Source:http://web.era-edta.org/ Reviewed by Alina Shrourou, B.Sc. (Editor)Apr 10 2019The link between brain dysfunction and advanced kidney disease was first noted in 1930, so it is not a new finding. Experts spoke of ‘dialysis dementia’ or ‘uremic encephalopathy’. What is new, however, is the finding that mild cognitive impairment (MCI) may already be present in earlier stages of CKD, affecting approximately one in two CKD patients (prevalence varies in studies between 30% and 60%). In contrast to ‘normal’ dementia, CKD-related MCI is not age-related, meaning the cognitive impairment exceeds that expected of the normal aging process. It usually worsens with declining glomerular filtration rate (GFR) of patients – the lower the GFR, the higher the risk of being affected by cognitive impairments.Related StoriesLow dose of endotoxin could have protective effect on men at risk of acute kidney injuryChronic kidney disease patients are excluded from clinical trialsIndigestion remedy improves survival in people with late-stage CKDThe pathogenesis appears complex, involving a variety of factors besides vascular disease – the most frequent trigger for ‘standard’ dementia in elderly people. Dialysis does not help or stop the process of cognitive decline, thus experts believe that factors which are not corrected completely by dialysis, for example the clearance of middle molecules, uncontrolled secondary hyperparathyroidism and anemia, may further the process of cognitive impairment.’One interesting finding, though, is that kidney transplantation appears to slow cognitive decline’, explains Professor Giovambattista Capasso, one of the authors of a review recently published in NDT. ‘This highlights the importance of transplantation, because we have no other intervention strategies once cognitive decline has been diagnosed in CKD patients.’The paucity of intervention strategies is the reason why there is no routine screening for MCI in CKD patients. The authors of the review emphasize that cognitive decline is one of many manifestations of brain damage that clearly accompany the decline of kidney function. Other manifestations include sleep disorders and depression, both of which are also common in CKD patients. ‘Chronic kidney disease is an illness that obviously affects the body and the brain. The latter has been neglected by research, but new tools in neuroscience, such as tractography or two-photon microscopy hold out the promise of gaining further insights in the pathogenesis of MCI so that we might identify therapy targets and be able to treat it one day’, explains Professor Capasso.’Until then, we have to be aware that CKD is a severe disease which affects not only the kidneys, but also other organs systems and the brain – even in early stages. This is why we should strengthen CKD prevention strategies and raise awareness for this illness that is much more severe than most people think’, adds Professor Carmine Zoccali, president of the ERA-EDTA.
Reviewed by James Ives, M.Psych. (Editor)Apr 17 2019The commonly used diabetes drug metformin could reverse the harmful thickening of heart muscle that leads to cardiovascular disease, according to a study at the University of Dundee.Scientists led by Professor Chim Lang, Head of the Division of Molecular and Clinical Medicine at Dundee, discovered that metformin has the potential to be repurposed as a heart disease treatment in non-diabetic patients.The MET-REMODEL Trial, published today in the prestigious European Heart Journal, showed that metformin, used to treat type 2 diabetes safely for the last six decades, reduced left ventricular hypertrophy (LVH) in patients with prediabetes and pre-existing heart disease. LVH is the thickening of the muscle wall in the heart’s left pumping chamber and is a serious risk factor for future heart attack, stroke and heart failure.LVH is often a silent symptom and most people do not know they have it prior to experiencing a heart attack or stroke. Large studies have previously shown that patients with LVH are at higher risk of adverse cardiovascular events and reducing LVH can substantially reduce mortality rates.Professor Lang said, “Cardiovascular diseases are the leading cause of global mortality. We have previously shown that metformin can have beneficial effects in patients with cardiovascular diseases. But this is the first time anyone has looked specifically at the effects of metformin on LVH in nondiabetic patients with coronary artery disease in a clinical trial.”The study involved treating prediabetic people with coronary artery disease with metformin or a placebo over a period of 12 months to see how the drug affected the heart muscle wall, using state-of-the-art MRI technology.”The major causes of LVH are high blood pressure, obesity and insulin resistance, which are also thought to be key contributors of coronary artery disease. The dangerous thickening of the left ventricle was reduced by twice as much in those taking metformin compared to the placebo.Related StoriesHeart disease is still the number 1 killer in Australia, according the latest figuresTeam approach to care increases likelihood of surviving refractory cardiogenic shockRNA-binding protein SRSF3 appears to be key factor for proper heart contraction, survival”We also found that metformin reduced blood pressure, oxidative stress and lost body weight – an average of 3.6 kg, compared to no changes in the placebo group. If the findings from this study are substantiated in a larger-scale study, metformin could offer hope for millions of patients across the globe.”The MET-REMODEL trial, funded by the British Heart Foundation (BHF), is the first clinical trial in the world to show that metformin could reverse harmful thickening heart muscle wall in a clinical trial. Repurposing cheap and readily available drugs, such as metformin, to treat other health conditions could potentially save the NHS billions of pounds every year.Mohapradeep Mohan, lead author and principal investigator of the MET-REMODEL trial, said blood pressure medications were the standard treatment modalities for LVH but that this approach was not particularly effective as LVH can also be present in patients who have well-controlled blood pressure. This highlighted the need for new treatment strategies in these patients.”In this context, we need non-blood pressure medication and we had good reason to suppose that metformin should help to reduce thickening of heart muscle wall,” he said.”The findings from our study reinforce the notion that metformin has the potential to improve cardiovascular health, offering the possibility of improving life expectancy of patients. From the standpoint of clinical practice, this drug is already approved and well tolerated with minimal side effects.”If our findings are backed up by bigger studies, using metformin to target LVH presents a novel treatment option and unique opportunity for a quicker translation to the clinic. We are thankful to BHF for funding this study and extremely grateful to all the participants of this study.” Source:https://www.dundee.ac.uk/ read more
Source:ISPOR Reviewed by James Ives, M.Psych. (Editor)Jul 16 2019Value in Health, the official journal of ISPOR- the professional society for health economics and outcomes research, announced today the publication of a high-level overview of machine learning for healthcare outcomes researchers and decision makers. The report, “Machine Learning for Health Services Researchers,” was published in the July 2019 issue of Value in Health.Machine learning is a rapidly growing field that attempts to extract general concepts from large datasets, commonly in the form of an algorithm that predicts an outcome-;a task that has become increasingly difficult to accomplish by humans because data volume and complexity has increased beyond what was capable with traditional statistics and desktop computers.Related StoriesOlympus Europe and Cytosurge join hands to accelerate drug development, single cell researchAXT enhances cellular research product portfolio with solutions from StemBioSysAMSBIO offers new, best-in-class CAR-T cell range for research and immunotherapyMachine learning methods may be useful to health service researchers seeking to improve prediction of a healthcare outcome with large datasets available to train and refine an estimator algorithm. Machine learning methods can help generalizable data-driven estimators when many covariates are being selected among and when the outcome of interest may be produced by complex nonlinear relationships and interaction terms.In this report, the authors introduce key concepts for understanding the application of machine learning methods to healthcare outcomes research. They first provide an overview of machine learning, then identify 5 steps to developing and applying a machine learning algorithm (commonly referred to as a predictive model or estimator): (1) data preparation, (2) estimator family selection, (3) estimator parameter learning, (4) estimator regularization, and (5) estimator evaluation.The report goes on to compare 3 of the most common machine learning methods: (1) decision tree methods that can be useful for identifying how different subpopulations experience different risks for an outcome, (2) deep learning methods that can identify complex nonlinear patterns or interactions between variables predictive of an outcome, and (3) ensemble methods that can improve predictive performance by combining multiple machine learning methods. Finally, the authors demonstrate the application of common machine methods to a simulated insurance claims dataset. While machine learning methods may be useful to health service researchers, they offer considerable challenges that are worth considering before engaging in a machine learning activity. Specifically, they may be difficult to interpret (particularly for deep learning), difficult to glean mechanistic understandings from, and may require substantial investment of time and resources for computation. Nevertheless, improvements in hardware and cloud computing technologies have made machine learning methods increasingly accessible to healthcare outcomes researchers and healthcare organizations. With this article, we aim to lower the barriers to implementing machine learning methods.”Patrick Doupe, PhD, Zalando SE, Berlin, Germany read more
© 2019 AFP Samsung Electronics—the flagship company of the sprawling Samsung Group, by far the biggest of the family-controlled conglomerates that dominate the South’s economy—spent nearly eight years developing the Galaxy Fold Samsung delays launch of folding Galaxy smartphone The Galaxy Fold has been widely promoted as the “world’s first foldable smartphone” The move by the world’s biggest smartphone maker—announced after reviewers provided with early devices reported screens breaking within days of use—comes less than three years after its Galaxy Note 7 disaster.The company said the Galaxy Fold, which had been due for its US release on Friday, “needs further improvements” before customers can receive it and a new release date will be announced in the coming weeks.Samsung Electronics—the flagship company of the sprawling Samsung Group, by far the biggest of the family-controlled conglomerates that dominate the South’s economy—spent nearly eight years developing the Galaxy Fold.It has been widely promoted as the “world’s first foldable smartphone” and is part of its strategy to propel growth with groundbreaking gadgets, while rivals such as China’s Huawei have been racing to bring similar devices to market.Kim Dae-ho, an analyst at Institute for Global Economy, said Samsung can regain customer trust as long as it identifies the problem and releases the perfected Fold “in the quickest possible time”.”Samsung is facing its biggest test ever,” he said. “If they manage to pull this one off, it can bring greater success. Right now it is standing at the crossroads of destiny.” Citation: Samsung facing crucial test over Galaxy Fold delay, analysts warn (2019, April 23) retrieved 17 July 2019 from https://phys.org/news/2019-04-samsung-crucial-galaxy-analysts.html Samsung earlier this month launched the 5G version of its top-end Galaxy S10 device but faces increasing competition from Huawei across different price ranges, and has warned of a more than 60 percent plunge in first-quarter operating profit in the face of weakening markets.Independent technology analyst Rob Enderle said the failure of a flagship item could send Samsung buyers to rivals.”If a halo product fails, people don’t trust that you build quality stuff,” Enderle said.”It can do incredible damage. And Huawei is moving up like a rocket, so this could be good for Huawei.”Samsung Electronics shares closed down 0.33 percent in Seoul on Tuesday.’Pre-emptive action’But analysts say that while the decision to delay may hurt Samsung’s brand reputation in the short term, it could ultimately prevent it from repeating the critical mistakes of 2016, which cost it billions of dollars. Explore further That year, Samsung’s reputation suffered a major blow after a damaging worldwide recall of Galaxy Note 7 devices over exploding batteries. South Korean tech giant Samsung Electronics is “facing its biggest test ever”, analysts said Tuesday after it delayed the release of its $2,000 foldable phone over screen problems. At the time, the firm showed a slow response to initial reports of the devices catching fire, claiming the hazard was only limited to a “small fraction of phones” manufactured.But it later ended up announcing a recall of 2.5 million smartphones after several devices exploded. It eventually traced the problem to the batteries, but decided to kill off the model for good.Analyst Kim said the tech giant’s approach with the Fold was quite different from the way it handled the Note 7 fiasco.”Back in 2016, Samsung was overconfident with its technology,” and did not respond to the initial reports immediately, he said. “As a result, the damage was enormous,” he said.”The fact that Samsung is delaying the release of the Fold—although the problem isn’t as serious as the one Note 7 had—means it is taking pre-emptive action this time.” Samsung’s reputation suffered a major blow in 2017 after a damaging worldwide recall of Galaxy Note 7 devices over exploding batteries This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no part may be reproduced without the written permission. The content is provided for information purposes only. read more