Liupritchard4672

Inconsistent results across regions have been reported in a number of recent large trials. In this research, by reviewing results from studies that showed inconsistent treatment effects, and summarizing lessons learned, we provide some recommendations for minimizing the chance of inconsistency and allowing more accurate interpretation when such signs of heterogeneity arise, for example keep the number of regions for consistency evaluation at a minimum to avoid observing false inconsistency signals; proactively address in the protocol the differences in culture, medical practices, and other factors that are potentially different across regions; closely monitor the blinded data from early-enrolled patients to more effectively identify and address issues such as imbalance of baseline covariates or inconsistency of primary outcome rates across regions. For treatments of life-threatening conditions, the stakes for accurate interpretation of MRCT results are high; the criteria for decisions warrant careful consideration.BACKGROUND Delays in clinical trial enrollment and difficulties enrolling representative samples continue to vex sponsors, sites, and patient populations. GSK2606414 PERK inhibitor Here we investigated use of an artificial intelligence-powered technology, Mendel.ai, as a means of overcoming bottlenecks and potential biases associated with standard patient prescreening processes in an oncology setting. METHODS Mendel.ai was applied retroactively to 2 completed oncology studies (1 breast, 1 lung), and 1 study that failed to enroll (lung), at the Comprehensive Blood and Cancer Center, allowing direct comparison between results achieved using standard prescreening practices and results achieved with Mendel.ai. Outcome variables included the number of patients identified as potentially eligible and the elapsed time between eligibility and identification. RESULTS For each trial that enrolled, use of Mendel.ai resulted in a 24% to 50% increase over standard practices in the number of patients correctly identified as potentially eligible. No patients correctly identified by standard practices were missed by Mendel.ai. For the nonenrolling trial, both approaches failed to identify suitable patients. An average of 19 days for breast and 263 days for lung cancer patients elapsed between actual patient eligibility (based on clinical chart information) and identification when the standard prescreening practice was used. In contrast, ascertainment of potential eligibility using Mendel.ai took minutes. CONCLUSIONS This study suggests that augmentation of human resources with artificial intelligence could yield sizable improvements over standard practices in several aspects of the patient prescreening process, as well as in approaches to feasibility, site selection, and trial selection.BACKGROUND Non-alcoholic fatty liver disease (NAFLD) is the liver manifestation of metabolic syndrome, a risk factor for mortality and cardiovascular morbidity, but we ignore the role of steatosis per se in survival, and there is very little information about this condition in the geriatric patient. AIMS With the present study, we investigated the independent prognostic value of NAFLD on overall mortality in the elderly. METHODS Within the Pianoro Project, involving people ≥ 65 years, anamnestic, clinical and laboratoristic data related to NAFLD, insulin resistance, diabetes/hyperglycemia, hypertension, obesity and dyslipidemia were collected in 804 subjects (403 male, 401 female). These subjects were followed up for mortality for a median time of 12.6 years. A multivariate analysis was performed to evaluate the prognostic value of the covariates. RESULTS At Kaplan-Meier estimator the presence of NAFLD seems to be associated to a lower mortality, and survival tends to increase with the increasing of steatosis grade. Cox's analysis found that survival is increased for subjects having hypercholesterolemia (RR = 0.565), NAFLD (RR = 0.777), hypertension (RR = 0.711) and in female (RR = 0.741), while it is decreased for the older subjects (RR = 3.046), in patients with hypertriglyceridemia (RR = 1.699) and for diabetics (RR = 1.797). The variables BMI and HDL-cholesterol have no role. CONCLUSION The data obtained in our study show that NAFLD is not associated to overall mortality in the elderly population.BACKGROUND Older adults experience greater cognitive motor interference (CMI) due to declines in cognitive and physical function. Although aerobic fitness has beneficial effects on cognition, its association with CMI is not clear. AIMS This study aims to investigate the effects of aerobic fitness on CMI during self-paced treadmill walking in older adults. METHODS Thirty participants (67.6 ± 10.34 years, 21 females) were included in a 2-day cross-sectional design study. Aerobic fitness was assessed with the Rockport 1-mile test. The dual-task paradigm consisted of walking only, and dual-task standing and dual-task walking (i.e., standing/walking while performing the Modified Stroop color word test) on a treadmill. To assess CMI, gait speed and accuracy rate were measured to later calculate the dual-task cost for each parameter. RESULTS Individuals with low aerobic fitness exhibited significantly greater gait speed dual-task cost than individuals with high aerobic fitness (p  less then  0.05). There were no significant findings for accuracy rate dual-task cost. DISCUSSION These study findings are the first to demonstrate increases in CMI in relation to low aerobic fitness. Results can be attributed to the relationship between aerobic fitness and cognition as well as theories related to attentional capacity. CONCLUSION Older adults with low aerobic fitness possess greater CMI when compared to older adults with high aerobic fitness. This provides a foundation of knowledge on how aerobic fitness in older adults may affect CMI which can lead researchers to examine the causal relationships between an aerobic exercise intervention program and CMI in older adults.BACKGROUND Potential herb-drug interactions (pHDIs) often go unrecognized, and little is known about the prevalence of pHDIs in older adults. AIMS This study aimed to investigate the prevalence of pHDIs in community-dwelling older adults in Shanghai and identify patterns and factors associated with pHDIs. METHODS Baseline data from the Shanghai Aging Study, which was designed to establish a prospective community-based cohort of older adults in Shanghai, were analyzed regarding pHDIs with Lexi-Interact Online software. RESULTS Among 1227 participants who used any combination of drug-herb or herb-herb, 43.3% were exposed to at least one pHDI. A total of 1641 different pHDIs were identified among the study samples. Only seven (0.4%) pHDIs were rated as risk category X, indicating that the combinations were contraindicated and should be avoided. Worryingly, 876 (53.4%) pHDIs were rated as risk category D, indicating that significant interactions may occur and therapeutic modification should be considered. Of particular concern is that 99.