Connections. Activities, Substitution, and Other Strategies) and four additional factors (Mutual-help Groups, Self-Reliance, Spirituality, and Aging/Maturing) that contributed to their recovery. Most participants employed multiple strategies and were intentional in adopting the ones that best suited them. By far, the two most common strategies were Changing Contexts (reported by 69.2% of participants) whereby people reduced their alcohol exposure by modifying social networks or physical settings and relying on Social Connections (reported by 67.7%), especially connections to people with similar lived experiences and struggles. Notably, Social Connections and Mutual-Help groups were the themes most often discussed jointly. Among other contributing factors mentioned, Spirituality appeared to play an important, but not universal, role as it was invoked by approximately half (49.2%) of participants. Conclusions: Our study confirms that recovery without specialty treatment is possible, and that multiple strategies and contributing factors help to achieve it. These findings may inform novel interventions to support recovery among people unwilling or unable to obtain treatment for AUD. [ABSTRACT FROM AUTHOR]

Desecrate tire is the dominating waste from the resource of rubber. These wastages are profusion from the disposal of tire material that is increasing every year. Tire wastage shall raise environmental pollution thus to a never stop and continuous progress. Hence, efforts have been taken to identify the potential application of waste rubber tires in manufacturing projects. Manufacturing is one of the ways of utilizing waste tires to resolve this disposal problem. The waste tire is one of the best alternative materials for natural aggregate. Waste tire rubber may be utilized in a variety of ways in concrete, making it both cost-effective and ecologically benign. In this focus, our current aim plan is to rubberize the mortar ratio of 1:3 and M30 Grade of concrete to use waste tire rubber powder part replacement of sand. The Tire derivate aggregate (TDA) mortar and concrete is made from 80 mesh TDA, as a partial substitute for fine aggregates that have been pre-treated with KOH solution. Compressive strength is one of the mechanical qualities of cement mortar to be evaluated with various quantities of TDA. Waste tire powder replace with (0%, 3%, 6%, 9%, 12%, and 15%) by weight of sand are casted. Compressive strength is calculated after the proper curing period of 3, 7, and 28 days, and the permeability of concrete cubes are also estimated. The results show that up to 9% of KOH-treated waste tire powder gave high compressive strength and lower permeability. It is suggested to waste rubberized mortar using non-structural manufacturing activity. [ABSTRACT FROM AUTHOR]

Summary: Background: How often hypertensive patients could achieve remission to normal blood pressure (BP) (i.e.,

BackgroundThe current landscape and treatment patterns of disease-modifying therapy (DMT) use in pediatric patients with multiple sclerosis (MS) are not yet well understood. This study examined DMT utilization and treatment patterns in pediatric patients newly diagnosed as having MS.MethodsPediatric patients (

Abstract This study compared some quality properties of yellow-fleshed sweet potato flour samples as affected by pretreatments (0.02% sulfite; blanching 85 °C for 3 min 30 s and steam blanching 100 °C for 2 min) and drying methods (oven, sun, and drum drying). The physicochemical composition, functional properties, pasting profile, and least gelation concentration of the flours were determined. Before pretreatment, the sweet potato tubers were sorted, weighed, rinsed, peeled, and diced. The smallest particle size (58 μm) was recorded for samples blanched at 85 °C followed by oven drying while drum-dried samples had the largest particle size (119.5 μm). The pH values (5.58 - 5.90) of the pretreated sun- and oven-dried samples were significantly (p

Copyright of Erzincan University Journal of Science & Technology is the property of Erzincan Binali Yildirim Universitesi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The optimal treatment algorithm for patients with degenerative lumbar spondylolisthesis has not been clarified. Part of the reason for this is that the natural history of degenerative spondylolisthesis (DS) has not been sufficiently studied. Comprehension of the natural history is essential for surgical decision making. We aimed to determine 1) the proportion of patients that develop de novo DS during follow-up; and 2) the proportion of patients with progression of preexistent DS by conducting a systematic review and meta-analysis of the literature. This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Ovid, EMBASE, and the Cochrane Library were searched from their inception through April 2022. Demographic values of the study populations, grade of slip, rate of slippage before and after the follow-up period, and percentage of patients with slip in the populations at baseline and after follow-up were the extracted parameters. Of the 1909 screened records, eventually 10 studies were included. Of these studies, 5 reported the development of de novo DS and 9 reported on the progression of preexistent DS. Proportions of patients developing de novo DS ranged from 12% to 20% over a period ranging from 4 to 25 years. The proportion of patients with progression of DS ranged from 12% to 34% over a period ranging from 4 to 25 years. Systematic review and metanalysis of DS on the basis of radiologic parameters revealed both an increasing incidence over time and an increasing progression of the slip rate in up to a third of the patients older than 25 years, which is important for counseling patients and surgical decision making. Importantly, two thirds of patients did not experience slip progression. [ABSTRACT FROM AUTHOR]

The aim of this study is to analyze the phase separation that occurs between treated and untreated rubber crumb particles produced by wet processes in the laboratory. The percentage of replacement used for both the treated and untreated crumb rubber-modified asphalt (CRMA) was 5%, 10%, 15%, and 20%. Tests to evaluate binder properties were performed using a rotational viscometer and a DSR, and the following properties were determined—viscosity, G*/sinδ, % recovery, and Jnr. The phase separation study was analyzed using the viscosity and G*/sinδ results. In general, the results of the study show the following. (1) The treated CRMA binders had higher viscosity values than untreated CRMA binders, although some values could not be measured due to the high viscosity values. (2) The G*/sinδ, % recovery and Jnr results also had a similar trend with viscosity results. (3) The viscosity and G*/sinδ phase separation values demonstrate that treated CRMA binders perform better than untreated CRMA binders. (4) Different experimental methods have shown variations in the calculated SI value; hence, a more improved approach should be explored to accurately assess the storage stability of asphalt binders containing various additives. [ABSTRACT FROM AUTHOR]

Background: Duration of untreated psychosis (DUP) is an important modifiable factor affecting schizophrenia outcomes. A dearth of research in India on untreated versus treated schizophrenia warrants further research. Methods: This was a longitudinal study in a tertiary hospital over 2 years. Inpatients diagnosed with schizophrenia (N = 116), aged 18–45, were divided into untreated and treated groups. Diagnostic confirmation, severity assessment, and clinical outcome were done using ICD-10 criteria, Positive and Negative Syndrome Scale (PANSS), and Clinical Global Impression (CGI) scale. Follow-up was done at 12 and 24 weeks. DUP was measured, and its association with the outcome was assessed. Results: Final analysis included 100 patients, 50 each of previously untreated and treated. Untreated patients had lower age and duration of illness (DOI), but higher DUP (p <.001). Treated patients showed much improvement on CGI-I at 12 weeks (p =.029), with no difference at 24 weeks. PANSS severity comparison showed no difference, and both groups followed a declining trend. In untreated patients, age of onset (AoO) was negatively correlated with severity (except general symptoms at baseline) at all follow-ups (' r ' range = −0.32 to –0.49, p <.05), while DOI showed a positive correlation with negative and general symptoms at 12 weeks (r ~ 0.3, p <.05). Treated patients showed inconsistent and lower negative correlation between AoO and PANSS, with no correlation between severity and DOI. The mean sample DUP was 17.9 ± 31.6 weeks; it negatively correlated with education (r = –0.25, p =.01) and positively with PANSS severity (' r ' range = 0.22 to 0.30, p <.05) at all follow-ups, especially negative symptoms. Patients with no or minimal improvement on CGI at 24 weeks had higher DUP (Quade's ANOVA F[1,98] = 6.24, p =.014). Conclusion: Illness variables in untreated schizophrenia affect severity, which has delayed improvement than treated schizophrenia. Higher DUP is associated with negative symptoms of schizophrenia. [ABSTRACT FROM AUTHOR]

The years 2021 and 2022 evolved differently from a climatic point of view, one being particularly rainy and the other being relatively dry. During this period, through the ERA-Net MERIAVINO project, studies were carried out on the Sauvignon blanc variety treated and untreated variants with phytosanitary protection substances regarding the degree of attack on the main diseases - Downy Mildew, Powdery Mildew and Gray Rot, along with determinations regarding stomatal conductance and sensor recordings for leaf humidity. The determinations that were made showed that the climatic factors, especially the precipitation and the relative humidity of the air have an uneven distribution during the vegetation period; determine the occurrence of cryptogamic diseases and have a great influence over the rate of extension of grapevine diseases (GA). In 2021, the degree of pathogen attack was higher compared to 2022, being directly correlated with the value of leaf humidity and also, the stomatal conductance determined for 4 days immediately after the appearance of the first symptoms of Plasmopara viticola and Botrytis cinerea infections recorded decreasing values. [ABSTRACT FROM AUTHOR]

This study compared some quality properties of yellow-fleshed sweet potato flour samples as affected by pretreatments (0.02% sulfite; blanching 85 °C for 3 min 30 s and steam blanching 100 °C for 2 min) and drying methods (oven, sun, and drum drying). The physicochemical composition, functional properties, pasting profile, and least gelation concentration of the flours were determined. Before pretreatment, the sweet potato tubers were sorted, weighed, rinsed, peeled, and diced. The smallest particle size (58 μm) was recorded for samples blanched at 85 °C followed by oven drying while drum-dried samples had the largest particle size (119.5 μm). The pH values (5.58 - 5.90) of the pretreated sun- and oven-dried samples were significantly (p<0.05) impacted by 0.02% sulfite. Compared to other drying methods. drum-dried samples had low bulk density (0.36 g/ml), the highest water (531%) and oil absorption capacities (168.5%,) and the least dispersibility (35%). Drum-dried samples had the highest swelling capacities at 60 – 80 °C but the values decreased at 80 – 90 °C compared to samples from other drying methods that had low swelling capacity at 60 - 70 °C but the values increased as the temperature increased from 70 – 90 °C. Results of the sample pasting profiles showed that pretreatment and drying techniques were significant on the various viscosities measured. Drum-dried samples had the lowest trough viscosity (18.13 RVU), final viscosity (24.88 RVU), setback viscosity (6.75 RVU), peak time (1.07 min), and pasting temperature (0 °C). This study concluded that the pretreatment and drying methods affected the quality properties of the yellow-fleshed sweet potato flour samples differently, consequently altering their functionality. [ABSTRACT FROM AUTHOR]

We aimed to determine: (1) the prevalence and socio-economic distribution of undiagnosed, untreated, and uncontrolled diabetes mellitus (DM); (2) the relationship between socio-economic status (SES) and undiagnosed, untreated, and uncontrolled DM; and (3) if this relationship is mediated by gender. Cross-sectional nationally representative household-based survey. We used data from the Bangladesh Demographic Health Survey from 2017 to 18. Our findings were based on the responses of 12,144 individuals aged 18 years and older. As a measure of SES, we focused on standard of living (hereinafter referred to as wealth). The study's outcome variables were prevalence of total (diagnosed + undiagnosed), undiagnosed, untreated, and uncontrolled DM. We used three regression-based approaches—adjusted odds ratio, relative inequality index, and slope inequality index—to assess different aspects of SES differences in the prevalence of total, undiagnosed, untreated, and uncontrolled DM. We used logistic regression analysis to look at the adjusted association between SES and the outcomes after gender stratification to see whether gender status moderates the association between SES and the targeted outcomes. In our sample analysis, the age-adjusted prevalence of total, undiagnosed, untreated, and uncontrolled DM was 9.1%, 61.4%, 64.7%, and 72.1%, respectively. Females had a higher prevalence of DM and undiagnosed, untreated, and uncontrolled DM than males. When compared to people in the poor SES group, people in the rich and middle SES groups had 2.60 times (95% confidence interval [CI] 2.05–3.29) and 1.47 times (95% CI 1.18–1.83) higher chance of developing DM. When compared to individuals in the poor SES group, those in the rich SES groups were 0.50 (95% CI 0.33–0.77) and 0.55 times (95% CI 0.36–0.85) less likely to have undiagnosed and untreated DM. In Bangladesh, rich SES groups were more likely than poor SES groups to have DM, whereas poor SES groups with DM were less likely than rich SES groups to be aware of their disease and obtain treatment. The government and other concerned parties are urged by this study to pay more attention to developing suitable policy measures to reduce the risk of DM, particularly among rich SES groups, as well as targeted efforts to screen for and diagnose DM in socio-economically disadvantaged groups. [ABSTRACT FROM AUTHOR]

Glaucoma is a chronic, progressive disease leading to irreversible blindness if left untreated; however, since reducing intraocular pressure has proven to be successful in slowing disease progression, little is known about the natural history of untreated glaucoma. This knowledge can be valuable in guiding management decisions in the era of personalized medicine. A systematic search was performed in Medline (PubMed), Embase, and Web of Science in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRIMSA) guidelines. The rate of structural and/or functional progression and conversion to glaucoma or to a more advanced stage of glaucoma are discussed for ocular hypertension and different types of open-angle glaucoma. Forty-three studies were included. Different rates of progression were found both among and within the different diagnostic groups that belong to the open-angle glaucoma spectrum. The highest rate was found in pseudoexfoliation glaucoma, followed by high tension glaucoma, normal tension glaucoma, and ocular hypertension, in decreasing order. The lowest rate was observed in glaucoma suspects. The known rates of progression provide valuable prognostic information for ophthalmologists and patients. Nonetheless, due to high variability among patients, individual progression cannot be accurately predicted and repeated follow-up examinations are required to estimate individual progression. [ABSTRACT FROM AUTHOR]

Abstract Aim This study aimed to clarify the association between treatment status (untreated or treated) at the start of community mental health outreach services and service intensity. Methods This retrospective cohort study was conducted using the Tokorozawa City mental health outreach service users' data. Treatment status at the start of service (exposure variable) and the service intensity (outcome variables) were taken from clinical records. Poisson regression and linear regression analyses were conducted. The frequency of medical or social service use 12 months after service initiation was also calculated. This study was approved by the Research Ethics Committee at the National Center of Neurology and Psychiatry (No. A2020‐081). Results Of 89 people, 37 (42%) were untreated. Family members in the untreated group were more likely to be targets or recipients of services than in the treated group (b = 0.707, p

The paper presents the effect of chemical treatment on the durability study of untreated/treated woven/non-woven coir geotextile. The p-aminophenol, sodium periodate, and sodium hydroxide were used for the treatment of the coir geotextiles. For this, laboratory wide width tensile strength test was conducted in a universal testing machine for untreated/treated woven/non-woven coir geotextile placed at the interface of sand-overlaying clay after the period of 2, 6, 8, 12 months, respectively. The results of this study reveal that the tensile strength decreased for the untreated and treated woven coir geotextiles with increase in the period. The reduction in the tensile strength for the woven coir geotextiles was more in the weft direction as compared to the warp direction. The reduction in the tensile strength of the treated woven coir geotextiles was more as compared to the untreated coir geotextiles. The reduction in the tensile strength for the non-woven coir geotextiles was more in the weft direction as compared to the warp direction. The reduction in the tensile strength for the untreated non-woven coir geotextile was more as compared to the treated non-woven coir geotextiles.

To date, there is no solid agreement on the relationship between mandibular molars, mandibular alveolar bone, and vertical facial types. Therefore, we aim to assess the buccolingual inclination of mandibular first molars and respective alveolar bones and their relationship with different vertical skeletal patterns. The CBCT data from fifty-four untreated Caucasian adult patients (12 males and 42 females, 18–65 years old) were obtained from a private orthodontic practice. We measured the inclination of the tooth and alveolar bone of the right and left mandibular first molars using CBCT. From the two-dimensional lateral cephalometric radiographic images extracted from CBCT, we assessed FMA, SN-GoGn, and PFH:AFH. All subjects showed lingual inclinations of the mandibular molars and alveolar bones which were significantly correlated with each other. However, there was no significant correlation between the inclination of alveolar bone and vertical facial types. Our study supports the conclusion that a proper curve of Wilson is physiological and should be maintained during orthodontic treatment. [ABSTRACT FROM AUTHOR]

The proportion of patients with locally advanced, unresectable or metastatic urothelial carcinoma that do not receive systemic anticancer treatment and the reasons for lack of treatment are largely unknown. The aim of this study was to investigate the prevalence and overall survival of this patient group and reasons for omission of treatment. This retrospective, single-center cohort study from Rigshospitalet, Denmark included patients diagnosed with locally advanced, unresectable or metastatic urothelial carcinoma during the study period from 1 January 2010 to 31 March 2016 who did not receive systemic anticancer treatment. Patients were identified through the Danish Pathology Register and the electronic medical records. 100 patients were included, representing 34% of all patients diagnosed with locally advanced, unresectable or metastatic urothelial carcinoma at Rigshospitalet during the study period. Lack of treatment was most often due to poor physical condition (59%), decreased renal function (15%), or patient preferences (14%). Median overall survival was 1.9 months (95% CI: 1.6–2.8 months). One in three patients diagnosed with locally advanced, unresectable or metastatic urothelial carcinoma in the pre-immunotherapy era did not receive systemic anticancer treatment. Prompt identification of advanced disease and interventions to optimize these patients for treatment are essential. Our findings underscore the compelling need for novel, better tolerated treatment regimens in this frail patient group. [ABSTRACT FROM AUTHOR]

Caregivers of cancer patients were prone to deterioration of their QOL due to the caregiving burden. A high caregiving burden and low QOL were common among CG. In India, only a few studies were done on the caregivers of cancer patients. Hence this study was undertaken. The aim: To study psychopathology, quality of life and burden in caregivers of cancer patients Materials and methods: The study was done on 100 caregivers of cancer patients attending after fulfilling the inclusion criteria. A semi-structured Proforma was administrated to collect the socio-demographic details. Following by Mini International Neuropsychiatric Interview (MINI), WHO-QOL and Burden assessment scale was administered to the caregivers. Data were analysed using SPSS. Descriptive statistics, Pearson and Spearman Correlations and ANOVA were used. Results: 31 % of caregivers suffer from generalised anxiety disorders (15 %) and depression (16 %). The environmental domain of QOL (mean-18.2, SD-15.4) was the most affected. 83 % of caregivers experienced a moderate burden, and 17 % had a severe burden. These variables are significantly associated with caregiver relation with patient and socio-economic status (<0.05). A significant correlation was found between Psychiatric morbidity, QOL and Burden in caregivers. Conclusion: psychiatric morbidity, quality of life and burden in CGs influence one another. The least attention was paid to caregivers' mental health, many of them left unidentified and untreated. These results highlight the need to educate them about mental health and counsel and treat them for their psychiatric problems [ABSTRACT FROM AUTHOR]

IntroductionVariation in treatment and survival outcomes for NSCLC is high among patients with stage III or IV disease, but patients with untreated NSCLC have not been critically analyzed to evaluate for improvable outcomes. We evaluated treatment trends and their association with oncologic outcomes for NSCLC, hypothesizing that there are a substantial number of untreated patients who are similar to patients who undergo treatment.MethodsLinear regression was used to calculate trends in utilization of treatment. Kaplan-Meier and Cox regression modeling were used to determine predictors of receiving treatment. Propensity matching was used to compare survival among subsets of treated versus untreated patients.ResultsPatients with primary NSCLC were identified from the National Cancer Data base from 1998 to 2012, and 21% of patients (190,539) received no treatment. For stage IIIA and IV, the proportion of untreated patients increased over the study period by 0.21% and 0.4%, respectively (p = 0.003 and p < 0.0001). Regardless of stage, untreated patients had significantly shorter overall survival (OS) (p < 0.0001). Propensity-matched analyses of 6144 stage IIIA patient pairs treated with chemoradiation versus no treatment confirmed shorter OS for untreated patients (median 16.5 versus 6.1 months, p < 0.0001). For 19,046 stage IV patient pairs treated with chemotherapy versus no treatment, similar results were obtained (median OS 9.3 versus 2.0 months, p < 0.0001).ConclusionsThe proportion of untreated patients with stage IIIA and IV disease is increasing. Survival outcomes among patients with advanced-stage disease are superior with treatment, independent of selection bias. The benefits and risks of treatment should be carefully assessed before choosing to forego treatment.

The productivity of wheat in the Mediterranean region is under threat due to climate-change-related environmental factors, including fungal diseases that can negatively impact wheat yield and quality. Wheat phenotyping tools utilizing affordable, high-throughput plant phenotyping (HTPP) techniques, such as aerial and ground RGB images and quick canopy and leaf sensors, can aid in assessing crop status and selecting tolerant wheat varieties. This study focused on the impact of fungal diseases on wheat productivity in the Mediterranean region, considering the need for a precise selection of tolerant wheat varieties. This research examined the use of affordable HTPP methods, including imaging and active multispectral sensors, to aid in crop management for improved wheat health and to support commercial field phenotyping programs. This study evaluated 40 advanced lines of bread wheat (Triticum aestivum L.) at five locations across northern Spain, comparing fungicide-treated and untreated blocks under fungal disease pressure (Septoria, brown rust, and stripe rust observed). Measurements of leaf-level pigments and canopy vegetation indexes were taken using portable sensors, field cameras, and imaging sensors mounted on unmanned aerial vehicles (UAVs). Significant differences were observed in Dualex flavonoids and the nitrogen balance index (NBI) between treatments in some locations (p < 0.001 between Elorz and Ejea). Measurements of canopy vigor and color at the plot level showed significant differences between treatments at all sites, highlighting indexes such as the green area (GA), crop senescence index (CSI), and triangular greenness index (TGI) in assessing the effects of fungicide treatments on different wheat cultivars. RGB vegetation indexes from the ground and UAV were highly correlated (r = 0.817 and r = 0.810 for TGI and NGRDI). However, the Greenseeker NDVI sensor was found to be more effective in estimating grain yield and protein content (R2 = 0.61–0.7 and R2 = 0.45–0.55, respectively) compared to the aerial AgroCam GEO NDVI (R2 = 0.25–0.35 and R2 = 0.12–0.21, respectively). We suggest as a practical consideration the use of the GreenSeeker NDVI as more user-friendly and less affected by external environmental factors. This study emphasized the throughput benefits of RGB UAV HTPPs with the high similarity between ground and aerial results and highlighted the potential for HTPPs in supporting the selection of fungal-disease-resistant bread wheat varieties.

Lymph nodes with acellular mucin harvested from treated colorectal cancers (CRC) are staged as pN0. However, there is variability among pathologists while reporting the pN stage when acellular mucin is found within nodes of untreated CRCs. While the UICC guidelines suggest staging them as pN1, the AJCC and CAP do not offer any recommendations. In order to characterize their clinicopathologic features and outcome, we compared 16 untreated CRCs (study group; mean age: 68 years) harboring nodes with acellular mucin with 34 pN0 and 25 pN1 untreated CRC controls. All tumors were unifocal; 12 (75%) were right-sided lesions. Most cases (75%) showed one node with acellular mucin (range: 1–3). MMR-deficient tumors were significantly more common in the study group (83%) compared to pN0 (33%; p = 0.006) and pN1 controls (8%; p < 0.001). The overall survival of study group patients was closer to pN0 compared to pN1 controls; however, this difference was not statistically significant. In conclusion, untreated CRC that harbor acellular mucin within lymph nodes commonly present as right-sided, MMR-deficient tumors in older women that show a non-mucinous phenotype. While the limited number of cases precludes us from making any formal recommendations about staging, we suggest that the finding of acellular mucin in a node should prompt evaluation of deeper levels (with or without cytokeratin immunohistochemistry) and submission of all pericolonic fat for additional lymph node harvest. Whether acellular mucin in nodes of untreated CRCs is related to the indolent biology of the disease, a robust local immune response or MMR deficiency requires further investigation. [ABSTRACT FROM AUTHOR]

The availability of new disease-modifying therapies (DMTs) for patients with multiple sclerosis (MS) provides an opportunity for improving outcomes but makes disease management more complex. Our study aimed to describe changes in therapeutic practices over the period 2009–2018 and measure the impact of the arrival of oral DMTs on the use of injectable DMTs. Data were extracted from a representative 1/97 sample of the French population covered by the healthcare insurance system. Study period was set from 1 January 2009 to 31 December 2018. Four periods of MS identification were defined (before 2009, 2009–2011, 2012–2015, and 2016–2018). Overall, 1,508 patients with MS were included, of whom 876 (58.1%) were treated at least once over the study period. Untreated patients were older and had more comorbidities than treated ones. First-line DMTs were the most frequent initial DMT (78.5%), and a shift has operated from injectable to oral drugs over time. The proportion of patients receiving several DMTs increased with the number of available drugs. End 2018, relative parts of all DMTs were almost equal. This study provides valuable insights into the real-world use of DMTs and changes that have operated over time. [ABSTRACT FROM AUTHOR]

Previous research related to the effect of alkali treatment on mechanical properties of composite materials which generate the regression model is still rare. From the previous research, alkali treatment does not always improve the mechanical properties of composite materials. Therefore, it is necessary to research to make sure the effect of alkali treatment on coconut fiber composite. This study aims to examine the effect of alkali treatment of fiber combined with fiber weight content on the mechanical and physical properties of epoxy resin matrix composite. Mechanical properties testing is done by impact test and torsion test. The fracture surface was observed using optical microscopy. Data from the test results were analyzed to see the effect of alkali treatment on the mechanical properties of the resulting composite material by generating the regression model of impact strength and shear strength for treated and untreated fiber composites. The coefficient of determination (R2) of all models was 1. This study obtained that the untreated fibers have better impact strength and shear strength than the treated ones. The highest impact strength, 7.07 kJ.m2, and the highest shear strength, 1.81 MPa were obtained from the samples containing 4% untreated fibers. [ABSTRACT FROM AUTHOR]

Abstract Background Patient journeys for hypertensive individuals after detection at screening have not been well examined in a general population. Thus, we aimed to assess the medical treatment status and subsequent longitudinal changes in blood pressure in a middle-aged Japanese population. Methods We conducted a cohort study using a nationwide Japanese health screening cohort, from April 2014 to March 2019. Among health screening participants aged 40–74 years who had not previously received treatment for hypertension, hypertensive patients were newly identified based on screening results, and their medical treatment status for hypertension during the year following their initial screening was assessed. The main outcomes were longitudinal changes in systolic blood pressure (SBP) and diastolic blood pressure (DBP) over 4 years after initial screening. Results Of the 153,523 screening participants (mean age = 49.7 years), 16,720 (10.9%) and 4150 (2.7%) were newly detected as having hypertension, with baseline SBP of 140–159 mmHg (grade 1) and ≥ 160 mmHg (grade 2–3), respectively. Among them, 15.9% of the grade 1 hypertensive participants and 36.3% of the grade 2–3 hypertensive participants started receiving medical treatment during the year following initial screening. A linear generalised estimating equation with propensity score matching showed that receiving medical treatment was associated with 5.77 mmHg lower SBP (95% CI − 6.64 to − 4.90) and 3.82 mmHg lower DBP (95% CI − 4.47 to − 3.16) in the grade 1 hypertensive group, and 14.69 mmHg lower SBP (95% CI − 16.35 to − 13.04) and 8.42 mmHg lower DBP (95% CI − 9.49 to − 7.34) in the grade 2–3 hypertensive group. Conclusions Health screenings detected hypertension in a substantial percentage of the middle-aged population in this study. However, detection was often followed by insufficient medical treatment and inappropriate blood pressure management. These findings indicate an inadequate link between health screenings and medical treatments in patients with hypertension.

When left untreated, psoriasis and rosacea can have long-term health and psychosocial implications. The purpose of this study was to estimate the percentage of Americans with psoriasis or rosacea who are not being treated. Patient data from a large claims-based database were analyzed to identify the number of patients who are treated for psoriasis or rosacea. The numbers of patients treated were compared to the estimated prevalences of these diseases in the general population, identified from previously published sources. Of the 18,632,362 patients in the database, 140,439 (0.75%) were seen for psoriasis and 165,130 (0.89%) were seen for rosacea. Based on published sources, 3.2% of Americans have psoriasis and about 5.0% have rosacea. We therefore estimated that 77% of people with psoriasis and 82% of people with rosacea are untreated. Greater awareness, resources, and community outreach projects are potential tools that could eliminate this disparity and increase the quality of life for patients with these diseases.

This study investigated the effects of untreated oil palm-nut fibre reinforcements on the strength and durability properties of non-fired pressed mud blocks. Different proportions of untreated oil palm-nut fibre from 1% to 5% by weight of the blocks were incorporated into already characterized soil samples and used to produce blocks. Blocks containing 0% fibre were used as the control. The effects of the incorporated fibres were examined in terms of density, water absorption ratio, and compressive strength of the produced blocks. The water absorption of the blocks increased linearly with an increase in fibre content as the control exhibited the least water absorption of 7.9%. The density of the blocks decreased with an increase in fibre content. Block sample containing 5% fibre had the least density of 1644.44kg/m³ as compared to the control with density of 1866.66 kg/m³. The addition of untreated oil palm-nut fibre reinforcements to the block increased its compressive strength up to 3% fibre addition where the maximum strength (1.91N/mm2) was observed. Beyond 3% fibre addition, the compressive strength decreased. Results obtained indicate that untreated oil palm-nut fibre reinforced earth block is a sustainable building material. This study recommends 3% fibre addition to attain optimum strength results and dissuades the use of fibres to reinforce mud blocks in high humidity environments. [ABSTRACT FROM AUTHOR]

Aim: To examine the incidence of with first‐episode psychosis (FEP) in the Integrated Department of Mental Health and Pathological Addictions in Ferrara, Italy, and to examine the association between the Duration of Untreated Psychosis (DUP) and the clinical course. Methods: Participants recruited in 2013–2019 were assessed with the Health of the Nation Outcome Scale (HoNOS) every 6 months for 24 months. Hierarchical growth models analysed changes of global severity (HoNOS total scores) and symptom dimensions. Regression modelled factors associated with remission (HoNOS < 8) and clinical improvement (<12). Results: The incidence of FEP was 21.5 (95%CI: 21.2–21.9) cases per 100 000 person year. Among participants (n = 86, mean age 23, 76% males), baseline HoNOS scores were higher for those with a longer DUP. More than half subjects reached clinical remission (61.6%) or improvement (82.6%), while very few (2.3%) were re‐hospitalized. HoNOS total scores decayed with a mixed linear/quadratic trend, with a slower decay among migrants. A longer DUP was associated with reduced improvements of positive symptoms and lower likelihood of clinical improvement (OR: 0.84; 95%CI: 0.73–0.96). Conclusions: Patients from the FEP program of Ferrara reached good clinical outcomes. Nonetheless, individuals with a longer DUP may need additional clinical attention. Systematic monitoring of clinical outcomes may be an optimal strategy to improve the outcomes of FEP in the real world. [ABSTRACT FROM AUTHOR]

Background: There is limited research examining the natural trajectories of depression and anxiety, how these trajectories relate to baseline neural circuit function, and how symptom trajectory-circuit relationships are impacted by engagement in lifestyle activities including exercise, hobbies, and social interactions. To address these gaps, we assessed these relations over three months in untreated participants.Methods: 262 adults (59.5% female, mean age 35) with symptoms of anxiety and depression, untreated with pharmacotherapy or behavioral therapy, completed the DASS-42, WHOQOL, and custom surveys at baseline and follow-up to assess symptoms, psychosocial function, and lifestyle activity engagement. At baseline, participants underwent fMRI under task-free and task-evoked conditions. We quantified six circuits implicated in these symptoms: default mode, salience, negative and positive affect, attention, and cognitive control.Results: From baseline to 3 months, some participants demonstrated a natural improvement in anxiety (24%) and depression (26%) symptoms. Greater baseline salience circuit connectivity (pFDR=0.045), specifically between the left and right insula (pFDR=0.045), and greater negative affect circuit connectivity elicited by sad faces (pFDR=0.030) were associated with anxiety symptom improvement. While engagement in lifestyle activities were not associated with anxiety improvements, engagement in hobbies moderated the association between negative affect circuit connectivity and anxiety symptom improvement (p = 0.048).Limitations: The observational design limits causal inference.Conclusions: Our findings highlight the role of the salience and negative affect circuits as potential circuit markers of natural anxiety symptom improvements over time. Future studies that identify biomarkers associated with symptom improvements are critical for the development of personalized treatment targets. [ABSTRACT FROM AUTHOR]

Phenylketonuria (PKU) is an inborn error of metabolism caused by variants in the phenylalanine hydroxylase (PAH) gene and it is characterized by excessively high levels of phenylalanine in body fluids. PKU is a paradigm for a genetic disease that can be treated and majority of developed countries have a population-based newborn screening. Thus, the combination of early diagnosis and immediate initiation of treatment has resulted in normal intelligence for treated PKU patients. Although PKU is a monogenic disease, decades of research and clinical practice have shown that the correlation between the genotype and corresponding phenotype is not simple at all. Attempts have been made to discover modifier genes for PKU cognitive phenotype but without any success so far.We conducted whole genome sequencing of 4 subjects from unrelated non-consanguineous families who presented with pathogenic mutations in the PAH gene, high blood phenylalanine concentrations and near-normal cognitive development despite no treatment. We used cross sample analysis to select genes common for more than one patient. Thus, the SHANK gene family emerged as the only relevant gene family with variants detected in 3 of 4 analyzed patients. We detected two novel variants, p.Pro1591Ala in SHANK1 and p.Asp18Asn in SHANK2, as well as SHANK2:p.Gly46Ser, SHANK2:p.Pro1388_Phe1389insLeuPro and SHANK3:p.Pro1716Thr variants that were previously described. Computational analysis indicated that the identified variants do not abolish the function of SHANK proteins. However, changes in posttranslational modifications of SHANK proteins could influence functioning of the glutamatergic synapses, cytoskeleton regulation and contribute to maintaining optimal synaptic density and number of dendritic spines.Our findings are linking SHANK gene family and brain plasticity in PKU for the first time. We hypothesize that variant SHANK proteins maintain optimal synaptic density and number of dendritic spines under high concentrations of phenylalanine and could have protective modifying effect on cognitive development of PKU patients.

Knowledge about the frictional characteristics of materials is required for equipment design, either to exploit the friction or to overcome it. This paper deals with studying the coefficients of sliding friction of non-treated and extrusion-exploded wheat straw and rice straw on mild steel and aluminum surfaces and the effects of several factors, including the moisture content (at five levels 35, 45, 55, 65, and 75%), normal pressure (at the following five levels: 2, 4, 6, 8, and 10 kPa), and length (at the following five levels: 30, 60, 90, 120, and 150 mm). Through the use of a statistical analysis method, we found that the moisture content, normal pressure, and interactions between them had statistically significant effects on the coefficient of sliding friction (p < 0.01). The coefficient of sliding friction was much larger than that of rice straw on both contact surfaces, and the coefficient values of both straw samples on the aluminum surface were notably higher than those on mild steel. A significantly higher value was found for the coefficient of sliding friction of extrusion-exploded straw compared with that of untreated straw on both surfaces. As the normal pressure increased from 2 to 10 kPa, the coefficient of sliding friction decreased first, and then increased sharply, finally fluctuating slowly for both kinds of straw and on both tested surfaces, with the maximum value was observed at a normal pressure of 6 kPa. When the length increased from 30 to 150 mm, a slightly linear upward trend was observed for the coefficient of sliding friction of untreated wheat straw, and the coefficient of sliding friction of untreated rice straw initially increased and then decreased.

The dynamic nature of the SIV population during disease progression in the SIV/macaque model of AIDS and the factors responsible for its behavior have not been documented, largely owing to the lack of sufficient spatial and temporal sampling of both viral and host data from SIV-infected animals. In this study, we detail Bayesian coalescent inference of the changing collective intra-host viral effective population size (Ne) from various tissues over the course of infection and its relationship with what we demonstrate is a continuously changing immune cell repertoire within the blood. Although the relative contribution of these factors varied among hosts and time points, the adaptive immune response best explained the overall periodic dynamic behavior of the effective virus population. Data exposing the nature of the relationship between the virus and immune cell populations revealed the plausibility of an eco-evolutionary mathematical model, which was able to mimic the large-scale oscillations in Ne through virus escape from relatively few, early immunodominant responses, followed by slower escape from several subdominant and weakened immune populations. The results of this study suggest that SIV diversity within the untreated host is governed by a predator-prey relationship, wherein differing phases of infection are the result of adaptation in response to varying immune responses. Previous investigations into viral population dynamics using sequence data have focused on single estimates of the effective viral population size (Ne) or point estimates over sparse sampling data to provide insight into the precise impact of immune selection on virus adaptive behavior. Herein, we describe the use of the coalescent phylogenetic frame- work to estimate the relative changes in Ne over time in order to quantify the relationship with empirical data on the dynamic immune composition of the host. This relationship has allowed us to expand on earlier simulations to build a predator-prey model that explains the deterministic behavior of the virus over the course of disease progression. We show that sequential viral adaptation can occur in response to phases of varying immune pressure, providing a broader picture of the viral response throughout the entire course of progression to AIDS.

The dynamic nature of the SIV population during disease progression in the SIV/macaque model of AIDS and the factors responsible for its behavior have not been documented, largely owing to the lack of sufficient spatial and temporal sampling of both viral and host data from SIV-infected animals. In this study, we detail Bayesian coalescent inference of the changing collective intra-host viral effective population size (Ne) from various tissues over the course of infection and its relationship with what we demonstrate is a continuously changing immune cell repertoire within the blood. Although the relative contribution of these factors varied among hosts and time points, the adaptive immune response best explained the overall periodic dynamic behavior of the effective virus population. Data exposing the nature of the relationship between the virus and immune cell populations revealed the plausibility of an eco-evolutionary mathematical model, which was able to mimic the large-scale oscillations in Ne through virus escape from relatively few, early immunodominant responses, followed by slower escape from several subdominant and weakened immune populations. The results of this study suggest that SIV diversity within the untreated host is governed by a predator-prey relationship, wherein differing phases of infection are the result of adaptation in response to varying immune responses. Previous investigations into viral population dynamics using sequence data have focused on single estimates of the effective viral population size (Ne) or point estimates over sparse sampling data to provide insight into the precise impact of immune selection on virus adaptive behavior. Herein, we describe the use of the coalescent phylogenetic frame- work to estimate the relative changes in Ne over time in order to quantify the relationship with empirical data on the dynamic immune composition of the host. This relationship has allowed us to expand on earlier simulations to build a predator-prey model that explains the deterministic behavior of the virus over the course of disease progression. We show that sequential viral adaptation can occur in response to phases of varying immune pressure, providing a broader picture of the viral response throughout the entire course of progression to AIDS. [ABSTRACT FROM AUTHOR]

Purpose: Osteoarthritis (OA) pain is among the leading causes of disability worldwide in older people. Since its prevalence is growing in aging, a significant burden for society is expected. This work ascertained whether level of disability in self-reported functioning differs by pain severity and usual analgesic treatment among older OA patients in Spain. Methods: The Spanish-National-Health-Survey, a large, nationally representative, cross-sectional general health survey including 23,089 persons, was analyzed. Patients aged 65 + years with a self-reported physician OA diagnosis were classified according to severity of pain (no/mild, moderate or severe pain) and treated or untreated with analgesia. Assessment of function included basic and instrumental activities-of-daily-living (BADL, IADL), mental, social, and cognitive functions, scored on a 0% (no limitation) to 100% (complete limitation) standardized metric. Caregiver need for BADL and IADL was also recorded. Results: A total of 3526 patients were analyzed (women 73.3%; age 77.4 [SD: 7.5]). Adjusted functioning scores showed significant association with pain severity, and for BADL, IADL and social function. Patients with severe pain and treated with analgesia had higher limitation scores, ranging on average between 31.5% on BADL, 34.1% on IADL, 45.0% on mental, 42.2% on social, and 23.4% in cognitive domain. The proportions of patients needing a caregiver for BADL (43.4%) and IADL (56.2%) were also the highest in patients with severe pain and treated with analgesia. Conclusions: Regardless of usual utilization of analgesics, the severity of pain seemed to be the major determinant of functional impairment, and caregiving need, in all domains of functioning in older OA patients in Spain. Existing treatment strategies are analgesics based and do not meet patient needs for adequate pain management. [ABSTRACT FROM AUTHOR]