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Developing Predictive Models for Periodontitis Progression Using Artificial Intelligence: A Longitudinal Cohort Study
Get PDFAIM: To construct predictive models of periodontitis progression by applying Machine Learning (ML) to baseline data from a study of periodontitis progression. MATERIALS AND METHODS: Logistic regression (LR), multi-layer perceptron (MLP) and probabilistic graphic model (PGM) were utilised on data from a multi-centre longitudinal study in which periodontally healthy (n = 113) and periodontitis participants (n = 302) were examined bi-monthly for 12 months without treatment. Periodontal examination was performed, and salivary levels of 10 analytes were determined. Clinical and demographic parameters and analytes levels were input into the model. The performance of 14 models was compared using the area under the receiver operating characteristic curve (AUROC), and feature importance was assessed using SHapley Additive exPlanations (SHAP). RESULTS: The PGM model (Clinical measures, saliva IL-1β, age, sex) demonstrated the best overall performance (AUROC = 0.88), compared to LR (AUROC = 0.72) and MLP (AUROC = 0.58). Although MLP had a lower Brier score (0.12), its sensitivity was 0, limiting its clinical utility. In contrast, PGM achieved a balanced sensitivity (0.55) and specificity (0.81). Feature importance analyses highlighted the number of deep periodontal pockets as a key driver of model predictions in both PGM and MLP. CONCLUSIONS: ML models can predict periodontitis progression, supporting early detection strategies. Our integrative approach, combining clinical data with salivary biomarkers such as IL-1β, improved predictive accuracy
Assessing the impact of TET2 and TET3 deletion in TCRalpha and TCRbeta repertoire in murine CD4 T cells in physiological and pathophysiological conditions
Get PDFTen Eleven Translocation (TET) proteins can oxidize 5-methylcytosine to generate in sequential steps oxidized forms of cytosine: 5-hydroxymethylcytosine, 5-formylcytosine and 5-carboxylcytosine. Through their catalytic activity TET proteins promote active DNA demethylation. There are three TET proteins: TET1, TET2 and TET3. In T cells, TET2 and TET3 are more highly expressed. In the past years we have extensively analyzed the impact of TET proteins and 5-hydroxymethylcytosine in T cell development. In this report, we focus on the impact of TET proteins in the TCR alpha (α) and beta (β) repertoires in thymic CD4 single positive cells and upon migration in the periphery. Our data reveal that both wild type and Tet2/3 DKO CD4 cells in the thymus and the spleen are polyclonal. Then, we focus on Tet2/3 DKO CD4 cells that are serially transplanted in recipient mice. Our TCR sequencing data reveals that expanded Tet2/3 DKO CD4 cells are less diverse and oligoclonal. Overall, this report serves as a resource of TCRα and TCRβ repertoire in both wild type and Tet2/3 DKO murine conventional CD4 T cells and provides insights on how expanded Tet2/3 DKO CD4 cells opt for specific TCRα and β repertoires
HIV risk perception and associated factors among pregnant and breastfeeding women in Zambia: implications for PrEP uptake in antenatal and postnatal settings
Get PDFHIV risk perception is seen as a key motivation for individuals to use biomedical HIV prevention interventions, including pre-exposure prophylaxis (PrEP). We determined HIV risk perception and associated factors among pregnant and breastfeeding women in Lusaka, Zambia. We conducted a cross sectional study among pregnant and breastfeeding women not living with HIV in a hospital setting in Lusaka, Zambia. Study team members administered a structured questionnaire to pregnant and breastfeeding women at the hospital's maternal and child health clinic to get information on socio-demographics, obstetrics and pregnancy history, sexual behavior and HIV risk perception. Participants assessed their HIV risk perception (outcome variable) as no, low, moderate, or high; these were later collapsed into a binary variable of lower vs. higher risk. Logistic regression analysis was used to determine factors associated with high HIV self-risk perception. From September to December 2021, we recruited 389 pregnant and breastfeeding women in our study. Of these, 172 (44%) were pregnant and 217 (56%) were breastfeeding. Most participants were aged between 25 and 34 years 181 (47%), and the majority 338 (87%) never used a condom with their regular sexual partner. About 129 (33%) of participants perceived higher HIV risk. This appeared higher in breastfeeding vs. pregnant women (40% vs. 25%).Over half (52%) of participants with unknown partner HIV status and one-third (33%) of those who never used condoms with their regular sexual partners perceived higher HIV risk. In adjusted models, higher HIV self-risk perception was associated with breastfeeding status (AOR = 1.82; 95% CI: 1.14–2.91), having more than 5 lifetime sexual partners (AOR = 4.27; 95% CI: 1.84–9.90), and having a partner of unknown HIV status (AOR = 2.15; 95% CI: 1.22–3.78). A low proportion of women perceived higher HIV risk, even when their sexual behaviours and partner characteristics would suggest HIV exposure. HIV prevention programs should focus on the accurate assessment of HIV risk to improve uptake of PrEP in the study population
Polygenic Risk Score Associated with Gestational Diabetes Mellitus in an AmericanIndian Population
Get PDFBackground/Objectives: Gestational diabetes mellitus (GDM) is a state of hyperglycemia during pregnancy, increasing the risk of birth complications, and subsequent type 2 diabetes mellitus in the mother and offspring. Risk factors such as diet, obesity, and family history have demonstrated strong association with GDM, but no clear pathophysiology has been ascertained. Methods: An analysis was conducted on 38 women with and 296 without GDM, within a case/control study of pre-eclampsia. The genetic variants examined were selected from among a published polygenic risk score of 10 variants (PRS-10). Genetic models were evaluated for each variant by multivariate logistic regression methods adjusted for age, body mass index, and pre-eclampsia. Since the genotypes for three of the PRS-10 were not available, a risk score comprising the total risk alleles among seven of the variants (PRS-7) was evaluated among those with all genotypes available. Results: Multivariate logistic regression showed significant, independent, positive associations between body mass index (BMI) and age. The posited PRS-7 showed a trend (OR 1.56, 95% CI 0.92–2.56, p = 0.070), and sensitivity analysis comprising three variants (PRS-3) was significantly associated with GDM (OR 2.43, 95% CI 1.17–5.06, p = 0.017). In univariate analysis, rs1421085 was associated with GDM (OR 0.50, 95% CI 0.26–0.95, p = 0.034), but not after adjustment for covariates, and paradoxically not for the expected risk allele. None of the other six variants showed an individual association with GDM. The previously published meta-analysis of PRS-10 showed a degree of heterogeneity (pQ= 0.03) among the three cohorts analyzed, suggesting that variant effects may differ according to the genetic background, which points to the importance of examining the generalizability of any posited polygenic risk scores. Conclusions: In conclusion, we provide additional support for and further refine the results of a previously published polygenic risk score for GDM in an ethically unrelated population
Dark Energy from Time Crystals
Get PDFIn this work, we analyze a scalar field model which gives rise to stable bound states in field space characterized by nonzero motion that breaks the underlying time translation symmetry of its Hamiltonian, known as time crystals. We demonstrate that an ideal fluid made up of these time crystals behaves as phantom dark energy characterized by an equation of state w<−1, speed of sound squared cs2≥0, and nonnegative energy density ρ≥0
Sources of Strength in North Carolina's Graduate Student Unions
Get PDFThis study compared sources of strength of public and private graduate student unions in North Carolina universities. Using Marxist theoretical framework that describes unionized workers as products of their material conditions, I looked at access to collective bargaining (an external source of strength) as a mechanism of legal conditions in North Carolina. Private university unions in North Carolina have access to collective bargaining, whereas public university unions do not, so I analyzed the ways that graduate unions have been able to accumulate internal and external strength given their differences in legal conditions. After interviewing members of graduate student unions at one public university (UNC-Chapel Hill) and one private university (Duke University), I found that the private university union had more external strength, which was supported by the legal conditions that allow them to engage in collective bargaining. Meanwhile, the public university union's strength was primarily internal, with sources of power coming mostly from its members themselves.Bachelor of Art
Co‐Occurring Weight‐ and/or Shape‐Motivated Restriction in 5747 Adults With Probable Avoidant/Restrictive Food Intake Disorder
Get PDFOBJECTIVE: According to DSM-5-TR, avoidant/restrictive food intake disorder (ARFID) cannot be diagnosed alongside anorexia nervosa (AN), bulimia nervosa (BN), or any other body image disturbance. This does not accurately reflect real-world symptomatology and recent research, indicating the potential need to revise DSM-5-TR Criteria. We investigated the co-occurrence of weight- and/or shape-motivated restriction (WSR) in adults who screened positive for ARFID, providing evidence to inform such changes. METHOD: The sample comprised 5747 adults who consented to participate in the ARFID-Genes and Environment (ARFID-GEN) research study, screened positive for ARFID on the NIAS and PARDI-AR-Q, and completed the EDE-Q. We placed our participants into four groups: groups one and two screened positive for AN (ARFID-AN; n = 147) or BN (ARFID-BN; n = 193), group three endorsed WSR without meeting AN or BN criteria (ARFID-WSR; n = 2159), and group four endorsed ARFID symptoms only (ARFID-nWSR; n = 3248). We used generalized linear models to test group differences on the NIAS, PARDI-AR-Q, and EDE-Q. RESULTS: Where significant differences were present, ARFID-nWSR demonstrated lower scores than all other groups across ARFID dimensions on the NIAS and PARDI-AR-Q, and lower odds of meeting DSM-5-TR Criteria A1 to A3 (i.e., weight loss; nutritional deficiencies; dependence on nutritional supplements). DISCUSSION: These findings indicate a mixed phenotype with features of both ARFID and WSR associated with more severe ARFID symptomatology. The DSM-5-TR Criteria may not capture complex real-world symptomatology in adults with probable ARFID, potentially precluding those with the most severe symptoms from receiving accurate diagnoses and appropriate care
A call to action: dissemination and implementation science education and training is needed in physical therapy and athletic training health professions
Get PDFPrevention and appropriate management of musculoskeletal (MSK) conditions is a key contributor to a healthy and well population. Physical therapists (PTs) and athletic trainers (ATs) are allied health professionals at the forefront of prevention and management of MSK conditions, working in wide-ranging healthcare settings, from outpatient clinics, with specialized populations (e.g., athletes), within schools, and in industrial settings and public health. PTs and ATs receive extensive education in evidence-based practice for the prevention and treatment of common MSK conditions, but little to no formal education in dissemination and implementation (D&I) science. This curricular omission may contribute to persistent challenges and gaps in the real-world translation of injury prevention and rehabilitation research into sustainable and effective PT and AT practice. Here the authors, five MSK injury prevention and management researchers and clinicians with experience or expertise in D&I science, present a brief background on the emergence of D&I in the MSK literature, and outline short- and longer-term goals for the integration of D&I into PT and AT education and training, setting forth a vision for the prominence of D&I in the PT/AT professions
First- and second-order social contact network structure in southern China
Get PDFThe contact network structure resulting from social interaction between people is a key aspect of epidemic dynamics and control. While many studies have measured first-order network characteristics such as degree, measuring higher order properties of these networks, such as clustering, remains a challenge. Here, we present the results of a study of first- and second-order network structure from a representative cohort of individuals in Guangdong province, China. The number of reported daily contacts is similar across individuals aged 2 to 55 years, except for young adults (ages 16-25) who have relatively fewer daily contacts, while the number of contacts declines with age above 55 years old. The association between age and contact rate persisted after adjusting for mediating factors. Individuals living in higher population density areas made more contacts outside the home than individuals in low-density areas. Contacts of young children and older adults were more locally clustered than middle-aged adults. Individuals living in high population density areas had lower levels of local clustering compared with individuals from low-density areas. Adjustment for characteristics of the contacts themselves reduces the variation in local clustering between participants of different ages; however, the strong association with population density remains
Trends in cardiovascular disease prevalence among adults with type 1 diabetes in the USA: analysis of commercial claims data, 2017–2021
Get PDFINTRODUCTION: Cardiovascular disease (CVD) is a common complication and major cause of mortality in people with type 1 diabetes (T1D). This study quantifies the prevalence of CVD among commercially insured adults with T1D in the USA from 2017 to 2021, overall and among age-defined and sex-defined subgroups. RESEARCH DESIGN AND METHODS: We used Merative MarketScan nationwide commercial insurance claims database (2017-2021) to identify adults ≥20 years with T1D (International Classification of Diseases, 10th Revision (ICD-10) codes). CVD ascertainment was based on ICD-10 codes for myocardial infarction, atrial fibrillation, ischemic heart disease, heart failure, peripheral artery disease, and stroke. Comorbidities included hypertension, obesity, hyperlipidemia, retinopathy, neuropathy, nephropathy, severe hypoglycemia, and diabetic ketoacidosis. Annual prevalence and age-specific and sex-specific prevalence of CVD were calculated overall and by comorbidities. Logistic regression was used to examine associations between sex, prevalent comorbidities, and odds of CVD. RESULTS: The sample size ranged from n=21 748 in 2017 to n=13 294 in 2021. Among adults with T1D (mean (SD) age (48.51 (13.95) years in 2017 and 46.80 (13.04) years in 2021; 47% female), the prevalence of CVD ranged from 18.18% (95% CI 17.77 to 18.66%) in 2017 to 20.58% (95% CI 19.91 to 21.24%) in 2021. In 2021, among those aged 20-39 years, 40-64 years, and 65+years, the prevalence of CVD was 4.97%, 20.41%, and 52.94%, respectively. The age-adjusted prevalence of CVD was higher in males than females (21.93% vs 19.07%). Age, sex, and all comorbidities were independently associated with CVD. Odds of CVD were highest among those with hypertension (adjusted OR 3.15, 95% CI: 2.77 to 3.57). CONCLUSION: In this sample of US commercially insured adults with T1D, CVD prevalence remained stable at ~20% from 2017 to 2021. Early detection via improved screening and targeted management of comorbidities are key preventive strategies