Enhancing gestational diabetes mellitus risk assessment and treatment through GDMPredictor: a machine learning approach.

BACKGROUND: Gestational diabetes mellitus (GDM) is a serious health concern that affects pregnant women worldwide and can lead to adverse pregnancy outcomes. Early detection of high-risk individuals and the implementation of appropriate treatment can enhance these outcomes. METHODS: We conducted a study on a cohort of 3467 pregnant women during their pregnancy, with a total of 5649 clinical and biochemical records collected. We utilized this dataset as our training dataset to develop a web server called GDMPredictor. The GDMPredictor utilizes advanced machine learning techniques to predict the risk of GDM in pregnant women. We also personalize treatment recommendations based on essential biochemical indicators, such as A1MG, BMG, CysC, CO2, TBA, FPG, and CREA. Our assessment of GDMPredictor's effectiveness involved training it on the dataset of 3467 pregnant women and measuring its ability to predict GDM risk using an AUC and auPRC. RESULTS: GDMPredictor demonstrated an impressive level of precision by achieving an AUC score of 0.967. To tailor our treatment recommendations, we use the GDM risk level to identify higher risk candidates who require more intensive care. The GDMPredictor can accept biochemical indicators for predicting the risk of GDM at any period from 1 to 24 weeks, providing healthcare professionals with an intuitive interface to identify high-risk patients and give optimal treatment recommendations. CONCLUSIONS: The GDMPredictor presents a valuable asset for clinical practice, with the potential to change the management of GDM in pregnant women. Its high accuracy and efficiency make it a reliable tool for doctors to improve patient outcomes. Early identification of high-risk individuals and tailored treatment can improve maternal and fetal health outcomes http://www.bioinfogenetics.info/GDM/ .

Quantitative Assessment of Hepatic Steatosis Using Label-Free Multiphoton Imaging and Customized Image Processing Program.

Nonalcoholic fatty liver disease is rapidly becoming one of the most common causes of chronic liver disease worldwide and is the leading cause of liver-related morbidity and mortality. A quantitative assessment of the degree of steatosis would be more advantageous for diagnostic evaluation and exploring the patterns of disease progression. Here, multiphoton microscopy, based on the second harmonic generation and 2-photon excited fluorescence, was used to label-free image the samples of nonalcoholic fatty liver. Imaging results confirm that multiphoton microscopy is capable of directly visualizing important pathologic features such as normal hepatocytes, hepatic steatosis, Mallory bodies, necrosis, inflammation, collagen deposition, microvessel, and so on and is a reliable auxiliary tool for the diagnosis of nonalcoholic fatty liver disease. Furthermore, we developed an image segmentation algorithm to simultaneously assess hepatic steatosis and fibrotic changes, and quantitative results reveal that there is a correlation between the degree of steatosis and collagen content. We also developed a feature extraction program to precisely display the spatial distribution of hepatocyte steatosis in tissues. These studies may be beneficial for a better clinical understanding of the process of steatosis as well as for exploring possible therapeutic targets.

Impact of Health Insurance Contract Timing on Breast Reconstruction Completion.

BACKGROUND: Cost of breast reconstruction can create a substantial burden for patients. As patients hope to maximize insurance plan benefits, it is crucial to receive efficient, cost-reducing care. This study analyzes the impact of insurance cycle [calendar-based insurance (CBI) versus non-calendar-based insurance (NCBI)] on breast reconstruction. METHODS: Between January of 2014 and 2018, patients undergoing postmastectomy breast reconstruction performed by two senior surgeons (N.T.H. and S.S.T.) at a single academic institution were retrospectively evaluated. Data were collected on insurance contract timing (CBI versus NCBI) and insurance payor. RESULTS: A total of 514 patients were included: 136 patients on NCBI and 378 patients on CBI. Individuals enrolled in CBI were more likely than NCBI patients to have their last operation toward the end of the calendar year ( P < 0.0005). In addition, individuals on private CBIs are more likely to have their last operation closer to the end of the year than those on public CBIs ( P < 0.0001). Individuals enrolled in CBI were less likely to receive autologous reconstruction than individuals on NCBI ( P = 0.011). Among patients on private CBIs, patients with all major revisions were more likely to start their reconstructive journey earlier in the year than patients who did not finish major revisions ( P = 0.011). Lastly, individuals on private insurance also undergo more revision procedures than those on public insurance ( P < 0.0001). CONCLUSIONS: Insurance contract cycle and payor impact the timing of breast reconstruction. This study emphasizes the importance of both patient and provider working toward maximizing health insurance plan benefits.

Adverse Childhood Experiences and Health Care Utilization in a Low-Income Population.

OBJECTIVE: To determine associations of adverse childhood experiences (ACE) with adult health care utilization in an underserved, low-income population. METHODS: Questionnaires on ACE were completed by 38,200 adults (mean age 54), two-thirds African American, recruited from community health centers (CHCs) across 12 Southeastern states. Odds ratios (ORs) and accompanying 95% confidence intervals (CIs) were computed. RESULTS: The percentages reporting emergency room visits and doctor's office visits, with high chronic disease index scores, rose monotonically (ptrend<.001) with rising ACE score. Odds ratios (CIs) for those with four or more vs. zero ACEs were 1.37 (95% CI 1.27-1.47) for 1-10 times and 1.80 (95% CI 1.29-2.52) for more than 10 times ER visits, 1.37 (95% CI 1.18-1.59) for over 10 doctor's visits, and 2.29 (95% CI 2.06-2.54) for three or more chronic diseases. CONCLUSIONS: High ACE levels were associated with greater chronic disease burden and greater health care utilization in adulthood. Long-lasting effects from ACE on the health care of underserved populations are indicated. There is an urgent need to train health care providers, patients, and their families on ACE effects and treatments for better health care outcomes.

Association of infant feeding with adiposity in early childhood in a WIC sample.

OBJECTIVES: To evaluate the association of different infant feeding practices with adiposity in early childhood. METHODS: Survey was conducted among 150 White, Black, and Hispanic low-income families with children ages 2­4. RESULTS: History of supplementing breast milk with formula (mixed feeding) was more prevalent among Hispanic children (67.4%) than either White (8.5%) or Black children (22.7%) (p<.001). African American children had the highest BMI percentile of the three groups (p=.043), although Hispanic children had slightly higher birth weight than the other two groups (p=.06). Among Hispanic children, after adjusting for confounding variables including maternal BMI, the mixed feeding group and the exclusive formula-feeding group had significantly higher BMI percentile (b=3.068 and b=2.936, respectively) than the exclusive breastfeeding group. These associations were not observed among Blacks and Whites. CONCLUSION: Further research is warranted on the impact of different feeding practices during infancy on subsequent adiposity during pre-school years

Highly unsaturated n-3 fatty acids status of Canadian Inuit: International Polar Year Inuit Health Survey, 2007-2008.

OBJECTIVES: Previous studies suggest that dietary patterns and the extent of reliance upon traditional food vary among Inuit communities. Inuit traditional foods are an important source of nutrients such as highly unsaturated n-3 fatty acids (HUFA n-3), whose beneficial effects include protection against ischemic heart disease. Dietary transition is occurring with younger generations consuming less traditional foods and more market foods with low nutrient density. Utilizing erythrocyte membrane fatty acid composition as an indicator of body HUFA n-3 status, which reflects dietary intake levels of traditional Inuit foods, we explored the regional and age variability of highly unsaturated n-3 fatty acids (HUFA n-3) in the International Polar Year Inuit Health Survey. STUDY DESIGN: Cross-sectional health survey. METHODS: Participants were recruited through random sampling of households. Fatty acid data were available among 2,200 adults (≥18 yr). RESULTS: HUFA n-3 levels in the Eastern Arctic were significantly higher than in the Western Arctic, with Nunatsiavut (northern Labrador) and Baffin showing the highest HUFA n-3 status compared to Kivalliq, Kitikmeot and Inuvialuit Settlement Region (ISR) (p<0.0001). Fatty acid proportion in erythrocyte membranes showed pronounced differences between coastal communities and inland communities, including a higher HUFA n-3 status among the coastal communities (p<0.0001). Additionally, the HUFA n-3 status showed a strong positive association with age, particularly in Baffin and Kivalliq. HUFA n-3 were inversely associated with saturated (ß=-0.98 [SE=0.03], R2=0.36, p<0.0001) and trans fatty acids (ß=-0.06 [SE=0.004], R2=0.07, p<0.0001). CONCLUSIONS: The present study results provided biochemical support for varying dietary patterns and dietary transition among Inuit across the Canadian Arctic. The analyses also suggested multifactorial determinants of HUFA n-3 status among Canadian Arctic Inuit. A nutritional intervention strategy with multiple approaches may be needed to improve and maintain their HUFA n-3 status.