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《Journal of diabetes and its complications》2022,36(8):108260
AimTo verify whether arterial stiffness and endothelial dysfunction influence lower limb muscle strength and gait speed in older adults with type 2 diabetes mellitus (T2DM).MethodsCross-sectional study including seventy-eight older adults with T2DM (aged 67 ± 6 years and 42 % male). Arterial stiffness was assessed using pulse wave velocity (PWV), while endothelial function was measured by flow-mediated dilation (FMD). Lower limb muscle strength and gait speed were assessed using the 30-second chair stand test (30s-CST) and 10-Meter Walk Test, respectively.ResultsBoth PWV (m/s) and FMD (%) were univariately associated with number of repetitions in 30s-CST and gait speed (P < 0.05). After control for age, sex and body mass index, PWV remained associated with repetitions in 30s-CST (95 % CI: ?0.494 to ?0.054; P = 0.015) and gait speed (95 % CI: ?0.039 to ?0.002; P = 0.031). After adjustments for control variables, T2DM duration and glycemic control, FMD was associated with repetitions in 30s-CST (95 % CI: 0.008 to 0.324; P = 0.039) and gait speed (95 % CI: 0.011 to 0.038; P = 0.001).ConclusionIn older adults with T2DM, both arterial stiffness and endothelial dysfunction are associated with decreased leg muscle strength and slower gait speed. 相似文献
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《Journal of Geriatric Oncology》2022,13(5):563-571
Breast cancer is the most common type of cancer affecting women worldwide and its risk increases with age. Compared with other breast cancer subtypes, triple negative breast cancer (TNBC) behaves more aggressively, with earlier relapses and poorer survival outcomes. Although the incidence of TNBC decreases with age, it still affects about 10% of older women with breast cancer. The management of TNBC in older patients is particularly challenging as chemotherapy is the main treatment choice in both early and advanced diseases and older patients are often prone to increased treatment-related toxicities. This review highlights the specific considerations in this vulnerable group of patients and summarizes the current evidence for TNBC management in older adults from early to late stage of disease. 相似文献
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While pap test is the most common diagnosis methods for cervical cancer, their results are highly dependent on the ability of the cytotechnicians to detect abnormal cells on the smears using brightfield microscopy. In this paper, we propose an explainable region classifier in whole slide images that could be used by cyto-pathologists to handle efficiently these big images (100,000x100,000 pixels). We create a dataset that simulates pap smears regions and uses a loss, we call classification under regression constraint, to train an efficient region classifier (about 66.8% accuracy on severity classification, 95.2% accuracy on normal/abnormal classification and 0.870 KAPPA score). We explain how we benefit from this loss to obtain a model focused on sensitivity and, then, we show that it can be used to perform weakly supervised localization (accuracy of 80.4%) of the cell that is mostly responsible for the malignancy of regions of whole slide images. We extend our method to perform a more general detection of abnormal cells (66.1% accuracy) and ensure that at least one abnormal cell will be detected if malignancy is present. Finally, we experiment our solution on a small real clinical slide dataset, highlighting the relevance of our proposed solution, adapting it to be as easily integrated in a pathology laboratory workflow as possible, and extending it to make a slide-level prediction. 相似文献
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