Nutrition in clinical care : an official publication of Tufts University最新文献

{"title":"Neural network emulation of the human ventricular cardiomyocyte action potential: a tool for more efficient computation in pharmacological studies.","authors":"Thomas Grandits, Christoph M Augustin, Gundolf Haase, Norbert Jost, Gary R Mirams, Steven A Niederer, Gernot Plank, András Varró, László Virág, Alexander Jung","doi":"10.1101/2023.08.16.553497","DOIUrl":"10.1101/2023.08.16.553497","url":null,"abstract":"<p><p>Computer models of the human ventricular cardiomyocyte action potential (AP) have reached a level of detail and maturity that has led to an increasing number of applications in the pharmaceutical sector. However, interfacing the models with experimental data can become a significant computational burden. To mitigate the computational burden, the present study introduces a neural network (NN) that emulates the AP for given maximum conductances of selected ion channels, pumps, and exchangers. Its applicability in pharmacological studies was tested on synthetic and experimental data. The NN emulator potentially enables massive speed-ups compared to regular simulations and the forward problem (find drugged AP for pharmacological parameters defined as scaling factors of control maximum conductances) on synthetic data could be solved with average root-mean-square errors (RMSE) of 0.47mV in normal APs and of 14.5mV in abnormal APs exhibiting early afterdepolarizations (72.5% of the emulated APs were alining with the abnormality, and the substantial majority of the remaining APs demonstrated pronounced proximity). This demonstrates not only very fast and mostly very accurate AP emulations but also the capability of accounting for discontinuities, a major advantage over existing emulation strategies. Furthermore, the inverse problem (find pharmacological parameters for control and drugged APs through optimization) on synthetic data could be solved with high accuracy shown by a maximum RMSE of 0.21 in the estimated pharmacological parameters. However, notable mismatches were observed between pharmacological parameters estimated from experimental data and distributions obtained from the Comprehensive in vitro Proarrhythmia Assay initiative. This reveals larger inaccuracies which can be attributed particularly to the fact that small tissue preparations were studied while the emulator was trained on single cardiomyocyte data. Overall, our study highlights the potential of NN emulators as powerful tool for an increased efficiency in future quantitative systems pharmacology studies.</p>","PeriodicalId":83835,"journal":{"name":"Nutrition in clinical care : an official publication of Tufts University","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10793461/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79679573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Iron: tolerable upper intake levels.","authors":"Reprinted from Iom Report on DRIs for Micronutrients","doi":"10.1046/j.1523-5408.2002.05506.x","DOIUrl":"https://doi.org/10.1046/j.1523-5408.2002.05506.x","url":null,"abstract":"Gastrointestinal side effects were selected as the critical adverse effects on which to base the UL for iron. Although gastrointestinal distress is not a serious side effect when compared with the possible risk for vascular disease and cancer, the other side effects considered (impaired zinc absorption, increased risk for vascular disease and cancer, and systemic iron overload) did not permit the determination of a UL. Gastrointestinal distress is primarily observed in individuals who have consumed high levels of supplemental iron on an empty stomach. Large doses of iron supplements may inhibit zinc absorption when both are consumed in the fasting state, but zinc absorption is not impaired when supplementary iron is taken with meals. The relationship between iron intake and both vascular disease and cancer is unclear at the present time. With the possible exception of individuals living in Southern Africa who suffer from sub-Saharan iron overload, iron overload has not been shown to result solely from a high dietary iron intake. Moreover, no differences were found in the serum ferritin concentrations between individuals who fell in the lower and upper quartiles for total dietary iron intake in the Third National Health and Nutrition Examination Survey (NHANES 111) (Appendix Table H-5). Heterozygous carriers of the C282Y mutation most commonly associated with hereditary hemochromatosis could be at increased risk for accumulating harmful amounts of iron, but there are no direct observations to confirm this suspicion. Homozygotes and individuals with other iron-loading disorders may not be protected by the UL and are addressed under \"Special Considerations\".","PeriodicalId":83835,"journal":{"name":"Nutrition in clinical care : an official publication of Tufts University","volume":"12 1","pages":"236-50"},"PeriodicalIF":0.0,"publicationDate":"2008-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84316767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Childhood obesity: etiology, prevention, and treatment.","authors":"Niki G Philippas,&nbsp;Clifford W Lo","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The rapid increase in the prevalence of obesity in children and adolescents is alarming, particularly in light of its many medical and psychosocial consequences. In this review, we discuss key concepts of nutrition and physical activity. Etiology, prevention, and treatment strategies are also discussed, focusing on the macronutrient content of the diet, portion control, meal patterns, physical activity, and sedentary behaviors. Television viewing, lack of physical activity, and intake of fast food and soft drinks are also examined as potential contributing factors in the obesity epidemic. Children should be helped to develop healthy nutrition and exercise habits early, since interventions are most effective when behaviors are still being formed.</p>","PeriodicalId":83835,"journal":{"name":"Nutrition in clinical care : an official publication of Tufts University","volume":"8 2","pages":"77-88"},"PeriodicalIF":0.0,"publicationDate":"2005-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24896177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Total parenteral nutrition in cancer patients: why and when?","authors":"Laura Joque,&nbsp;Aminah Jatoi","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Total parenteral nutrition (TPN) is sometimes utilized in cancer patients. Previous studies suggest that TPN provides clinical benefit in the perioperative setting among severely malnourished cancer patients and among those who are receiving blood or marrow transplants. However, the negative impact of TPN on quality of life, its adverse event profile, and its cost all suggest that this intervention must be used judiciously in cancer patients. Although a few case reports and other studies imply that TPN may benefit select patients with metastatic cancer, this approach represents a departure from the standard of care and therefore must be clearly thought through and justified prior to implementation.</p>","PeriodicalId":83835,"journal":{"name":"Nutrition in clinical care : an official publication of Tufts University","volume":"8 2","pages":"89-92"},"PeriodicalIF":0.0,"publicationDate":"2005-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24896180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Celiac disease: epidemiology, pathogenesis, diagnosis, and nutritional management.","authors":"Detlef Schuppan,&nbsp;Melinda D Dennis,&nbsp;Ciaran P Kelly","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Celiac disease (CD) is an inflammatory small intestinal disorder that can lead to severe villous atrophy, malabsorption, and malignancy. It is triggered by the gluten proteins of wheat, barley, and rye. All patients express the antigen-presenting molecules human leukocyte antigen-DQ2 (HLA-DQ2) and/or HLA-DQ8, which bind gluten peptides and thus activate destructive intestinal T cells. Patients with untreated CD have circulating IgA autoantibodies to the enzyme tissue transglutaminase (tTG), a component of endomysium. Testing for serum IgA tTG has a high predictive value. Therapy of CD is a lifelong gluten-free diet. Counseling by an expert dietitian and association with a celiac support group are important in helping the patient embark on a healthy gluten-free diet. Current research focuses on non-dietary therapies and treatment of refractory (diet-unresponsive) CD.</p>","PeriodicalId":83835,"journal":{"name":"Nutrition in clinical care : an official publication of Tufts University","volume":"8 2","pages":"54-69"},"PeriodicalIF":0.0,"publicationDate":"2005-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24896174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nutritional therapy in chronic kidney disease.","authors":"Vincenzo Savica,&nbsp;Domenico Santoro,&nbsp;Francesco Ciolino,&nbsp;Agostino Mallamace,&nbsp;Menotti Calvani,&nbsp;Rodolfo Savica,&nbsp;Guido Bellinghieri","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In patients with chronic kidney disease (CKD), specialized nutritional therapy may help reduce the risk of electrolyte imbalances, vitamin deficiencies, and protein energy malnutrition. Protein-restricted diets may slow the progression of renal disease and decrease the risk of morbidity and mortality in patients with CKD. In this review, we discuss some of the major nutritional concerns in individuals with CKD and offer practical recommendations for dietary therapy.</p>","PeriodicalId":83835,"journal":{"name":"Nutrition in clinical care : an official publication of Tufts University","volume":"8 2","pages":"70-6"},"PeriodicalIF":0.0,"publicationDate":"2005-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24896175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MyPyramid.gov.","authors":"Ann Yelmokas McDermott","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":83835,"journal":{"name":"Nutrition in clinical care : an official publication of Tufts University","volume":"8 2","pages":"102-4"},"PeriodicalIF":0.0,"publicationDate":"2005-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24895614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hyperglycemia in the critically ill.","authors":"Colleen Digman,&nbsp;Dara Borto,&nbsp;Stanley A Nasraway","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Hyperglycemia is frequently seen in acutely ill patients and has historically been viewed as a normal response to stress. Treatment is often not initiated unless blood glucose exceeds 200 to 250 mg/dL. Recent evidence suggests that hyperglycemia is associated with worse outcomes within the population of medical and surgical intensive care units. Hyperglycemia in this population of patients develops from increased gluconeogenesis and insulin resistance. Although the specific mechanisms by which hyperglycemia contributes to poor outcomes are as yet unknown, disruption of normal mitochondrial respiration, direct glucose toxicity, accumulation of asymmetric dimethylarginine, and impairment of immune cell function are among the possibilities implicated. Studies demonstrate that intensive insulin therapy to achieve euglycemia reduces mortality and morbidity in critically ill patients. In addition to recognizing and treating hyperglycemia, it is as important to identify other frequently overlooked factors that contribute to hyperglycemia, such as medications, intravenous fluids, and enteral and parenteral nutrition.</p>","PeriodicalId":83835,"journal":{"name":"Nutrition in clinical care : an official publication of Tufts University","volume":"8 2","pages":"93-101"},"PeriodicalIF":0.0,"publicationDate":"2005-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24895612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient information. Omega-3 fatty acids: what? why? and how?","authors":"Margo N Woods","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":83835,"journal":{"name":"Nutrition in clinical care : an official publication of Tufts University","volume":"8 1","pages":"50-1"},"PeriodicalIF":0.0,"publicationDate":"2005-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25074478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High-Dose Vitamin E Supplementation and Mortality.","authors":"Lisa M Neff","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":83835,"journal":{"name":"Nutrition in clinical care : an official publication of Tufts University","volume":"8 1","pages":"3-5"},"PeriodicalIF":0.0,"publicationDate":"2005-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24883726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}