A state-of-the-art review of quality-of-life assessment in venous disease.

OBJECTIVE: Chronic venous disease is a common condition and has a significant impact on patients' health status. Validated patient-reported outcome measures (PROMs) used to assess health status are needed to measure health status. This state-of-the-art review summarizes the current validation evidence for disease-specific PROMs for chronic venous disease and provides a framework for their use in the clinical setting. METHODS: A literature search in OVID Embase and Medline was conducted to identify relevant English-language studies of chronic venous disease that used disease-specific PROMs between January 1, 1993, and June 30, 2022. Abstracts and titles from identified studies were screened by four investigators, and full-text articles were subsequently screened for eligibility. Data on validation of disease-specific PROMs was abstracted from each included article. Classical test theory was used as a framework to examine a priori defined validation criteria for content validity, reliability (construct validity, internal reliability, and test-retest reliability), responsiveness, and expansion of the validation evidence base (use in randomized controlled trials and comparative effectiveness research, cultural or linguistic translations, predictive validity, or establishing the minimal clinically important difference threshold, defined as smallest amount an outcome or measure is perceived as a meaningful change to patients). The PROMs were categorized into three groups based on the manifestations of disease of the population for which they were developed. The overall validity of each PROM was assessed across three stages of validation including content validity (phase 1); construct validity, reliability, and responsiveness (phase 2); and expansion of the validation evidence base (phase 3). RESULTS: Of 2338 unique studies screened, 112 studies (4.8%) met inclusion criteria. The eight disease-specific PROMs identified were categorized into three groups: (1) overall chronic venous disease (C1 to C6); (2) C1 to C4 disease; and (3) C5 to C6 disease. Assessed by group, the Chronic Venous Insufficiency Questionnaire met criteria for validation at all three phases for patients with C1 to C4 disease, and the Charing Cross Venous Ulcer Questionnaire met criteria for validation at all three phases for patients with C5 to C6 disease. There were no PROMs that met all criteria for validation for use in overall chronic venous disease (C1 to C6). CONCLUSIONS: Of the eight PROMs assessed in this review, only two met prespecified criteria at each phase for validation. The Chronic Venous Insufficiency Questionnaire and Charing Cross Venous Ulcer Questionnaire should be considered for use in patients with chronic venous disease without venous ulcers and with venous ulcers, respectively.

A Distributed Classifier for MicroRNA Target Prediction with Validation Through TCGA Expression Data.

BACKGROUND: MicroRNAs (miRNAs) are approximately 22-nucleotide long regulatory RNA that mediate RNA interference by binding to cognate mRNA target regions. Here, we present a distributed kernel SVM-based binary classification scheme to predict miRNA targets. It captures the spatial profile of miRNA-mRNA interactions via smooth B-spline curves. This is accomplished separately for various input features, such as thermodynamic and sequence-based features. Further, we use a principled approach to uniformly model both canonical and non-canonical seed matches, using a novel seed enrichment metric. Finally, we verify our miRNA-mRNA pairings using an Elastic Net-based regression model on TCGA expression data for four cancer types to estimate the miRNAs that together regulate any given mRNA. RESULTS: We present a suite of algorithms for miRNA target prediction, under the banner Avishkar, with superior prediction performance over the competition. Specifically, our final kernel SVM model, with an Apache Spark backend, achieves an average true positive rate (TPR) of more than 75 percent, when keeping the false positive rate of 20 percent, for non-canonical human miRNA target sites. This is an improvement of over 150 percent in the TPR for non-canonical sites, over the best-in-class algorithm. We are able to achieve such superior performance by representing the thermodynamic and sequence profiles of miRNA-mRNA interaction as curves, devising a novel seed enrichment metric, and learning an ensemble of miRNA family-specific kernel SVM classifiers. We provide an easy-to-use system for large-scale interactive analysis and prediction of miRNA targets. All operations in our system, namely candidate set generation, feature generation and transformation, training, prediction, and computing performance metrics are fully distributed and are scalable. CONCLUSIONS: We have developed an efficient SVM-based model for miRNA target prediction using recent CLIP-seq data, demonstrating superior performance, evaluated using ROC curves for different species (human or mouse), or different target types (canonical or non-canonical). We analyzed the agreement between the target pairings using CLIP-seq data and using expression data from four cancer types. To the best of our knowledge, we provide the first distributed framework for miRNA target prediction based on Apache Hadoop and Spark. AVAILABILITY: All source code and sample data are publicly available at https://bitbucket.org/cellsandmachines/avishkar. Our scalable implementation of kernel SVM using Apache Spark, which can be used to solve large-scale non-linear binary classification problems, is available at https://bitbucket.org/cellsandmachines/kernelsvmspark.

Obstructive Sleep Apnea among Players in the National Football League: A Scoping Review.

OBJECTIVE: Obstructive sleep apnea (OSA) is a common sleep-disordered breathing condition that has emerged as a significant public health problem given its increased prevalence over the past decade. The high prevalence of obesity and large waist circumference among NFL players are two risk factors that might contribute to the high susceptibility of football players to develop OSA. National Football League linemen might be particularly vulnerable since they tend to have a higher body mass index. In this scoping review, we aim to bring attention to the limited research regarding OSA among National Football League players and highlight the negative consequences of OSA in an attempt to increase awareness of the urgent need for further research in this area. METHODS: Search terms associated with obstructive sleep apnea and football were used to examine Google Scholar, EMBASE, CINAHL, PubMed, ProQuest, and Web of Science Plus for relevant studies. All relevant studies were included and documented. RESULTS: Findings included (n=4) studies of interest. All 4 studies revealed a near or slightly above 50% prevalence of OSA in the investigated cohorts (mostly retired NFL linemen). Most participants in the study (active NFL players) showed symptoms associated with a sleep-disorder breathing condition (snoring). CONCLUSION: OSA requires more attention from the research and medical community. As suggested by results in the 4 studies included in this paper, OSA and associated symptoms are prevalent in the NFL population. Further research is required to investigate the extent of OSA and OSA risk in this population. There is an urgent need to conduct OSA risk surveillance in the athletic community.

Reciprocal Changes in Phosphoenolpyruvate Carboxykinase and Pyruvate Kinase with Age Are a Determinant of Aging in Caenorhabditis elegans.

Aging involves progressive loss of cellular function and integrity, presumably caused by accumulated stochastic damage to cells. Alterations in energy metabolism contribute to aging, but how energy metabolism changes with age, how these changes affect aging, and whether they can be modified to modulate aging remain unclear. In locomotory muscle of post-fertile Caenorhabditis elegans, we identified a progressive decrease in cytosolic phosphoenolpyruvate carboxykinase (PEPCK-C), a longevity-associated metabolic enzyme, and a reciprocal increase in glycolytic pyruvate kinase (PK) that were necessary and sufficient to limit lifespan. Decline in PEPCK-C with age also led to loss of cellular function and integrity including muscle activity, and cellular senescence. Genetic and pharmacologic interventions of PEPCK-C, muscle activity, and AMPK signaling demonstrate that declines in PEPCK-C and muscle function with age interacted to limit reproductive life and lifespan via disrupted energy homeostasis. Quantifications of metabolic flux show that reciprocal changes in PEPCK-C and PK with age shunted energy metabolism toward glycolysis, reducing mitochondrial bioenergetics. Last, calorie restriction countered changes in PEPCK-C and PK with age to elicit anti-aging effects via TOR inhibition. Thus, a programmed metabolic event involving PEPCK-C and PK is a determinant of aging that can be modified to modulate aging.