The Concept of Prognostic Model Assessment of Toxic Chemical Fate

Abstract Background: Patient safety and optimal resource allocation are essential during the COVID-19 pandemic. We present a COVID-19 prognostic algorithm implemented in real-time as a clinical decision support structure for symptomatic persons under investigation (PUI) for COVID-19 in the emergency department (ED).Methods: The training data included 1,469 patients who tested positive for SARS-CoV-2 within 14 days of acute care. The validation was done using a retrospective set of 414 SARS-CoV-2 positive patients and a PUI set of 13,271 patients who had symptomatic SARS-CoV-2 test during acute care visit. We performed a real-time model assessment on 2,174 patients with an ED visit and symptomatic test or COVID-19 positive result. The logistic regression prognostic model used demographics, comorbidities, home medications, and vital signs factors. The COVID-19 severity outcome comprised a composite of intensive care unit (ICU) admission, invasive mechanical ventilation (ventilator) use, and mortality.Results: The area under the receiver operating characteristic (AUROC) was 0.87 (95%-CI: 0.83, 0.91) in the retrospective validation and 0.82 (95%-CI: 0.81, 0.83) in the PUI population for predicting COVID-19 severity. The model had an AUROC of 0.85 (95%-CI, 0.83, 0.87) in the real-time set. The rates of ICU admission, ventilator use, and death in patients with the lowest 20% of the scores were zero, significantly lower compared to those rates (20.6%, 9.5%, and 18.1%, respectively) for patients with the highest 20% of the scores in the real-time set. The model performed equitably across racial/ethnic minorities.Conclusion: Our prognostic model score developed on COVID-19 positive patients performed well on PUI patients and in real-time in ED to support clinical decision making.

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Prognostic model of event-free survival for patients with androgen independent prostate cancer

European Urology Supplements ◽

10.1016/s1569-9056(03)90547-1 ◽

2003 ◽

Vol 2 (6) ◽

pp. 193

Author(s):

M SHULMAN

Keyword(s):

Prostate Cancer ◽

Prognostic Model ◽

Event Free Survival ◽

Free Survival ◽

Androgen Independent

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Therapeutic Effect of Metformin and Vitamin E Versus Prescriptive Diet in Obese Adolescents with Fatty Liver

International Journal for Vitamin and Nutrition Research ◽

10.1024/0300-9831/a000086 ◽

2011 ◽

Vol 81 (6) ◽

pp. 398-406 ◽

Cited By ~ 17

Author(s):

Akcam ◽

Boyaci ◽

Pirgon ◽

Kaya ◽

Uysal ◽

...

Keyword(s):

Insulin Resistance ◽

Vitamin E ◽

Fatty Liver ◽

Liver Steatosis ◽

Tnf Alpha ◽

Dietary Advice ◽

Model Assessment ◽

Fasting Insulin ◽

Alcoholic Fatty Liver ◽

Obese Adolescents

Objective: The aim of the study was to determine whether metformin or vitamin E treatment for six months is effective in reducing body weight, blood pressure, and also ameliorating insulin resistance, adiponectin, and tumor necrosis factor (TNF)-alpha in obese adolescents with non-alcoholic fatty liver disease (NAFLD). Methods: Sixty-seven obese adolescents with liver steatosis (age range, 9 - 17 years) were included in the study. The metformin group received an 850-mg dose of metformin daily and the vitamin E group received 400 U vitamin E /daily, in capsule form for 6 months, plus an individually tailored diet, exercise, and behavioral therapy. Results: After 6 months later, there was a significant decline in body mass index, and fasting insulin and homeostatic model assessment (HOMA) values in all three groups. Moreover, in comparingson of changes in HOMA among the groups, the metformin- treated group showed significantly improved metabolic control and insulin sensitivity (HOMA) at the end of the study. There were no significant differences for changes of adiponectin, TNF-alpha, in all three groups after 6 months study. Conclusion: These data suggest that metformin treatment is more effective than dietary advice and vitamin E treatment in reducing insulin resistance, and also in ameliorating metabolic parameters such as fasting insulin and lipid levels, in obese adolescents having NAFLD.

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Clinical factors correlated with vitamin D deficiency in patients with obesity scheduled for bariatric surgery: A single center experience

International Journal for Vitamin and Nutrition Research ◽

10.1024/0300-9831/a000662 ◽

2020 ◽

Vol 90 (3-4) ◽

pp. 346-352

Author(s):

Vincenzo Pilone ◽

Salvatore Tramontano ◽

Carmen Cutolo ◽

Federica Marchese ◽

Antonio Maria Pagano ◽

...

Keyword(s):

Bariatric Surgery ◽

Vitamin D ◽

Vitamin D Deficiency ◽

Serum Vitamin ◽

Inverse Correlation ◽

Model Assessment ◽

Cross Sectional ◽

Serum Vitamin D ◽

Female Sex ◽

Vitamin D Levels

Abstract. We aim to assess the prevalence of vitamin D deficiency (VDD) in patients scheduled for bariatric surgery (BS), and to identify factors that might be associated with VDD. We conducted a cross-sectional observational study involving all consecutive patients scheduled for BS from 2017 to 2019. The exclusion criteria were missing data for vitamin D levels, intake of vitamin D supplements in the 3 months prior to serum vitamin D determination, and renal insufficiency. A total of 206 patients (mean age and body mass index [BMI] of 34.9 ± 10.7 years, and 44.3 ± 6.99 kg/m2, respectively) met the inclusion criteria and were enrolled for data analysis. VDD (<19.9 ng/mL), severe VDD (<10 ng/mL), and vitamin D insufficiency (20–29.9 ng/mL) were present in 68.8 %, 12.5 %, and 31.2 % of patients, respectively. A significant inverse correlation was found between vitamin D levels and initial BMI, parathyroid hormone, and homeostatic model assessment of insulin resistance (r = −0.280, p < 0.05; r = −0.407, p = 0.038; r = −0.445, p = 0.005), respectively. VDD was significantly more prevalent in patients with higher BMI [−0.413 ± 0.12, CI95 % (−0.659; −0.167), p = 0.006], whereas no significant association between hypertension [−1.005 ± 1.65, CI95 % (−4.338; 2.326), p = 0.001], and diabetes type 2 (T2D) [−0.44 ± 2.20, CI95 % (−4.876; 3.986), p = 0.841] was found. We observed significant association between female sex and levels of vitamin D [6.69 ± 2.31, CI95 % (2.06; 11.33), p = 0.006]. The present study shows that in patients scheduled for BS, VDD deficiency is common and was associated with higher BMI, and female sex.

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The Weight Loss Effects of Branched Chain Amino Acids and Vitamin B6: A Randomized Controlled Trial on Obese and Overweight Women

International Journal for Vitamin and Nutrition Research ◽

10.1024/0300-9831/a000511 ◽

2018 ◽

Vol 88 (1-2) ◽

pp. 80-89 ◽

Cited By ~ 3

Author(s):

Zahra Shakibay Novin ◽

Saeed Ghavamzadeh ◽

Alireza Mehdizadeh

Keyword(s):

Amino Acids ◽

Weight Loss ◽

Body Composition ◽

Vitamin B6 ◽

Controlled Trial ◽

Density Lipoprotein ◽

Branched Chain Amino Acids ◽

Model Assessment ◽

Waist To Hip Ratio ◽

Branched Chain

Abstract. Branched chain amino acids (BCAA), with vitamin B6 have been reported to improve fat metabolism and muscle synthesis. We hypothesized that supplementation with BCAA and vitamin B6 would result in more weight loss and improve body composition and blood markers related to cardiovascular diseases. Our aim was to determine whether the mentioned supplementation would affect weight loss, body composition, and cardiovascular risk factors during weight loss intervention. To this end, we performed a placebo-controlled randomized clinical trial in 42 overweight and obese women (BMI = 25–34.9 kg/m2). Taking a four-week moderate deficit calorie diet (–500 kcal/day), participants were randomized to receive BCAA (6 g/day) with vitamin B6 (40 mg/day) or placebo. Body composition variables measured with the use of bioelectrical impedance analysis, homeostatic model assessment, and plasma insulin, Low density lipoprotein, High density lipoprotein, Total Cholesterol, Triglyceride, and fasting blood sugar were measured. The result indicated that, weight loss was not significantly affected by BCAA and vitamin B6 supplementation (–2.43 ± 1.02 kg) or placebo (–1.64 ± 1.48 kg). However, significant time × treatment interactions in waist to hip ratio (P = 0.005), left leg lean (P = 0.004) and right leg lean (P = 0.023) were observed. Overall, supplementation with BCAA and vitamin B6 could preserve legs lean and also attenuated waist to hip ratio.

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The interaction between dietary approaches to stop hypertension and MC4R gene variant in predicting cardiovascular risk factors

International Journal for Vitamin and Nutrition Research ◽

10.1024/0300-9831/a000690 ◽

2020 ◽

pp. 1-9

Author(s):

Habib Yarizadeh ◽

Alireza Bahiraee ◽

Sara Asadi ◽

Niloofar Sadat Maddahi ◽

Leila Setayesh ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Model Assessment ◽

Iranian Women ◽

Cvd Risk ◽

Dash Diet ◽

Melanocortin 4 Receptor Gene ◽

Significant Difference ◽

High Adherence

Abstract. Objective: The genetic variants near the melanocortin-4 receptor gene (MC4R), a key protein regulating energy balance and adiposity, have been related to obesity and cardiovascular risk factors. However, qualitative and quantitative aspects of diet may modulate the association of this polymorphism with obesity and cardiovascular diseases (CVDs). The aim of this study was to evaluate interactions among MC4R rs17782313, the Dietary Approaches to Stop Hypertension (DASH) diet and risk factors for CVDs. Method: This cross-sectional study was conducted on 266 Iranian women categorized by body mass index (BMI) range of 25–40 kg/m2 as overweight or obese. CVD risk factors included waist circumference (WC), lipid profile, blood pressure, insulin circulation and fasting blood sugar (FBS). Insulin and FBS were used to calculate homeostatic model assessment insulin resistance (HOMA-IR) Body composition was assessed by a multi-frequency bioelectrical impedance analyzer, InBody 770 scanner. Results: The findings of this study show that high adherence to the DASH diet in the CC groups were associated with decreased SBP and DBP compared to the TT group. In addition, a significant difference between women with high adherence to the DASH diet compared to low adherence was observed for body weight (p < 0.001), fat free mass (FFM) (p = 0.01) and BMI (p = 0.02). Women with the CC genotype had higher insulin (mg/dl) (mean and SD, for TT: 14.6 ± 4.6, TC: 17.3 ± 9.2, CC: 15.3 ± 4.8, p = 0.04) and HOMA-IR (mean for and SD, TT: 3.1 ± 1.07, TC: 3.9 ± 2.4, CC: 3.2 ± 1.1, p = 0.01) than TT group. Inclusion of potential confounding variables (age, physical activity, BMI and daily caloric intake) did not attenuate the difference. Conclusion: Among overweight/obese Iranian women with the CC genotype, incorporating the DASH diet may serve as a dietary prescription to decrease CVD risk. A dietary intervention trial is warranted.

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