scholarly journals Temporal response characterization across individual multiomics profiles of prediabetic and diabetic subjects

2021 ◽  
Author(s):  
Minzhang Zheng ◽  
Carlo Piermarocchi ◽  
George I. Mias
Keyword(s):  
Great Promise ◽  
Individual Subject ◽  
Individual Level ◽  
Diabetic Status ◽  
Personal Level ◽  
Clinical Measures ◽  
Immune Changes ◽  
Individual Profiles ◽  
Precision Health

Longitudinal deep multi-omics profiling, which combines biomolecular, physiological, environmental and clinical measures data, shows great promise for precision health. However, integrating and understanding the complexity of such data remains a big challenge. Here we propose a bottom-up framework starting from assessing single individuals' multi-omics time series, and using individual responses to assess multi-individual grouping based directly on similarity of their longitudinal deep multi-omics profiles. We applied our method to individual profiles from a study profiling longitudinal responses in type 2 diabetes mellitus. After generating periodograms for individual subject omics signals, we constructed within-person omics networks and analyzed personal-level immune changes. The results showed that our method identified both individual-level responses to immune perturbation, and the clusters of individuals that have similar behaviors in immune response and which was associated to measures of their diabetic status.

scholarly journals The Effect of Surrounding Greenness on Type 2 Diabetes Mellitus: A Nationwide Population-Based Cohort in Taiwan

2020 ◽  
Vol 18 (1) ◽  
pp. 267
Author(s):  
Hui-Ju Tsai ◽  
Chia-Ying Li ◽  
Wen-Chi Pan ◽  
Tsung-Chieh Yao ◽  
Huey-Jen Su ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Vegetation Index ◽  
Normalized Difference Vegetation Index ◽  
Population Based ◽  
Research Database ◽  
Individual Level ◽  
The Relationship

This study determines whether surrounding greenness is associated with the incidence of type 2 diabetes Mellitus (T2DM) in Taiwan. A retrospective cohort study determines the relationship between surrounding greenness and the incidence of T2DM during the study period of 2001–2012 using data from the National Health Insurance Research Database. The satellite-derived normalized difference vegetation index (NDVI) from the global MODIS database in the NASA Earth Observing System is used to assess greenness. Cox proportional hazard models are used to determine the relationship between exposure to surrounding greenness and the incidence of T2DM, with adjustment for potential confounders. A total of 429,504 subjects, including 40,479 subjects who developed T2DM, were identified during the study period. There is an inverse relationship between exposure to surrounding greenness and the incidence of T2DM after adjustment for individual-level covariates, comorbidities, and the region-level covariates (adjusted HR = 0.81, 95% CI: 0.79–0.82). For the general population of Taiwan, greater exposure to surrounding greenness is associated with a lower incidence of T2DM.

scholarly journals Protocol for a hybrid type 2 cluster randomized trial of trauma-focused cognitive behavioral therapy and a pragmatic individual-level implementation strategy

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Aaron R. Lyon ◽  
Michael D. Pullmann ◽  
Shannon Dorsey ◽  
Carol Levin ◽  
Larissa M. Gaias ◽  
...  
Keyword(s):  
Mental Health ◽  
Cost Effectiveness ◽  
Behavior Change ◽  
Implementation Strategy ◽  
Youth Mental Health ◽  
Successful Implementation ◽  
Individual Level ◽  
Implementation Outcomes ◽  
Cluster Randomized

Abstract Background More than two-thirds of youth experience trauma during childhood, and up to 1 in 5 of these youth develops posttraumatic stress symptoms that significantly impair their functioning. Although trauma-focused cognitive behavior therapy (TF-CBT) has a strong evidence base, it is rarely adopted, delivered with adequate fidelity, or evaluated in the most common setting where youth access mental health services—schools. Given that individual behavior change is ultimately required for successful implementation, even when organizational factors are firmly in place, focusing on individual-level processes represents a potentially parsimonious approach. Beliefs and Attitudes for Successful Implementation in Schools (BASIS) is a pragmatic, motivationally focused multifaceted strategy that augments training and consultation and is designed to target precise mechanisms of behavior change to produce enhanced implementation and youth clinical outcomes. This study protocol describes a hybrid type 2 effectiveness-implementation trial designed to concurrently evaluate the main effects, mediators, and moderators of both the BASIS implementation strategy on implementation outcomes and TF-CBT on youth mental health outcomes. Methods Using a cluster randomized controlled design, this trial will assign school-based mental health (SMH) clinicians and schools to one of three study arms: (a) enhanced treatment-as-usual (TAU), (b) attention control plus TF-CBT, or (c) BASIS+TF-CBT. With a proposed sample of 120 SMH clinicians who will each recruit 4–6 youth with a history of trauma (480 children), this project will gather data across 12 different time points to address two project aims. Aim 1 will evaluate, relative to an enhanced TAU condition, the effects of TF-CBT on identified mechanisms of change, youth mental health outcomes, and intervention costs and cost-effectiveness. Aim 2 will compare the effects of BASIS against an attention control plus TF-CBT condition on theoretical mechanisms of clinician behavior change and implementation outcomes, as well as examine costs and cost-effectiveness. Discussion This study will generate critical knowledge about the effectiveness and cost-effectiveness of BASIS—a pragmatic, theory-driven, and generalizable implementation strategy designed to enhance motivation—to increase the yield of evidence-based practice training and consultation, as well as the effectiveness of TF-CBT in a novel service setting. Trial registration ClinicalTrials.gov registration number NCT04451161. Registered on June 30, 2020.

scholarly journals Consistency and Heterogeneity of Individual Behavior under Uncertainty

2007 ◽  
Vol 97 (5) ◽  
pp. 1921-1938 ◽  
Author(s):  
Syngjoo Choi ◽  
Raymond Fisman ◽  
Douglas Gale ◽  
Shachar Kariv
Keyword(s):  
Utility Function ◽  
Portfolio Choice ◽  
Individual Behavior ◽  
Parameter Estimates ◽  
Individual Subject ◽  
Individual Level ◽  
Study Behavior ◽  
The Individual ◽  
Two Parameter ◽  
Good Interpretation

By using graphical representations of simple portfolio choice problems, we generate a very rich dataset to study behavior under uncertainty at the level of the individual subject. We test the data for consistency with the maximization hypothesis, and we estimate preferences using a two-parameter utility function based on Faruk Gul (1991). This specification provides a good interpretation of the data at the individual level and can account for the highly heterogeneous behaviors observed in the laboratory. The parameter estimates jointly describe attitudes toward risk and allow us to characterize the distribution of risk preferences in the population. (JEL D11, D14, D81, G11)

scholarly journals Effects of Positive Airway Pressure Treatment on Clinical Measures of Hypertension and Type 2 Diabetes

2012 ◽  
Vol 08 (05) ◽  
pp. 481-487 ◽  
Author(s):  
Bharati Prasad ◽  
David W. Carley ◽  
Jerry A. Krishnan ◽  
Terri E. Weaver ◽  
Frances M. Weaver
Keyword(s):  
Type 2 Diabetes ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Pressure Treatment ◽  
Clinical Measures

The utility of the single-subject method for comparison of temporal-spatial gait changes between a microprocessor and non-microprocessor prosthetic knees

2020 ◽  
Vol 44 (3) ◽  
pp. 133-144
Author(s):  
Charla L Howard ◽  
Chris Wallace ◽  
Bonnie Perry ◽  
Dobrivoje S Stokic
Keyword(s):  
Clinical Decision Making ◽  
Clinical Decision ◽  
Single Subject ◽  
Step Width ◽  
Individual Subject ◽  
Individual Level ◽  
Prosthetic Knee ◽  
Gait Characteristics ◽  
Single Limb Support ◽  
Weight Acceptance

Background: Despite increasing knowledge about the potential benefits of advanced user-controlled technology, the decision about switching an individual prosthesis user from a non-microprocessor prosthetic knee to a microprocessor prosthetic knee is mainly based on clinician’s experience rather than empirical evidence. Objectives: To demonstrate the utility of single-subject design and data analysis for evaluating changes in temporal-spatial gait characteristics between walking with a non-microprocessor prosthetic knee and microprocessor prosthetic knee. Study design: Single-subject ABA/BAB design. Methods: Seven non-microprocessor prosthetic knee users (all men, age 50–84 years, 3–40 years post-amputation) were transitioned through the ABA or BAB phases (A-NMPK, B-MPK, 5 weeks each). Four weekly gait evaluations were performed at three self-selected speeds with an electronic walkway. The non-microprocessor prosthetic knee–microprocessor prosthetic knee differences in stride length–cadence relationship, prosthetic weight acceptance, single-limb support, and step width were evaluated for each subject using the “non-overlap of all pairs” statistical method. Results: Most subjects improved temporal-spatial gait while on the microprocessor prosthetic knee; in only one subject, none of the 10 gait parameters were in favor of the microprocessor prosthetic knee. In the BAB group, longer use of the microprocessor prosthetic knee was associated with shorter prosthetic weight acceptance and longer single-limb support times across three speeds. Step width either improved with the microprocessor prosthetic knee or remained unchanged in most subjects. Conclusion: The evidence of individual subject improvements in gait coordination, greater reliance on the prosthetic side, and better stability with the microprocessor prosthetic knee than non-microprocessor prosthetic knee over a range of walking speeds demonstrate the practical utility of the single-subject method in clinical decision-making. Clinical relevance The results demonstrate the use of the single-subject method for examining person-specific differences in temporal-spatial gait characteristics between walking with a non-microprocessor prosthetic knee and microprocessor prosthetic knee at three self-selected speeds. The method proved feasible and reliable for documenting changes in gait at the individual level, which is relevant for clinical practice.

scholarly journals Clinical Measures of Physical Fitness Predict Insulin Resistance in People at Risk for Diabetes

2008 ◽  
Vol 88 (11) ◽  
pp. 1355-1364 ◽  
Author(s):  
Chiao-Nan Chen ◽  
Lee-Ming Chuang ◽  
Ying-Tai Wu
Keyword(s):  
Physical Activity ◽  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
Body Mass Index ◽  
At Risk ◽  
Risk Factor ◽  
Waist Circumference ◽  
Physical Fitness ◽  
Clinical Measures

Background and Purpose Physical inactivity has been well documented as a risk factor for type 2 diabetes. Previous studies measured the level of physical activity either with questionnaires or with direct measurements of maximum oxygen uptake. However, questionnaires are patient-report measures, and methods for obtaining direct maximum oxygen uptake measurements often are not available clinically. The purpose of this study was to investigate whether clinical measurement of health-related physical fitness with a simple test battery can predict insulin resistance, a precursor of type 2 diabetes, in people at risk for diabetes. Subjects and Methods A total of 151 volunteers with at least one diabetes risk factor (overweight, hypertension, dyslipidemia, family history, impaired glucose tolerance, gestational diabetes, or delivering a baby weighing more than 4.0 kg) were recruited. Insulin resistance (as determined with the homeostasis model assessment of insulin resistance [HOMA-IR]), physical fitness (including body composition, as determined with the body mass index and waist circumference), muscle strength (handgrip strength [force-generating capacity]), muscle endurance (sit-up test), flexibility (sit-and-reach test), and cardiorespiratory endurance (step test) were measured, and a physical activity questionnaire was administered. Backward regression analysis was used to build the prediction models for insulin resistance from components of physical fitness and physical activity. Results Body mass index, muscle strength, and cardiorespiratory fitness predicted HOMA-IR in men (adjusted R2=.264). In women, age, waist circumference, and cardiorespiratory fitness were the predictors of HOMA-IR (adjusted R2=.438). Discussion and Conclusion Clinical measures of physical fitness can predict insulin resistance in people at risk for diabetes. The findings support the validity of clinical measures of physical fitness for predicting insulin resistance in people at risk for diabetes.

scholarly journals Does where you live matter? : physical characteristics of neighbourhoods and type 2 diabetes in Toronto ; a cross sectional survey of ethnoracial groups living in St. James Town and Flemingdon Park

2021 ◽  
Author(s):  
Anne-Marie Tynan
Keyword(s):  
Type 2 Diabetes ◽  
Diabetes Education ◽  
Grocery Stores ◽  
Education Programs ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Individual Level ◽  
Self Reported Health Status ◽  
The Impact

The purpose of this study is to explore the impact of neighbourhood on type 2 diabetes among a sample of immigrants attending diabetes education programs in Toronto. Flemingdon Park (FP) has higher overall rates of diabetes than does St. James Town (SJ), even though both areas share similar socio-economic and immigrant profiles. A cross-sectional survey administered to participants of Diabetes Education Programs at Flemingdon and Sherbourne Health Centres asked questions about proximity of resources such as grocery stores, walking, biking trails, parks, access to and availability of recreation sites, public transit, social support and self-reported health status. The results provide individual-level information on the impact of neighbourhood and other social determinants on type 2 diabetes among a sample of immigrants. While the results support the notion that 'where you live' does matter, bigger sample size and further study are needed.

scholarly journals Diet Beverage Intake and Risk of Chronic Kidney Disease in People with Type 2 Diabetes: An Individual Level Meta-Analysis

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1467-1467
Author(s):  
Andrew Odegaard ◽  
David Jacobs ◽  
Lyn Steffen ◽  
Casey Rebholz ◽  
Katherine Tucker ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Chronic Kidney Disease ◽  
High Risk ◽  
Kidney Disease ◽  
Meta Analysis ◽  
Healthy Eating Index ◽  
Cardiovascular Health Study ◽  
Individual Level ◽  
Increased Risk

Abstract Objectives Diet beverages are calorie free beverages sweetened with non-nutritive sweeteners. People with diabetes are the highest per-capita consumers of diet beverages, tending to consume them as a replacement for sugar sweetened beverages. This behavior is endorsed by dietetic and scientific organizations and diet beverages are marketed synonymously with better health. The underlying concern is the lack of data to support or refute this concept. To begin addressing this gap we examined the association between diet beverage intake and incident chronic kidney disease (CKD) in a population at high risk for CKD. Methods We pooled data from the Atherosclerosis Risk in Communities study (years 1987–2014), Cardiovascular Health Study (1989–2014), Jackson Heart Study (2000–2012), and Multi-Ethnic Study of Atherosclerosis (2000–2013) to conduct a prospective study of the association of diet beverage intake with the incidence of CKD among participants with clinically ascertained type 2 diabetes (T2D) without prevalent CKD and with valid dietary data (n = 3250). CKD was defined using serum creatinine to define estimated glomerular filtration (eGFR) via the CKD-EPI creatinine equation. Incident CKD was defined as (eGFR <60 ml/min/1.73 m2). We carried out a 2-step meta-analysis using individual level, cohort-specific regression analyses with identical adjustment for demographic, lifestyle, overall diet quality (Alternative Healthy Eating Index), energy intake, and clinical risk factors (baseline eGFR, total cholesterol, blood pressure, fasting glucose) to generate effect estimates that were pooled together using fixed and random effects meta-analysis. Results 1018 participants developed CKD during follow-up. There was a positive association between diet beverage intake and risk of CKD. Compared to individuals reporting no intake of diet beverages, those consuming >0 and <1 diet beverage per day had a pooled relative risk and 95% confidence interval (RR, 95% CI) of 1.03 (0.87–1.22) and those consuming ≥1 beverage per day had a pooled RR (95% CI) of 1.20 (1.02–1.41). Conclusions Diet beverage intake was associated with an increased risk of CKD in a diverse population with T2D. These results suggest the need to further examine the role of diet beverages in this high risk population. Funding Sources AHA.

SGLT2 Inhibitors: A New Generation of Antidiabetic Drugs

2015 ◽  
Vol 8 (2) ◽  
pp. 2787-2798
Author(s):  
S.K Kulkarni ◽  
Madhavi Kuchana ◽  
D Samba Reddy
Keyword(s):  
Type 2 Diabetes ◽  
Blood Glucose ◽  
Sglt2 Inhibitors ◽  
Antidiabetic Drugs ◽  
New Drugs ◽  
Hypoglycemic Agents ◽  
Great Promise ◽  
Glucose Levels ◽  
Blood Glucose Levels

The incidence of type 2 diabetes is markedly increasing worldwide. Despite a plethora of therapeutic options available for the treatment of type 2 diabetes, the ability to effectively normalize blood glucose levels and prevent    long-term complications of diabetes remains elusive. There is intense search for new drugs for diabetes.  One novel therapeutic class of antidiabetic drugs is sodium-glucose cotransporter 2 (SGLT2) inhibitors. SGLT2 is renal membrane transporter that plays an important role in glucose reabsorption within kidneys. Hence, inhibition of SGLT2 enhances renal glucose excretion, consequently lowers blood glucose levels in an insulin- independent manner. This article describes various SGLT2 inhibitors currently available in the market and also agents that are undergoing clinical trials for the treatment of type 2 diabetes. Currently three SGLT2 inhibitors are approved for clinical use and several others are still in development. The emerging data suggest that SGLT2 inhibitors hold great promise for the clinical management of type 2 diabetes. It remains to be seen whether this class of drugs offers additional advantages over the existing oral hypoglycemic agents.

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