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Article ; Online: Predictors of the rate of cognitive decline in older adults using machine learning.

Ahmadzadeh, Maryam / Cosco, Theodore David / Best, John R / Christie, Gregory James / DiPaola, Steve

2023 Volume 18, Issue 3, Page(s) e0280029

Abstract: Background: The longitudinal rates of cognitive decline among aging populations are heterogeneous. Few studies have investigated the possibility of implementing prognostic models to predict cognitive changes with the combination of categorical and ... ...

Abstract	Background: The longitudinal rates of cognitive decline among aging populations are heterogeneous. Few studies have investigated the possibility of implementing prognostic models to predict cognitive changes with the combination of categorical and continuous data from multiple domains. Objective: Implement a multivariate robust model to predict longitudinal cognitive changes over 12 years among older adults and to identify the most significant predictors of cognitive changes using machine learning techniques. Method: In total, data of 2733 participants aged 50-85 years from the English Longitudinal Study of Ageing are included. Two categories of cognitive changes were determined including minor cognitive decliners (2361 participants, 86.4%) and major cognitive decliners (372 participants, 13.6%) over 12 years from wave 2 (2004-2005) to wave 8 (2016-2017). Machine learning methods were used to implement the predictive models and to identify the predictors of cognitive decline using 43 baseline features from seven domains including sociodemographic, social engagement, health, physical functioning, psychological, health-related behaviors, and baseline cognitive tests. Results: The model predicted future major cognitive decliners from those with the minor cognitive decline with a relatively high performance. The overall AUC, sensitivity, and specificity of prediction were 72.84%, 78.23%, and 67.41%, respectively. Furthermore, the top 7 ranked features with an important role in predicting major vs minor cognitive decliners included age, employment status, socioeconomic status, self-rated memory changes, immediate word recall, the feeling of loneliness, and vigorous physical activity. In contrast, the five least important baseline features consisted of smoking, instrumental activities of daily living, eye disease, life satisfaction, and cardiovascular disease. Conclusion: The present study indicated the possibility of identifying individuals at high risk of future major cognitive decline as well as potential risk/protective factors of cognitive decline among older adults. The findings could assist in improving the effective interventions to delay cognitive decline among aging populations.
MeSH term(s)	Humans ; Aged ; Activities of Daily Living ; Longitudinal Studies ; Cognitive Dysfunction ; Aging ; Machine Learning
Language	English
Publishing date	2023-03-03
Publishing country	United States
Document type	Journal Article
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0280029
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: End Stage Kidney Disease Patient Experiences of Renal Supportive Care in an Australian Teaching Hospital - A Qualitative Study.

Sobels, Eloise / Best, Megan / Chadban, Steve / Pais, Riona

Journal of pain and symptom management

2021 Volume 63, Issue 5, Page(s) 737–746

Abstract: Context: Renal Supportive Care Services (RSCS) were introduced in Australia to provide patient-centred care with a focus on better symptom management and improved quality of life in end stage kidney disease (ESKD) patients managed with or without ... ...

Abstract	Context: Renal Supportive Care Services (RSCS) were introduced in Australia to provide patient-centred care with a focus on better symptom management and improved quality of life in end stage kidney disease (ESKD) patients managed with or without dialysis. While RSCS have demonstrated clinical benefits with reduced length of hospital stay and symptom burden, there is a gap in understanding the experience of patients referred to RSCS. Objectives: To identify patient attitudes, beliefs, and perspectives on the RSCS. Methods: Qualitative interviews were conducted with 20 participants from both dialysis and conservative treatment pathways. Transcripts were then thematically analysed and primary themes identified, which were reviewed with a stakeholder group that included doctors, nurses and allied health staff to provide triangulation. Results: Patients perceived the RSCS as a provider of multidisciplinary, holistic and patient-centred care that, in addition, helped to ensure prognostic awareness and timely end-of-life care planning. This contributed to an overall sense of patient empowerment with healthcare decisions. This study identified three major themes: (1) Expectations of care; (2) Experience of care; and (3) Understanding patient needs. Conclusion: The study found that RSCS support patient-centred and family-orientated initiatives in decision making and control over healthcare management. This is empowering for patients. Additional patient values, needs and wants from the RSCS were also identified and these could be addressed to improve the patient experience. Our findings support the ongoing use of RSCS to improve the experience of ESKD patients.
MeSH term(s)	Australia ; Female ; Hospitals, Teaching ; Humans ; Kidney Failure, Chronic/therapy ; Male ; Patient Outcome Assessment ; Qualitative Research ; Quality of Life ; Renal Dialysis
Language	English
Publishing date	2021-12-22
Publishing country	United States
Document type	Journal Article
ZDB-ID	639142-4
ISSN	1873-6513 ; 0885-3924
ISSN (online)	1873-6513
ISSN	0885-3924
DOI	10.1016/j.jpainsymman.2021.12.024
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Article ; Online: Predictors of the rate of cognitive decline in older adults using machine learning.

Maryam Ahmadzadeh / Theodore David Cosco / John R Best / Gregory James Christie / Steve DiPaola

PLoS ONE, Vol 18, Iss 3, p e

2023 Volume 0280029

Abstract: Background The longitudinal rates of cognitive decline among aging populations are heterogeneous. Few studies have investigated the possibility of implementing prognostic models to predict cognitive changes with the combination of categorical and ... ...

Abstract	Background The longitudinal rates of cognitive decline among aging populations are heterogeneous. Few studies have investigated the possibility of implementing prognostic models to predict cognitive changes with the combination of categorical and continuous data from multiple domains. Objective Implement a multivariate robust model to predict longitudinal cognitive changes over 12 years among older adults and to identify the most significant predictors of cognitive changes using machine learning techniques. Method In total, data of 2733 participants aged 50-85 years from the English Longitudinal Study of Ageing are included. Two categories of cognitive changes were determined including minor cognitive decliners (2361 participants, 86.4%) and major cognitive decliners (372 participants, 13.6%) over 12 years from wave 2 (2004-2005) to wave 8 (2016-2017). Machine learning methods were used to implement the predictive models and to identify the predictors of cognitive decline using 43 baseline features from seven domains including sociodemographic, social engagement, health, physical functioning, psychological, health-related behaviors, and baseline cognitive tests. Results The model predicted future major cognitive decliners from those with the minor cognitive decline with a relatively high performance. The overall AUC, sensitivity, and specificity of prediction were 72.84%, 78.23%, and 67.41%, respectively. Furthermore, the top 7 ranked features with an important role in predicting major vs minor cognitive decliners included age, employment status, socioeconomic status, self-rated memory changes, immediate word recall, the feeling of loneliness, and vigorous physical activity. In contrast, the five least important baseline features consisted of smoking, instrumental activities of daily living, eye disease, life satisfaction, and cardiovascular disease. Conclusion The present study indicated the possibility of identifying individuals at high risk of future major cognitive decline as well as potential ...
Keywords	Medicine ; R ; Science ; Q
Subject code	120
Language	English
Publishing date	2023-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
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Article ; Online: Loss of hypoxia-inducible factor 1α affects hypoxia tolerance in larval and adult zebrafish (

Mandic, Milica / Best, Carol / Perry, Steve F

Proceedings. Biological sciences

2020 Volume 287, Issue 1927, Page(s) 20200798

Abstract: The coordination of the hypoxic response is attributed, in part, to hypoxia-inducible factor 1α (Hif-1α), a regulator of hypoxia-induced transcription. After the teleost-specific genome duplication, most teleost fishes lost the duplicate copy of Hif-1α, ... ...

Abstract	The coordination of the hypoxic response is attributed, in part, to hypoxia-inducible factor 1α (Hif-1α), a regulator of hypoxia-induced transcription. After the teleost-specific genome duplication, most teleost fishes lost the duplicate copy of Hif-1α, except species in the cyprinid lineage that retained both paralogues of Hif-1α (Hif1aa and Hif1ab). Little is known about the contribution of Hif-1α, and specifically of each paralogue, to hypoxia tolerance. Here, we examined hypoxia tolerance in wild-type (Hif1aa
MeSH term(s)	Animals ; Hypoxia ; Hypoxia-Inducible Factor 1, alpha Subunit/metabolism ; Zebrafish/physiology
Chemical Substances	Hypoxia-Inducible Factor 1, alpha Subunit
Language	English
Publishing date	2020-05-27
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	209242-6
ISSN	1471-2954 ; 0080-4649 ; 0962-8452 ; 0950-1193
ISSN (online)	1471-2954
ISSN	0080-4649 ; 0962-8452 ; 0950-1193
DOI	10.1098/rspb.2020.0798
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Article ; Online: Treatment of post-anesthesia dementia with perispinal etanercept injection and hyperbaric oxygen therapy: a case report.

Best, Steve / Pavel, Dan G

Journal of medical case reports

2017 Volume 11, Issue 1, Page(s) 105

Abstract: Background: We report on the first case of successful treatment for post-anesthesia dementia with perispinal etanercept injection combined with hyperbaric oxygen therapy.: Case presentation: Our patient was a 77-year-old Caucasian man of Mexican ... ...

Abstract	Background: We report on the first case of successful treatment for post-anesthesia dementia with perispinal etanercept injection combined with hyperbaric oxygen therapy. Case presentation: Our patient was a 77-year-old Caucasian man of Mexican ethnicity who presented to our clinic 4.5 years after a knee replacement surgery. Immediately post-surgery, the patient began to show dramatic cognitive, physical, and emotional impairment compared with his presurgical state; these symptoms were still present when he arrived at our clinic. A clinical assessment and brain single-photon emission computer tomography were performed. Diagnoses of dementia with major cognitive deficits and aphasia were established. A 40-session course of hyperbaric oxygen therapy was initiated to address our patient's impairments. After the first ten hyperbaric oxygen therapy treatments, our patient was administered 25 mg perispinal etanercept injections approximately once weekly for 5 months. Starting after the first perispinal etanercept injection, our patient began showing progressive improvements. By the 5-month follow-up, his cognitive and physical function were substantially restored. A follow-up single-photon emission computer tomography scan showed increased perfusion in several small, localized areas. Conclusions: In this case of dementia and major cognitive disorder post major surgery and anesthesia, the very beneficial effect of combining hyperbaric oxygen therapy with perispinal etanercept is outlined.
MeSH term(s)	Aged ; Anesthesia/adverse effects ; Anti-Inflammatory Agents, Non-Steroidal/administration & dosage ; Arthroplasty, Replacement, Knee ; Combined Modality Therapy ; Dementia/drug therapy ; Dementia/etiology ; Dementia/psychology ; Etanercept/administration & dosage ; Follow-Up Studies ; Humans ; Hyperbaric Oxygenation ; Injections, Spinal ; Male ; Postoperative Complications/etiology ; Postoperative Complications/physiopathology ; Postoperative Complications/therapy ; Recovery of Function ; Tomography, Emission-Computed, Single-Photon ; Treatment Outcome
Chemical Substances	Anti-Inflammatory Agents, Non-Steroidal ; Etanercept (OP401G7OJC)
Language	English
Publishing date	2017-04-14
Publishing country	England
Document type	Case Reports ; Journal Article
ZDB-ID	2269805-X
ISSN	1752-1947 ; 1752-1947
ISSN (online)	1752-1947
ISSN	1752-1947
DOI	10.1186/s13256-017-1259-6
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Article ; Online: Treatment of post-anesthesia dementia with perispinal etanercept injection and hyperbaric oxygen therapy

Steve Best / Dan G. Pavel

Journal of Medical Case Reports, Vol 11, Iss 1, Pp 1-

a case report

2017 Volume 4

Abstract: Abstract Background We report on the first case of successful treatment for post-anesthesia dementia with perispinal etanercept injection combined with hyperbaric oxygen therapy. Case presentation Our patient was a 77-year-old Caucasian man of Mexican ... ...

Abstract	Abstract Background We report on the first case of successful treatment for post-anesthesia dementia with perispinal etanercept injection combined with hyperbaric oxygen therapy. Case presentation Our patient was a 77-year-old Caucasian man of Mexican ethnicity who presented to our clinic 4.5 years after a knee replacement surgery. Immediately post-surgery, the patient began to show dramatic cognitive, physical, and emotional impairment compared with his presurgical state; these symptoms were still present when he arrived at our clinic. A clinical assessment and brain single-photon emission computer tomography were performed. Diagnoses of dementia with major cognitive deficits and aphasia were established. A 40-session course of hyperbaric oxygen therapy was initiated to address our patient’s impairments. After the first ten hyperbaric oxygen therapy treatments, our patient was administered 25 mg perispinal etanercept injections approximately once weekly for 5 months. Starting after the first perispinal etanercept injection, our patient began showing progressive improvements. By the 5-month follow-up, his cognitive and physical function were substantially restored. A follow-up single-photon emission computer tomography scan showed increased perfusion in several small, localized areas. Conclusions In this case of dementia and major cognitive disorder post major surgery and anesthesia, the very beneficial effect of combining hyperbaric oxygen therapy with perispinal etanercept is outlined.
Keywords	Dementia ; Perispinal etanercept ; HBOT ; SPECT ; Case report ; Medicine ; R
Subject code	150
Language	English
Publishing date	2017-04-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
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Article ; Online: Nonlinear DNA methylation trajectories in aging male mice.

Olecka, Maja / van Bömmel, Alena / Best, Lena / Haase, Madlen / Foerste, Silke / Riege, Konstantin / Dost, Thomas / Flor, Stefano / Witte, Otto W / Franzenburg, Sören / Groth, Marco / von Eyss, Björn / Kaleta, Christoph / Frahm, Christiane / Hoffmann, Steve

Nature communications

2024 Volume 15, Issue 1, Page(s) 3074

Abstract: Although DNA methylation data yields highly accurate age predictors, little is known about the dynamics of this quintessential epigenomic biomarker during lifespan. To narrow the gap, we investigate the methylation trajectories of male mouse colon at ... ...

Abstract	Although DNA methylation data yields highly accurate age predictors, little is known about the dynamics of this quintessential epigenomic biomarker during lifespan. To narrow the gap, we investigate the methylation trajectories of male mouse colon at five different time points of aging. Our study indicates the existence of sudden hypermethylation events at specific stages of life. Precisely, we identify two epigenomic switches during early-to-midlife (3-9 months) and mid-to-late-life (15-24 months) transitions, separating the rodents' life into three stages. These nonlinear methylation dynamics predominantly affect genes associated with the nervous system and enrich in bivalently marked chromatin regions. Based on groups of nonlinearly modified loci, we construct a clock-like classifier STageR (STage of aging estimatoR) that accurately predicts murine epigenetic stage. We demonstrate the universality of our clock in an independent mouse cohort and with publicly available datasets.
MeSH term(s)	Humans ; Male ; Animals ; Mice ; DNA Methylation/genetics ; Epigenesis, Genetic ; Aging/genetics ; Longevity ; Chromatin
Chemical Substances	Chromatin
Language	English
Publishing date	2024-04-09
Publishing country	England
Document type	Journal Article
ZDB-ID	2553671-0
ISSN	2041-1723 ; 2041-1723
ISSN (online)	2041-1723
ISSN	2041-1723
DOI	10.1038/s41467-024-47316-2
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Dispatches from a Police State

Steve Best

International Journal of Inclusive Democracy, Vol 3, Iss 1, p

Animal Rights in the Crosshairs of State Repression

2007 Volume 7

Keywords	Social movements ; Political theory ; JC11-607 ; Political science ; J ; DOAJ:Political Science ; DOAJ:Law and Political Science
Language	English
Publishing date	2007-01-01T00:00:00Z
Publisher	The International Network for Inclusive Democracy
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Substitute addictions in the context of the COVID-19 pandemic.

Sinclair, Deborah Louise / Vanderplasschen, Wouter / Savahl, Shazly / Florence, Maria / Best, David / Sussman, Steve

Journal of behavioral addictions

2020 Volume 9, Issue 4, Page(s) 1098–1102

Abstract: The global spread of COVID-19, subsequent stay-at-home requirements, spatial distancing measures, and long-term isolation present additional challenges for persons in recovery. Using an illustrative case from South Africa, we discuss COVID-19 related ... ...

Abstract	The global spread of COVID-19, subsequent stay-at-home requirements, spatial distancing measures, and long-term isolation present additional challenges for persons in recovery. Using an illustrative case from South Africa, we discuss COVID-19 related pornography use through the lens of relapse and substitute addiction. South Africa is the epicenter of the pandemic in Africa, and has issued an alcohol and cigarette ban. Historical examples suggest that responses to forced abstinence may include compliance and abstinence, but also seeking alternatives to the original addiction and substitution. Substitution of alternative activities/objects may provide similar appetitive effects to fill the void of the terminated addictive behavior, temporarily or in the long-term. While substitutes do not necessarily portend a relapse, coupled with isolation and reduced recovery support, they can potentiate relapse to the former or 'new' addictive behavior. Addiction professionals should be aware of the potential for such negative impacts during and after the COVID-19 pandemic.
MeSH term(s)	Alcoholism/psychology ; Alcoholism/rehabilitation ; Behavior, Addictive/psychology ; COVID-19/prevention & control ; Erotica/psychology ; Humans ; Male ; Middle Aged ; Pandemics ; Quarantine/psychology ; SARS-CoV-2 ; Social Isolation/psychology ; South Africa
Keywords	covid19
Language	English
Publishing date	2020-11-16
Publishing country	Hungary
Document type	Case Reports
ZDB-ID	2817933-X
ISSN	2063-5303 ; 2063-5303
ISSN (online)	2063-5303
ISSN	2063-5303
DOI	10.1556/2006.2020.00091
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Article: Spinal epidural lipomatosis: a rare association of Cushing's disease.

Ahmad, Sajjad / Best, Thomas / Lansdown, Andrew / Hayhurst, Caroline / Smeeton, Fiona / Davies, Steve / Rees, Aled

Endocrinology, diabetes & metabolism case reports

2020 Volume 2020

Abstract: Summary: Excess cortisol is associated with hypertrophy and redistribution of adipose tissue leading to central obesity which is classically seen in Cushing's syndrome. Abnormal accumulation of fatty tissue in the spinal canal is most commonly ... ...

Abstract	Summary: Excess cortisol is associated with hypertrophy and redistribution of adipose tissue leading to central obesity which is classically seen in Cushing's syndrome. Abnormal accumulation of fatty tissue in the spinal canal is most commonly associated with chronic steroid therapy and rarely reported with endogenous Cushing's syndrome. Herein, we describe a case of spinal epidural lipomatosis (SEL) associated with Cushing's disease. A 17-year-old man was referred with lower limb weakness, weight gain, multiple stretch marks, back pain and loss of height. He had clinical and biochemical features of Cushing's syndrome. MRI and Inferior Petrosal Sinus Sampling (IPSS) confirmed a pituitary adenoma as the source. On day 1 post trans-sphenoidal adenectomy he developed spastic paraparesis with a sensory deficit to the level of T5. MRI spine showed increased fat deposition in the spinal canal from T2 to T9 consistent with a diagnosis of SEL. He was managed conservatively and made a good recovery following restoration of eucortisolism and a period of rehabilitation. Learning points: SEL is a serious complication of glucocorticoid excess and should be considered in any patient presenting with new lower limb neurological symptoms associated with hypercortisolism. It is important to distinguish symptomatic SEL from cortisol-induced proximal myopathy by good history and clinical examination. MRI of the spine is the gold standard investigation for making a diagnosis of SEL. Restoration of eucortisolism can lead to resolution of fat accumulation and good neurological outcome.
Language	English
Publishing date	2020-10-19
Publishing country	England
Document type	Journal Article
ZDB-ID	2785530-2
ISSN	2052-0573
ISSN	2052-0573
DOI	10.1530/EDM-20-0111
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