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Executive functions in adults born small for gestational age at term: a prospective cohort study
Abstract There are mixed findings regarding executive functioning in individuals born small for gestational age (SGA) at term and associations between performance-based and self-reported executive functions have yet to be examined in adults. In a prospective cohort study, 56 SGA and 68 non-SGA control participants were assessed at 32 years using the performance-based Trail Making Test (TMT) and the self-report questionnaire Behavior Rating Inventory of Executive Function – Adult Version (BRIEF-A). The SGA group used 1.6 (95% confidence interval [CI] 0.1–3.1) to 3.9 (95% CI 1.2–6.5) seconds more on TMT conditions 1 and 3, indicating more difficulties with visual scanning and letter sequencing than controls. On BRIEF-A, the SGA group scored 1.5 (95% CI 0.2–2.8) points lower on the clinical scale Emotional Control. Correlation coefficients for the association between TMT and BRIEF-A scores ranged from -0.295 (p = 0.065) to 0.345 (p = 0.029) in the SGA group. In conclusion, we found that 32-year-old adults born SGA at term showed poorer performance on some executive function tasks than controls. However, they reported similar executive functioning in everyday life, except for emotional control. The associations between performance-based and self-report assessments of executive functions were weak.
The impact of specialised gastroenterology services for pelvic radiation disease (PRD): Results from the prospective multi-centre EAGLE study
To undertake a mixed-methodology implementation study to improve the well-being of men with gastrointestinal late effects following radical radiotherapy for prostate cancer. All men completed a validated screening tool for late bowel effects (ALERT-B) and the Gastrointestinal Symptom Rating Score (GSRS); men with a positive score on ALERT-B were offered management following a peer reviewed algorithm for pelvic radiation disease (PRD). Health-related quality of life (HRQoL) at baseline, 6 and 12 months; and healthcare resource usage (HRU) and patient, support-giver, staff experience and acceptability of staff training (qualitative analysis) were assessed. Two nurse- and one doctor-led gastroenterology services were set up in three UK cancer centres. Men (n = 339) who had had radical radiotherapy for prostate cancer at least 6 months previously, were recruited; of which 91/339 were eligible to participate; 58/91 men (63.7%) accepted the referral. Diagnoses included: radiation proctopathy (n = 18); bile acid malabsorption (n = 15); fructose or lactose intolerance and/or small intestinal bacterial overgrowth (n = 20); vitamin B12/D deficiency (n = 20). Increases in quality of life, sexual activity and/or sexual function, and decrease in specific symptoms (e.g. bowel-related or urinary) between 6 and 12 months were observed. Limited HRU modelling suggested staff costs were £117-£185, depending on the service model; total costs averaged £2,243 per patient. Both staff and patients welcomed the new service although there was concern about long-term funding and sustainability beyond the timeframe of the study (qualitative). PRD is increasingly recognised worldwide as an ongoing consequence of curative pelvic radiotherapy, despite widespread implementation of advanced radiotherapy techniques. Specialised services following national guidelines are required.
Impact of severe dysphagia on overall survival after percutaneous endoscopic gastrostomy
Abstract In this study, we investigated the effect of severe dysphagia on the overall survival of patients who underwent PEG. A cohort of patients who underwent PEG between April 2016 and April 2021 was retrospectively analyzed. The Hyodo–Komagane score was used to evaluate swallowing via endoscopy. Patients with a Hyodo–Komagane score ≤ 8 were defined as having moderate dysphagia, whereas those with a score ≥ 9 were defined as having severe dysphagia. The primary outcome was overall survival. The prognostic factors were identified using multivariate analysis with the Cox proportional hazards model. Values of p < 0.05 were considered statistically significant. Among the 107 patients, 60 (56.1%) were classified into the moderate dysphagia group and 47 (43.9%) into the severe dysphagia group. The median follow-up period was 16.7 months. The overall survival was significantly worse in the severe group than in the moderate group (p < 0.0001). A multivariate analysis revealed that severe dysphagia was an independent poor prognostic factor (hazard ratio, 2.956; 95% confidence interval, 1.592–5.489; p < 0.001). Aspiration-related pneumonia was most common causes of death after PEG. Severe dysphagia was identified as an independent poor prognostic factor for survival in patients who underwent PEG.
Divergent Total Syntheses of Phragmalin and Khayanolide-Type Limonoids: A Torquoselective Interrupted Nazarov Approach
Covariate-adjusted construction of gene regulatory networks using a combination of generalized linear model and penalized maximum likelihood
Many machine learning techniques have been used to construct gene regulatory networks (GRNs) through precision matrix that considers conditional independence among genes, and finally produces sparse version of GRNs. This construction can be improved using the auxiliary information like gene expression profile of the related species or gene markers. To reach out this goal, we apply a generalized linear model (GLM) in first step and later a penalized maximum likelihood to construct the gene regulatory network using Glasso technique for the residuals of a multi-level multivariate GLM among the gene expressions of one species as a multi-levels response variable and the gene expression of related species as a multivariate covariates. By considering the intrinsic property of the gene data which the number of variables is much greater than the number of available samples, a bootstrap version of multi-response multivariate GLM is used. To find most appropriate related species, a cross-validation technique has been used to compute the minimum square error of the fitted GLM under different regularization. The penalized maximum likelihood under a lasso or elastic net penalty is applied on the residual of fitted GLM to find the sparse precision matrix. Finally, we show that the presented algorithm which is a combination of fitted GLM and applying the penalized maximum likelihood on the residual of the model is extremely fast, and can exploit sparsity in the constructed GRNs. Also, we exhibit flexibility of the proposed method presented in this paper by comparing with the other methods to demonstrate the super validity of our approach.
Pain sensitivity mediates the relationship between empathy for pain and psychopathic traits
Low levels of Plasmodium falciparum parasitaemia among patients receiving antiretroviral therapy at the treatment centre of the Regional Hospital Bamenda, Northwest Cameroon
Background Malaria and HIV are leading causes of death in Africa, including Cameroon. Antiretroviral therapy (ART) is expected to boost immunity and reduce vulnerability to opportunistic infections. Reports on comorbidities including malaria are common in Cameroon. Objectives To determine the prevalence of malaria parasitaemia, clinical manifestations, treatment related factors and prevention methods associated with malaria parasitaemia as well as parasite density among HIV patients on ART. Methods It was a cross-sectional study among HIV patients on ART at the Regional Hospital Bamenda. A pre-tested questionnaire was used to collect data on participants’ socio-demographic characteristics, clinical manifestations, history of HIV treatment and malaria prevention methods. Microscopy was used for malaria parasite diagnosis and to determine white blood cell (WBC) count. Data was analysed using SPSS version 20. Results The study included 181 participants. The overall prevalence of malaria parasitaemia was 9.4%. Although there were no significant statistical differences, the following trends were observed in the results: 55-71 year old age group (14%) was most infected with malaria parasite with the highest prevalence among those on the 8A first-line ART (10.3%, 14/122); (χ2=1.03, p=0.96), only participants in the 8A and 12A ART protocols were infected; parasite prevalence was higher in patients with detectable viral load (14.3%, 3/21), (OR=.0.57 (CI: 0.15-2.2), p=0.41), while GMPD varied from 45.7-53.3-±23.1/μl of blood. Conclusion Low malaria parasite prevalence and density were detected amongst HIV patients receiving ART. A systematic malaria test could be helpful to avert morbidity and improve the general health of patients on ART.
A practical methodology for incorporating volume-translated equation of states in isochoric-isothermal phase equilibrium calculations for liquid phase pressure prediction
Joint trajectories of physical activity, health, and income before and after statutory retirement: A 22-year follow-up
Background Health behaviors, health, and income change during aging. However, no previous studies have examined, how they develop together over the transition to statutory retirement. We aimed to examine their joint development and to identify the determinants of any distinct trajectories. Methods We studied former employees of the City of Helsinki, Finland, who transitioned to full statutory retirement between 2000 and 2022 (n = 5209, 80% women). We examined five repeated questionnaire surveys to identify any joint developmental patterns in the key indicators of healthy aging and well-being—leisure-time physical activity, health measured by general health perceptions, and household income, over a follow-up of 22 years. We used joint group-based trajectory analysis to identify latent developmental groups. The social and health-related determinants of trajectory group membership are reported as average marginal effects. Results We found four distinct joint trajectory groups. Group 1 (22.6%) had consistently poor general health perceptions, less physical activity than the recommended amount, and low income. In Group 2 (34.2%), general health perceptions were first good but then declined, and income was low but slightly increasing. Group 3 (12.3%) had good general health perceptions, a very high level of physical activity, but fluctuating income. In Group 4 (30.9%), general health perceptions were first good but then declined, physical activity was at the recommended level, and income was sharply increasing. People with obesity had a 22 percentage-point (21–24) higher predicted probability of belonging to Group 1 than people with normal weight. They were also more likely to report low education and more physician-diagnosed chronic diseases and mental disorders. Conclusions We identified distinct trajectories in physical activity, general health perceptions, and income over a follow-up of over 20 years. The majority of those who had transitioned to statutory retirement had good general health perceptions but varying levels of physical activity and income. As not all those with a low income had a low level of physical activity or poor general health perceptions, public health interventions should target distinct groups with the most adverse risk factor profiles, to narrow health inequalities during aging.
Calculation and structural analysis of total factor energy efficiency in high carbon sectors
Cost-effectiveness analysis for implementation of smoking cessation strategies at primary health care settings in Tamil Nadu
Background Smoking is a major public health concern in Tamil Nadu, as it is in many parts of the world. It is a leading cause of preventable diseases and deaths, with a significant economic burden on healthcare systems and society as a whole. Recognizing the need to address this issue, the implementation of smoking cessation strategies at primary health care (PHC) settings has gained attention. Conducting a cost-effectiveness analysis in this context can help policymakers and healthcare providers make informed decisions about the allocation of resources for such interventions. Objectives To compare the cost-effectiveness of the smoking cessation of proposed strategies (PSs), PS1: enhanced counselling (EC) + nicotine replacement therapy (NRT) + bupropion tablet; PS2: behavioural intervention (BI) + NRT + promotion of bupropion sustained release (SR); PS3: EC + NRT + promotion of bupropion SR with the current strategy (BI +NRT+ Bupropion) in a population of smokers aged ≥15 years attending the PHC in Tamil Nadu. Methods In this hypothetical cohort of 100,000 individuals using the decision tree analysis, a cost-effectiveness assessment was conducted for both proposed and existing strategies. The results were evaluated in terms of incremental cost-effectiveness ratios (ICERs) per person quitting smoking. To assess the robustness of the findings, one-way sensitivity analysis and probabilistic sensitivity analysis were performed which aims to explore and address the uncertainties associated with the outcomes. Results The cost of the current strategy (CS) was higher (₹359 or $4.28 million) when compared with PS1 (₹327 or $3.90 million) and PS3 (₹327 or $3.90 million) strategies. The PS2 with BI + bupropion SR + NRT was found to be more cost (₹2,720,571 or $ 32,414.76) as compared to current strategy. ICER values indicates that compared to the current strategy, the PS1 and PS3 were found to be cost-saving, whereas the PS2 was found to be cost-effective. The cost-effectiveness acceptability curve demonstrated that the PS1 and PS3 indicates 100% probability of the intervention being cost-saving. After excluding dominated interventions (PS2 and CS), the remaining strategies (PS1 and PS3) were compared. The PS3, with an incremental cost of ₹462,497 ($5,510) for 131 additional quitters, resulted in an ICER of ₹3,531 ($42) per quitter, making it a cost-effective option compared to PS1. Conclusion Our study findings indicate that the need for healthcare providers and policymakers to implement PS3 with EC, NRT, Bupropion SR, as which was found to be cost-saving compared to current practices.
Understanding collective behavior in biological systems through potential field mechanisms
The question of strains in AA amyloidosis
Abstract The existence of transmissible amyloid fibril strains has long intrigued the scientific community. The strain theory originates from prion disorders, but here, we provide evidence of strains in systemic amyloidosis. Human AA amyloidosis manifests as two distinct clinical phenotypes called common AA and vascular AA. Glomerular amyloid deposition of the kidney defines the common form, while in the vascular type amyloid deposits are massive in the renal medulla and in arteries throughout the body, while glomeruli are spared. By electron microscopy the two types appeared morphologically different. The common type was composed of dispersed fibrils which tended to be clustered whereas the vascular type was composed of longer and more distinct less clustered fibrils. Staining with fluorescent amyloid binding ligands analyzed by hyperspectral microscopy showed differential staining patterns between the two groups supporting the notion of human AA amyloid strains. AA amyloid staining was significantly different from systemic AL amyloid. Both types of AA (common and vascular) and AL amyloid fibrils were isolated and used to seed mouse AA amyloid in groups of inflamed NMRI mice (n = 9–10 per group). All but two mice showed amyloid deposits in the spleen induced by the human seeds. Amyloid binding ligand analysis was applied on the splenic amyloid deposits and revealed no clear significant difference between mice seeded with AA fibrils from different donors being vascular or common, but the AA deposits of mice given AL fibrils showed significantly different amyloid fluorescent signals compared to all groups of mice receiving AA fibrils. The combined results support the hypothesis that AA amyloid fibril structures can vary depending on the seed and may manifest as amyloid strains.
A high-fat meal significantly impacts the bioavailability and biphasic absorption of cannabidiol (CBD) from a CBD-rich extract in men and women
Time-resolved momentum microscopy with fs-XUV photons at high repetition rates with flexible energy and time resolution
Abstract Time-resolved momentum microscopy is an emerging technique based on photoelectron spectroscopy for characterizing ultrafast electron dynamics and the out-of-equilibrium electronic structure of materials in the entire Brillouin zone with high efficiency. In this article, we introduce a setup for time-resolved momentum microscopy based on an energy-filtered momentum microscope coupled to a custom-made high-harmonic generation photon source driven by a multi-100 kHz commercial Yb-ultrafast laser that delivers fs pulses in the extreme ultraviolet range. The laser setup includes a nonlinear pulse compression stage employing spectral broadening in a Herriott-type bulk-based multi-pass cell. This element allows flexible tuning of the driving pulse duration, providing a versatile time-resolved momentum microscopy setup featuring two operational modes designed to enhance either the energy or time resolution. We show the capabilities of the system by tracing ultrafast electron dynamics in the conduction band valleys of a bulk crystal of the 2D semiconductor WS 2 . Using uncompressed driving laser pulses, we demonstrate an energy resolution better than (107 ± 2) meV, while compressed pulses lead to a time resolution better than (48.8 ± 17) fs.
Temperature Induced Unfolding and Compaction of Cytochrome <i>c</i> in the Same Aqueous Solutions
Evaluation of the Digital Ventilated Cage® system for circadian phenotyping
Abstract The study of circadian rhythms has been critically dependent upon analysing mouse home cage activity, typically employing wheel running activity under different lighting conditions. Here we assess a novel method, the Digital Ventilated Cage (DVC®, Tecniplast SpA, Italy), for circadian phenotyping. Based upon capacitive sensors mounted under black individually ventilated cages with inbuilt LED lighting, each cage becomes an independent light-controlled chamber. Home cage activity in C57BL/6J mice was recorded under a range of lighting conditions, along with circadian clock-deficient cryptochrome-deficient mice (Cry1 −/− , Cry2 −/− double knockout). C57BL/6J mice exhibited a 24 h period under light/dark conditions, with a free-running period of 23.5 h under constant dark, and period lengthening under constant light. Animals displayed expected phase shifting responses to jet-lag and nocturnal light pulses. Sex differences in circadian parameters and phase shifting responses were also observed. Cryptochrome-deficient mice showed subtle changes in activity under light/dark conditions and were arrhythmic under constant dark, as expected. Our results show the suitability of the DVC system for circadian behavioural screens, accurately detecting circadian period, circadian disruption, phase shifts and mice with clock defects. We provide an evaluation of the strengths and limitations of this method, highlighting how the use of the DVC for studying circadian rhythms depends upon the research requirements of the end user.