NMRFinder: a novel method for 1D 1H-NMR metabolite annotation.

INTRODUCTION: Methods for the automated and accurate identification of metabolites in 1D 1H-NMR samples are crucial, but this is still an unsolved problem. Most available tools are mainly focused on metabolite quantification, thus limiting the number of metabolites that can be identified. Also, most only use reference spectra obtained under the same specific conditions of the target sample, limiting the use of available knowledge. OBJECTIVES: The main goal of this work was to develop novel methods to perform metabolite annotation from 1D 1H-NMR peaks with enhanced reliability, to aid the users in metabolite identification. An essential step was to construct a vast and up-do-date library of reference 1D 1H-NMR peak lists collected under distinct experimental conditions. METHODS: Three different algorithms were evaluated for their capacity to correctly annotate metabolites present in both synthetic and real samples and compared to publicly available tools. The best proposed method was evaluated in a plethora of scenarios, including missing references, missing peaks and peak shifts, to assess its annotation accuracy, precision and recall. RESULTS: We gathered 1816 peak lists for 1387 different metabolites from several sources across different conditions for our reference library. A new method, NMRFinder, is proposed and allows matching 1D 1H-NMR samples with all the reference peak lists in the library, regardless of acquisition conditions. Metabolites are scored according to the number of peaks matching the samples, how unique their peaks are in the library and how close the spectrum acquisition conditions are in relation to those of the samples. Results show a true positive rate of 0.984 when analysing computationally created samples, while 71.8% of the metabolites were annotated when analysing samples from previously identified public datasets. CONCLUSION: NMRFinder performs metabolite annotation reliably and outperforms previous methods, being of great value in helping the user to ultimately identify metabolites. It is implemented in the R package specmine.

Association between high titers of glutamic acid decarboxylase antibody and epilepsy in patients with type 1 diabetes mellitus: A cross-sectional study.

PURPOSE: Individuals with type 1 diabetes mellitus (T1D) are at higher risk of epilepsy. T1D is a progressive immune-mediated disease and the etiology of epilepsy remains unknown in most. Glutamic acid decarboxylase (GAD) catalyzes GABA formation. GABA-secreting neurons and pancreatic beta cells are the major cells expressing GAD. METHODS: Cross-sectional study. Patients with T1D from a multiethnic population underwent GADA measurement to investigate possible association between T1D and epilepsy of unknown etiology. RESULTS: T1D patients were analyzed (n = 375). Overall frequency of epilepsy was 5.9% (n = 22). Frequency of epilepsy of unknown etiology was 3.2% (n = 12). Of these, 8 (2.1%) had idiopathic generalized epilepsy (IGE) and 4 (1.1%) MRI-negative temporal lobe epilepsy (TLE). Patients with T1D and epilepsy of unknown etiology did not show differences in GADA frequency (83.3% vs 50%; p = 0.076); however, their titers were higher (106.9 ±â€¯136.5 IU/mL; median 7; IQR 1.65-256 vs 10.2 ±â€¯14.5 IU/ml; median 4.3; IQR 1.9-8.9; p = 0.019) compared to patients without epilepsy. Moreover, epilepsy of unknown etiology was associated with GADA titers ≥ 100 UI/mL [odds ratio (OR) 4.42, 95% CI 2.36-8.66]. CONCLUSION: Epilepsy frequency was elevated in patients with T1D and multiethnic background. Presence of epilepsy of unknown etiology was associated with high titers of GADA in this population with long-standing T1D, which has different ethnic and genetic background compared to previous studies. Further prospective studies are required to identify if GADA presence or its persistence are directly responsible for epilepsy in individuals with T1D.

Health-related quality of life and utility values associated to hypoglycemia in patients with type 1 diabetes mellitus treated in the Brazilian Public Health System: a multicenter study.

BACKGROUND: Hypoglycemia is a critical and limiting factor of a good metabolic control and can adversely affect the quality of life of diabetic patients. The aim of the study was to evaluate the health-related quality of life and calculate utilities values associated with hypoglycemia in patients with type 1 diabetes mellitus (T1DM). METHODS: A multicenter, cross-sectional and observational study with T1DM patients from reference centers of the Brazilian public health system was conducted in three cities. Demographic and clinical data were collected, besides details on the frequency and severity of hypoglycemia. Health-related quality of life was assessed using EQ-5D instrument and utility values generated. RESULTS: 221 patients (107 women, 114 men), aged 29.8 ± 11.6 and disease duration of 14.2 ± 9.1 years were included. Most patients (n = 214, 96.8%) reported at least one symptomatic hypoglycemia in the last three months, 68% (n = 150) reported nocturnal episodes and 34.8% (n = 77) reported severe episodes. High frequency (daily or weekly) was observed in 38.6 and 26% of those reporting nocturnal or severe hypoglycemia, respectively. The median visual analog scale was 70 [60-85] for all patients, with differences between those with and without severe hypoglycemia (70 [60-80] vs 80 [61-90]; p = 0.006) and those with high and low frequency (62.5 [50-72.25] vs 70 [60-80]; p = 0.007). The median utility values was 0.801 [0.756-1.000] for all patients, with difference between those with high and low frequency of severe episodes (0.737 [0.628-1.000] vs 0.801 [0.756-1.000]; p = 0.02). CONCLUSIONS: This study shows the high frequency of hypoglycemia in a sample of T1DM patients treated in three reference centers of the Brazilian public health system and the impact of severe episodes on health-related quality of life. Utility values were generated and can be used in economic analysis for treatments that could decrease hypoglycemia and consequently improve quality of life.

Measurement of salivary cortisol as a marker of stress in newborns in a neonatal intensive care unit.

AIMS: The study was designed to evaluate the newborn (NB) stress response during the inpatient time in the neonatal intensive care unit. METHODS: A quantitative, prospective, observational study was conducted with two NB groups. The first group consisted of 12 NB patients in the neonatal intensive care unit as the experimental group (EG), and the second included 43 NBs who were sent to their own homes and were considered the control group (CG). The EG's salivary cortisol concentration was measured on the 2nd day (D2) and 9th day (D9) of life. The CG's salivary cortisol concentration was measured on the 14th day of life at the child's own home. RESULTS: The salivary cortisol concentration levels for the EG on D2 and D9 and for the CG were 4.3151 ± 2.6492, 1.826 ± 1.2252, and 1.0166 ± 0.8300 ng/dl, respectively. These findings indicated the presence of an adrenal response to stress during the first inpatient days. CONCLUSIONS: The salivary cortisol concentration is an accurate method to indicate neonatal stress. The glucocorticoids frequently used in the prenatal period suppress the adrenal glands and interfere with the stress response.

Análise das oportunidades para o desenvolvimento motor (affordances) em ambientes domésticos no Ceará - Brasil / Analysis of the opportunities (affordances) for motor development in the home environment in Ceará - Brazil

Existe um consenso na literatura científica sobre a forte influência dos estímulos ambientais no desenvolvimento motor das crianças. O presente trabalho tem como objetivo analisar as oportunidades para o desenvolvimento motor em ambientes domésticos de diferentes níveis socioeconômicos no Estado do Ceará, Brasil. Os dados apresentados no estudo foram colhidos a partir das respostas ao questionário Affordances in the Home Enviroment for Motor Development - AHEMD - 18-42 meses quando se entrevistaram 128 tutores responsáveis por crianças com idade entre 18 e 42 meses. Os resultados do estudo são bastante preocupantes, pois mostram uma prevalência da inadequação das estruturas arquitetônicas das residências favorecedoras do desenvolvimento motor e a inexistência de materiais suficientes ao desenvolvimento da motricidade grossa e fina de crianças. Nota-se a necessidade, segundo os dados apresentados, de que seja avaliado o desenvolvimento motor das crianças para verificar se há uma associação entre as affordances e o desenvolvimento motor, e que haja uma aproximação das áreas de engenharia civil, arquitetura e educação física na busca de soluções para este problema. O estudo sugere, ainda, o surgimento de uma nova área de atuação para os profissionais que lidam com o movimento humano no sentido de prestarem consultorias para aquisição de brinquedos que auxiliem no desenvolvimento da motricidade grossa e fina.(AU)

Current literature in early childhood emphasizes a strong influence of environmental stimuli on motor skill development. The purpose of the present study was to investigate the opportunities for motor development in different socioeconomic home environments in the state of Ceara, Brazil. The study used the AHEMD (Affordances in the Home Environment for Motor Development) questionnaire with 128 caregivers of children between ages 18 to 42 months. The results appeared to be concerning, showing a prevalence of architectural structures that are unfavorable for motor development, and also for showing an insufficient number of materials that can stimulate gross- and fine-motor development. This study suggests that children's motor development must be assessed in order to detect if there is an association between affordances in the home environment and motor development, and if it is, an approximation of civil engineering, architecture and physical education areas could possibly find solutions for that problem. In addition, it suggests a need of a new career, where professionals who work with human movement can best indicate the acquisition of materials for developing children's gross- and fine-motor coordination.(AU)

Analysis of the opportunities (affordances) for motor development in the home environment in Ceará - BrazilAnálise das oportunidades para o desenvolvimento motor (affordances) em ambientes domésticos no Ceará - Brasil / Analysis of the opportunities (affordances) for motor development in the home environment in Ceará - Brazil

Existe um consenso na literatura científica sobre a forte influência dos estímulos ambientais no desenvolvimento motor das crianças. O presente trabalho tem como objetivo analisar as oportunidades para o desenvolvimento motor em ambientes domésticos de diferentes níveis socioeconômicos no Estado do Ceará, Brasil. Os dados apresentados no estudo foram colhidos a partir das respostas ao questionário Affordances in the Home Enviroment for Motor Development - AHEMD - 18-42 meses quando se entrevistaram 128 tutores responsáveis por crianças com idade entre 18 e 42 meses. Os resultados do estudo são bastante preocupantes, pois mostram uma prevalência da inadequação das estruturas arquitetônicas das residências favorecedoras do desenvolvimento motor e a inexistência de materiais suficientes ao desenvolvimento da motricidade grossa e fina de crianças. Nota-se a necessidade, segundo os dados apresentados, de que seja avaliado o desenvolvimento motor das crianças para verificar se há uma associação entre as affordances e o desenvolvimento motor, e que haja uma aproximação das áreas de engenharia civil, arquitetura e educação física na busca de soluções para este problema. O estudo sugere, ainda, o surgimento de uma nova área de atuação para os profissionais que lidam com o movimento humano no sentido de prestarem consultorias para aquisição de brinquedos que auxiliem no desenvolvimento da motricidade grossa e fina.