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BackgroundMachine learning techniques, specifically classification algorithms, may be effective to help understand key health, nutritional, and environmental factors associated with cognitive function in aging populations. ObjectiveThis study aims to use classification techniques to identify the key patient predictors that are considered most important in the classification of poorer cognitive performance, which is an early risk factor for dementia. MethodsData were used from the Trinity-Ulster and Department of Agriculture study, which included detailed information on sociodemographic, clinical, biochemical, nutritional, and lifestyle factors in 5186 older adults recruited from the Republic of Ireland and Northern Ireland, a proportion of whom (987/5186, 19.03%) were followed up 5-7 years later for reassessment. Cognitive function at both time points was assessed using a battery of tests, including the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), with a score

The burden of seasonal influenza disease in Australian children is substantial, especially for those with medical comorbidities including chronic cardiac, respiratory, neurological and immunosuppressive conditions. Influenza is more likely to [...]

Simple Summary: The renin–angiotensin system (RAS) is a well-known hormonal system that controls blood pressure and blood volume. Recent work has suggested that it also plays a role in cancer. Various studies in humans and animals have investigated blocking different parts of the RAS; many, but not all, studies have shown decreased tumor growth and spread. The RAS consists of various bypass pathways, which may explain the lack of a response to treatment in some studies. A treatment has been developed to simultaneously block multiple parts of the RAS (multimodal blockade). This treatment has been used in one clinical trial in humans with glioblastoma (a brain tumor) and another trial in cats with squamous cell carcinoma (skin cancer). The aim of this study was to assess the safety of multimodal blockade of the RAS in dogs with two different types of cancer (osteosarcoma and oral malignant melanoma). Two mild adverse effects were observed: one dog developed intermittent vomiting; another dog had a mildly increased serum SDMA concentration (a kidney function biomarker) at one time point. This sets the stage for conducting a larger-scale trial to assess the efficacy of this treatment for cancer in dogs. The renin–angiotensin system (RAS) is increasingly being recognized to play a role in the tumor microenvironment, promoting tumor growth. Studies blocking a single part of the RAS have shown mixed results, possibly due to the existence of different bypass pathways and redundancy within the RAS. As such, multimodal blockade of the RAS has been developed to exert more complete inhibition of the RAS. The aim of the present study was to assess the safety of multimodal RAS blockade in dogs. Five dogs (four with appendicular osteosarcoma, one with oral malignant melanoma) were treated with atenolol, benazepril, curcumin, meloxicam, and metformin. The dogs underwent clinical examination, blood pressure measurement, and hematology and serum biochemistry tests performed at 0, 1, 3, 6, 9, and 12 weeks, then every 3 months thereafter. End-of-life decisions were made by the owners. None of the dogs developed hypotension. One dog had intermittent vomiting during the 64 weeks it was on the trial. One dog had a one-off increase in serum SDMA(symmetrical dimethylarginine) concentration. Dogs were euthanized at weeks 3 (osteosarcoma), 10 (osteosarcoma), 17 (osteosarcoma), and 26 (oral malignant melanoma), and one dog was still alive at the end of the trial at 64 weeks (osteosarcoma). This is the first assessment of multimodal blockade of the RAS in dogs, and the results suggest it causes only mild adverse effects in some animals. The efficacy of the treatment was not assessed due to the small number of dogs. This pilot study allows for future larger studies assessing multimodal RAS blockade for the treatment of canine cancer. [ABSTRACT FROM AUTHOR]

Background: Antidepressant use has continually increased in recent decades and although they are an effective treatment for moderate-to-severe depression, when there is no longer a clinical benefit, deprescribing should occur. Currently, routine deprescribing is not part of clinical practice and research shows that there has been an increase in antidepressant users seeking informal support online. This small scoping exercise used a mixed-methods online survey to investigate the motives antidepressant users have for joining social media deprescribing support groups, and what elements of the groups are most valuable to them. Methods: Thirty members of two antidepressant deprescribing Facebook groups completed an online survey with quantitative and open-text response questions to determine participant characteristics and motivation for group membership. Quantitative data were analysed using descriptive statistics, and open-text responses were analysed thematically through NVivo. Results: Two overarching themes were evident: first, clinician expertise , where participants repeatedly reported a perceived lack of skills around deprescribing by their clinician, not being included in shared decision-making about their treatment, and symptoms of withdrawal during deprescribing going unaddressed. Motivated by the lack of clinical support, peer support developed as the second theme. Here, people sought help online where they received education, knowledge sharing and lived experience guidance for tapering. The Facebook groups also provided validation and peer support, which motivated people to continue engaging with the group. Conclusions: Antidepressant users who wish to cease their medication are increasingly subscribing to specialised online support groups due to the lack of information and support from clinicians. This study highlights the ongoing need for such support groups. Improved clinician understanding about the complexities of antidepressant deprescribing is needed to enable them to effectively engage in shared decision-making with their patients. Deprescribing of antidepressants is not routinely occurring in clinical practice, leading patients to seek help via other methods. Little is known about what role social media support groups play in a patient's journey when ceasing antidepressant medication. This is one of the first studies to gain insight from antidepressant users who are also members of two Facebook groups providing support for antidepressant deprescribing. Lack of clinical knowledge by clinicians is a big driver for patients help seeking from their peers. [ABSTRACT FROM AUTHOR]