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1.
Dev Psychopathol ; : 1-11, 2024 Sep 19.
Artículo en Inglés | MEDLINE | ID: mdl-39297239

RESUMEN

Childhood adversities have been linked to psychosocial outcomes, but it remains uncertain whether subtypes of adversity exert different effects on outcomes. Research is also needed to explore the dynamic interplay between adversity and psychosocial outcomes from childhood to mid-adolescence. This study aimed to investigate these relationships and their role in shaping adolescent wellbeing. Data were extracted from three timepoints of the UK Household Longitudinal Survey when participants (n = 646) were aged 10-15. Cross-lagged panel models were used to explore the relationship between cumulative adversities, and separately non-household (i.e., bullying victimization and adverse neighborhood) and household (i.e., sibling victimization, quarrelsome relationship with parents, financial struggles, and maternal psychological distress) adversities, and psychosocial outcomes (i.e., internalizing and externalizing problems, delinquency, and life satisfaction). Our results revealed that heightened cumulative adversity predicted psychosocial outcomes from childhood to mid-adolescence. Increased levels of household adversity predicted psychosocial outcomes throughout early to mid-adolescence, while non-household adversity only predicted psychosocial outcomes in early adolescence. Furthermore, worse psychosocial outcomes predicted higher levels of adversities during adolescence, highlighting bidirectionality between adversity and psychosocial outcomes. These findings underscore the varying impacts of adversity subtypes and the mutually reinforcing effects of adversities and psychosocial functioning from childhood to mid-adolescence.

2.
J Sports Sci Med ; 23(1): 537-547, 2024 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-39228778

RESUMEN

Sports injuries pose significant challenges in athlete welfare and team dynamics, particularly in high-intensity sports like soccer. This study used machine learning algorithms to assess non-contact injury risk in professional male soccer players from physiological and mechanical load variables. Twenty-five professional male soccer players with a first-time, non-contact muscle injury were included in this study. Recordings of external load (speed, distance, and acceleration/deceleration data) and internal load (heart rate) were obtained during all training sessions and official matches over a 4-year period. Machine learning model training and evaluation features were calculated for each of nine different metrics for a 28-day period prior to the injury and an equal-length baseline epoch. The acute surge in the values of each workload metric was quantified by the deviation of maximum values from the average, while the variations of cumulative workload over the last four weeks preceding injury were also calculated. Seven features were selected by the model as prominent estimators of injury incidence. Three of the features concerned acute load deviations (number of sprints, training load score-incorporating heart rate and muscle load- and time of heart rate at the 90-100% of maximum). The four cumulative load features were (total distance, high speed and sprint running distance and training load score). The accuracy of the muscle injury risk assessment model was 0.78, with a sensitivity of 0.73 and specificity of 0.85. Our model achieved high performance in injury risk detection using a limited number of training load variables. The inclusion, for the first time, of heart rate related variables in an injury risk assessment model highlights the importance of physiological overload as a contributor to muscle injuries in soccer. By identifying the important parameters, coaches may prevent muscle injuries by controlling surges of training load during training and competition.


Asunto(s)
Traumatismos en Atletas , Frecuencia Cardíaca , Aprendizaje Automático , Carrera , Fútbol , Humanos , Fútbol/lesiones , Fútbol/fisiología , Masculino , Traumatismos en Atletas/prevención & control , Medición de Riesgo , Carrera/lesiones , Carrera/fisiología , Adulto Joven , Acondicionamiento Físico Humano/efectos adversos , Acondicionamiento Físico Humano/métodos , Aceleración , Adulto , Músculo Esquelético/lesiones , Músculo Esquelético/fisiología
3.
World Neurosurg ; 2024 Sep 11.
Artículo en Inglés | MEDLINE | ID: mdl-39270789

RESUMEN

OBJECTIVE: Cauda Equina Syndrome (CES) is diagnosed both clinically and radiologically. However, it's unclear if a specific degree of cauda equina compression (CEC) on imaging can confirm the diagnosis. This study aimed to identify an optimal percentage of prolapse to canal ratio (PCR) on MRI that correlates with CEC, facilitating reliable decision-making for CES symptoms. METHODS: A single-center retrospective case series analysis was conducted from 2020 to 2021. Sixty-one patients who underwent emergency lumbar discectomy within 48 hours of presentation were included, divided into a CES group and a disc prolapse (DP) group. CES cases were identified using ICD-10 code G83.4. PCR was calculated by dividing the width of the disc herniation by the total width of the spinal canal at the level of the herniation on single mid-sagittal T2 MRI scans, using the IC Measure software on Windows. RESULTS: CES most frequently occurred at the L4/5 level (37/61). The median PCR in CES cases was 76.19% (66.67 - 85.71), significantly higher than in DP cases, 48.08% (31.33 - 55.56) (p<0.001). A PCR threshold of 40% maximized sensitivity at 100% but had a specificity of 45%. Conversely, a threshold of 75% maximized specificity at 100% with a sensitivity of 50%. The optimal PCR, determined by the Youden index, was 66%, yielding a sensitivity of 75% and specificity of 97%, with an area under the curve (AUC) of 0.923. CONCLUSIONS: Simple radiological measurements of PCR can potentially triage CES patients and guide their management. Future studies should correlate PCR with clinical signs and symptoms for a comprehensive assessment.

4.
Math Biosci ; 376: 109274, 2024 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-39218212

RESUMEN

Vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) results in transient antibody response against the spike protein. The individual immune status at the time of vaccination influences the response. Using mathematical models of antibody decay, we determined the dynamics of serum immunoglobulin G (IgG) and serum immunoglobulin A (IgA) over time. Data fitting to longitudinal IgG and IgA titers was used to quantify differences in antibody magnitude and antibody duration among infection-naïve and infection-positive vaccinees. We found that prior infections result in more durable serum IgG and serum IgA responses, with prior symptomatic infections resulting in the most durable serum IgG response and prior asymptomatic infections resulting in the most durable serum IgA response. These findings can guide vaccine boosting schedules.


Asunto(s)
Anticuerpos Antivirales , Vacunas contra la COVID-19 , COVID-19 , Inmunoglobulina A , Inmunoglobulina G , SARS-CoV-2 , Humanos , Anticuerpos Antivirales/sangre , Anticuerpos Antivirales/inmunología , COVID-19/inmunología , COVID-19/prevención & control , SARS-CoV-2/inmunología , Inmunoglobulina A/sangre , Inmunoglobulina A/inmunología , Inmunoglobulina G/sangre , Inmunoglobulina G/inmunología , Vacunas contra la COVID-19/inmunología , Vacunas contra la COVID-19/administración & dosificación , Vacunación , Glicoproteína de la Espiga del Coronavirus/inmunología , Modelos Inmunológicos
5.
Surg Neurol Int ; 15: 246, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39108366

RESUMEN

Background: In recent times, clinical negligence claims against National Health Service hospitals have doubled, with 8% of claims being made due to "failure to warn/informed consent." This study aimed to assess the current compliance of the neurosurgical division within a large tertiary neuroscience center with the national legal framework and professional guidelines around the issue of surgical consent and to develop strategies to improve the consent process. Methods: Electronic patient records (EPR) were accessed to collect demographic data and information regarding the surgical procedures. Telephone questionnaires were carried out. Neurosurgical registrars were interviewed. The author met with the trust's Legal team, the neuropsychology lead, and the trust's consent lead. Results: Fifty-eight patients were included in the analysis. Of the respondents to the questionnaire, 98% felt that they were adequately informed during the consent process. When consenting patients, all registrars felt that they explained the reason for the procedure, detailed benefits, and major risks, including uncommon and rare risks. However, 50% admitted to not specifically discussing the postoperative recovery time or alternatives. Only 15% admitted to documenting on the EPR or through a letter to the patient's General Practitioner. Conclusion: Informed consent is a delicate moment of communication between a clinician and the patient. Regular training and good communication skills help staff to focus on the most relevant aspects of consent, which should be delivered in an appropriate environment and with family support. Audio-visual aids can support the process but do not replace good communication.

6.
IEEE Open J Eng Med Biol ; 5: 700-706, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39184964

RESUMEN

Continuous and unobtrusive monitoring of daily human activities in homes can potentially improve the quality of life and prolong independent living for the elderly and people with chronic diseases by recognizing normal daily activities and detecting gradual changes in their conditions. However, existing human activity recognition (HAR) solutions employ wearable and video-based sensors, which either require dedicated devices to be carried by the user or raise privacy concerns. Radar sensors enable non-intrusive long-term monitoring, while they can exploit existing communication systems, e.g., Wi-Fi, as illuminators of opportunity. This survey provides an overview of passive radar system architectures, signal processing techniques, feature extraction, and machine learning's role in HAR applications. Moreover, it points out challenges in wireless human activity sensing research like robustness, privacy, and multiple user activity sensing and suggests possible future directions, including the coexistence of sensing and communications and the construction of open datasets.

7.
PLoS One ; 19(8): e0308420, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39110760

RESUMEN

This study aimed to characterise three Ghanaian local chicken ecotypes, namely, Interior Savannah, Forest, and Coastal Savannah, based on morphological data and single nucleotide polymorphism (SNP) genotypes. Morphological data including body weight, shank length, body girth, back length, thigh length, beak length, comb length, and wattle length were collected from 250 local chickens. DNA isolated from blood of 1,440 local chickens was used for SNP genotyping with the Affymetrix chicken 600k SNP chip. Principal component analysis showed that Forest and Coastal Savannah birds were closely related. Generally, all three ecotypes exhibited high genetic diversity, especially birds from the Interior Savannah zone. Morphological characterisation showed that ecotype (p = 0.016) and sex (p = 0.000) had significant effects on body weight. Birds of the Interior Savannah ecotype were the heaviest (p = 0.004), with mean weights of 1.23 kg for females and 1.40 kg for males. Sex also had a strong significant effect on most of the morphological measurements, but the sex * ecotype interaction effect was not significant. Very few of the feather phenotypes previously reported to be associated with heat resistance-frizzle (2%) and naked neck (1.6%)-were found in the studied populations. It is concluded that the three local ecotypes are genetically diverse but with similar morphological features and the information provided would be useful for future selection decisions.


Asunto(s)
Pollos , Ecotipo , Genotipo , Fenotipo , Polimorfismo de Nucleótido Simple , Análisis de Componente Principal , Animales , Pollos/genética , Ghana , Femenino , Masculino , Peso Corporal
8.
Sci Rep ; 14(1): 19127, 2024 Aug 19.
Artículo en Inglés | MEDLINE | ID: mdl-39155327

RESUMEN

Electron self-injection in laser wakefield accelerators (LWFAs) is an important determinator of electron beam parameters. Controllable and adjustable LWFA beams are essential for applications. Controlled injection by capturing sheath electrons can be achieved using plasma density down-ramps or bumps, which perturb the LWFA bubble phase velocity by varying the plasma frequency and by affecting relativistic self-focussing of the laser. We report on a comprehensive study, using particle-in-cell simulations, of the effect of laser pulse evolution on injection on density perturbations. We show how the LWFA can be optimised to make it suitable for use in a wide range of applications, in particular those requiring short duration, low slice-emittance and low energy spread, and high-charge electron bunches.

9.
J Orthop Case Rep ; 14(8): 155-158, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-39157464

RESUMEN

Introduction: The rising use of modular implants in revision total knee arthroplasty offers surgeons greater flexibility in addressing bone defects and achieving uniform gaps compared to monoblock counterparts. However, this enhanced functionality brings specific complications such as loosening and breakage at component coupling sites, leading to challenges due to mechanical failures and suboptimal fixation. Extracting broken components during revision surgery poses a significant challenge, prompting innovative techniques to facilitate extraction. Case Report: We present a rare case of modular femoral component mechanical failure in a 69-year-old male, manifesting as left knee instability and acute pain while walking 4 years following revision of total knee replacement due to infection. Radiographs revealed mechanical failure of the Sigma Total Condylar-III Revision prosthesis bolt, with intra-operative extraction efforts complicated by a lodged broken bolt. Despite initial challenges, successful extraction was achieved using mosquito forceps and a universal nail extractor. Conclusion: This case highlights the importance of documenting rare instances of mechanical failure in modular implants, emphasizing the need to understand prevalence rates and various surgical techniques for implant extraction. Our experience underscores the utility of the universal nail extractor as a valuable tool in managing difficult implant removal during revision surgery. Surgeons must remain vigilant and innovative in addressing challenges encountered during modular implant revisions.

10.
Reprod Toxicol ; 130: 108690, 2024 Aug 22.
Artículo en Inglés | MEDLINE | ID: mdl-39178970

RESUMEN

Aquatic ecosystems face significant exposure to endocrine-disrupting chemicals (EDCs), which can mimic, block, or alter the synthesis of endogenous hormones. Bisphenol A (BPA), a widely known EDC, has been phased out from consumer products due to concerns about its potential impacts on human health. In its place, bisphenol S (BPS), an organic compound, has been increasingly used in the production of polycarbonate plastics, epoxy resins, thermal receipt papers, and currency. Vitellogenin (Vtg), a yolk precursor protein synthesized in the liver and present in oviparous fish, particularly males, serves as a pertinent biomarker for studying the effects of estrogenic EDCs on fish. This study aimed to assess the impact of BPS on reproductive parameters and hepatic vitellogenin expression in Channa striatus. The LC50 of BPS was determined to be 128.8 mg/L. Experimental groups included control and BPS-exposed fish, with sub-lethal concentrations of BPS (1 mg/L, 4 mg/L, and 12 mg/L) administered and effects monitored at seven- and twenty-one-day intervals. Significant decreases in gonadosomatic index (GSI), ova diameter, and fecundity were observed in BPS-exposed Channa striatus. Hepatic Vtg mRNA expression was downregulated in female and upregulated in male following BPS exposure. Serum hormone analysis confirmed the estrogenic activity of BPS. These findings underscore BPS's ability as an endocrine disruptor to interfere with hormone synthesis and disrupt spermatogenesis and oogenesis processes in Channa striatus. This research contributes to understanding the endocrine-disrupting effects of BPS on aquatic organisms, highlighting potential ecological implications and the need for continued monitoring and regulatory considerations.

11.
Am J Gastroenterol ; 2024 Jul 17.
Artículo en Inglés | MEDLINE | ID: mdl-39016385

RESUMEN

INTRODUCTION: The prevalence of metabolic dysfunction-associated fatty liver disease (MAFLD) and its complication, MAFLD-related acute-on-chronic liver failure (MAFLD-ACLF), is rising. Yet, factors determining patient outcomes in MAFLD-ACLF remain understudied. METHODS: Patients with MAFLD-ACLF were recruited from the Asian Pacific Association for the Study of the Liver-ACLF Research Consortium (AARC registry). The diagnosis of MAFLD-ACLF was made when the treating unit had identified the etiology of chronic liver disease as MAFLD (or previous nomenclature such as non-alcoholic fatty liver disease, non-alcoholic steatohepatitis, or non-alcoholic steatohepatitis-cirrhosis). Patients with coexisting other etiologies of chronic liver disease (such as alcohol, hepatitis B virus, hepatitis C virus, etc.) were excluded. Data were randomly split into derivation (n = 258) and validation (n = 111) cohorts at a 70:30 ratio. The primary outcome was 90-day mortality. Only the baseline clinical, laboratory features and severity scores were considered. RESULTS: The derivation group had 258 patients; 60% were male, with a mean age of 53. Diabetes was noted in 27% and hypertension in 29%. The dominant precipitants included viral hepatitis (hepatitis A virus and hepatitis E virus, 32%), drug-induced injury (drug-induced liver injury, 29%), and sepsis (23%). Model for End-Stage Liver Disease-Sodium (MELD-Na) and AARC scores on admission averaged 32 ± 6 and 10.4 ± 1.9. At 90 days, 51% survived. Nonviral precipitant, diabetes, bilirubin, international normalized ratio, and encephalopathy were independent factors influencing mortality. Adding diabetes and precipitant to MELD-Na and AARC scores, the novel MAFLD-MELD-Na score (+12 for diabetes, +12 for nonviral precipitant), and MAFLD-AARC score (+5 for each) were formed. These outperformed the standard scores in both cohorts. DISCUSSION: Almost half of patients with MAFLD-ACLF die within 90 days. Diabetes and nonviral precipitants such as drug-induced liver injury and sepsis lead to adverse outcomes. The new MAFLD-MELD-Na and MAFLD-AARC scores provide reliable 90-day mortality predictions for patients with MAFLD-ACLF.

12.
J Exp Child Psychol ; 246: 106004, 2024 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-39003925

RESUMEN

The purpose of this study was to compare the effects of implicit and explicit morphological analysis instruction in Spanish, a language characterized by high morphological complexity and relatively consistent letter-sound correspondences. For 3 days, 94 Grade 3 Spanish monolingual students (43 girls; Mage = 8.9 years) were trained on target words containing experimenter-designed suffixes consistent in form and meaning (e.g., the suffix -isba refers to a factory in words such as "botisba" [a boot factory] and "cajisba" [a box factory]). Explicit and implicit instruction differed in the attention given to the co-occurrence of the suffixes in the target words. One day (immediate posttest) and 1 week (delayed posttest) after training concluded, participants were tested on their learning of the suffixes' form using a suffix identification task and meaning using a word definition and a multiple-choice task. Results of mixed-effects models showed that explicit instruction yielded better results for the learning of the form of the suffixes. Regarding meaning, across-condition differences were detected only in the word definition task; explicit instruction produced better results for both trained and transfer words. We discuss our findings in the context of the grain-size unit theory and examine the interplay between the language's orthographic and morphological characteristics, considering their impact on classroom instruction.


Asunto(s)
Lenguaje , Humanos , Femenino , Masculino , Niño , España , Aprendizaje
13.
Patterns (N Y) ; 5(7): 100992, 2024 Jul 12.
Artículo en Inglés | MEDLINE | ID: mdl-39081575

RESUMEN

Prostate cancer diagnosis and treatment relies on precise MRI lesion segmentation, a challenge notably for small (<15 mm) and intermediate (15-30 mm) lesions. Our study introduces ProLesA-Net, a multi-channel 3D deep-learning architecture with multi-scale squeeze and excitation and attention gate mechanisms. Tested against six models across two datasets, ProLesA-Net significantly outperformed in key metrics: Dice score increased by 2.2%, and Hausdorff distance and average surface distance improved by 0.5 mm, with recall and precision also undergoing enhancements. Specifically, for lesions under 15 mm, our model showed a notable increase in five key metrics. In summary, ProLesA-Net consistently ranked at the top, demonstrating enhanced performance and stability. This advancement addresses crucial challenges in prostate lesion segmentation, enhancing clinical decision making and expediting treatment processes.

14.
J Infect Dis ; 230(1): e30-e33, 2024 Jul 25.
Artículo en Inglés | MEDLINE | ID: mdl-39052732

RESUMEN

Generation of a stable long-lived plasma cell (LLPC) population is the sine qua non of durable antibody responses after vaccination or infection. We studied 20 individuals with a prior coronavirus disease 2019 infection and characterized the antibody response using bone marrow aspiration and plasma samples. We noted deficient generation of spike-specific LLPCs in the bone marrow after severe acute respiratory syndrome coronavirus 2 infection. Furthermore, while the regression model explained 98% of the observed variance in anti-tetanus immunoglobulin G levels based on LLPC enzyme-linked immunospot assay, we were unable to fit the same model with anti-spike antibodies, again pointing to the lack of LLPC contribution to circulating anti-spike antibodies.


Asunto(s)
Anticuerpos Antivirales , Médula Ósea , COVID-19 , Células Plasmáticas , SARS-CoV-2 , Glicoproteína de la Espiga del Coronavirus , Humanos , COVID-19/inmunología , Células Plasmáticas/inmunología , Glicoproteína de la Espiga del Coronavirus/inmunología , Anticuerpos Antivirales/sangre , SARS-CoV-2/inmunología , Masculino , Persona de Mediana Edad , Femenino , Médula Ósea/virología , Adulto , Inmunoglobulina G/sangre , Anciano
15.
Cell Mol Gastroenterol Hepatol ; 18(4): 101380, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39038606

RESUMEN

BACKGROUND & AIMS: Metabolic dysfunction-associated steatotic liver disease (MASLD) has become the most prevalent chronic liver disorder, with no approved treatment. Our previous work demonstrated the efficacy of a pan-ErbB inhibitor, Canertinib, in reducing steatosis and fibrosis in a murine fast-food diet (FFD) model of MASLD. The current study explores the effects of hepatocyte-specific ErbB1 (ie, epidermal growth factor receptor [EGFR]) deletion in the FFD model. METHODS: EGFRflox/flox mice, treated with AAV8-TBG-CRE to delete EGFR specifically in hepatocytes (EGFR-KO), were fed either a chow-diet or FFD for 2 or 5 months. RESULTS: Hepatocyte-specific EGFR deletion reduced serum triglyceride levels but did not prevent steatosis. Surprisingly, hepatic fibrosis was increased in EGFR-KO mice in the long-term study, which correlated with activation of transforming growth factor-ß/fibrosis signaling pathways. Further, nuclear levels of some of the major MASLD regulating transcription factors (SREBP1, PPARγ, PPARα, and HNF4α) were altered in FFD-fed EGFR-KO mice. Transcriptomic analysis revealed significant alteration of lipid metabolism pathways in EGFR-KO mice with changes in several relevant genes, including downregulation of fatty-acid synthase and induction of lipolysis gene, Pnpla2, without impacting overall steatosis. Interestingly, EGFR downstream signaling mediators, including AKT, remain activated in EGFR-KO mice, which correlated with increased activity pattern of other receptor tyrosine kinases, including ErbB3/MET, in transcriptomic analysis. Lastly, Canertinib treatment in EGFR-KO mice, which inhibits all ErbB receptors, successfully reduced steatosis, suggesting the compensatory roles of other ErbB receptors in supporting MASLD without EGFR. CONCLUSIONS: Hepatocyte-specific EGFR-KO did not impact steatosis, but enhanced fibrosis in the FFD model of MASLD. Gene networks associated with lipid metabolism were greatly altered in EGFR-KO, but phenotypic effects might be compensated by alternate signaling pathways.


Asunto(s)
Modelos Animales de Enfermedad , Receptores ErbB , Hepatocitos , Cirrosis Hepática , Animales , Receptores ErbB/metabolismo , Receptores ErbB/genética , Ratones , Hepatocitos/metabolismo , Hepatocitos/patología , Cirrosis Hepática/patología , Cirrosis Hepática/metabolismo , Cirrosis Hepática/genética , Cirrosis Hepática/etiología , Ratones Noqueados , Hígado Graso/patología , Hígado Graso/metabolismo , Hígado Graso/genética , Masculino , Transducción de Señal , Eliminación de Gen
16.
Diabetes Care ; 47(9): 1608-1616, 2024 Sep 01.
Artículo en Inglés | MEDLINE | ID: mdl-38949847

RESUMEN

OBJECTIVE: To explore if oral insulin could delay onset of stage 3 type 1 diabetes (T1D) among patients with stage 1/2 who carry HLA DR4-DQ8 and/or have elevated levels of IA-2 autoantibodies (IA-2As). RESEARCH AND METHODS: Next-generation targeted sequencing technology was used to genotype eight HLA class II genes (DQA1, DQB1, DRB1, DRB3, DRB4, DRB5, DPA1, and DPB1) in 546 participants in the TrialNet oral insulin preventative trial (TN07). Baseline levels of autoantibodies against insulin (IAA), GAD65 (GADA), and IA-2A were determined prior to treatment assignment. Available clinical and demographic covariables from TN07 were used in this post hoc analysis with the Cox regression model to quantify the preventive efficacy of oral insulin. RESULTS: Oral insulin reduced the frequency of T1D onset among participants with elevated IA-2A levels (HR 0.62; P = 0.012) but had no preventive effect among those with low IA-2A levels (HR 1.03; P = 0.91). High IA-2A levels were positively associated with the HLA DR4-DQ8 haplotype (OR 1.63; P = 6.37 × 10-6) and negatively associated with the HLA DR7-containing DRB1*07:01-DRB4*01:01-DQA1*02:01-DQB1*02:02 extended haplotype (OR 0.49; P = 0.037). Among DR4-DQ8 carriers, oral insulin delayed the progression toward stage 3 T1D onset (HR 0.59; P = 0.027), especially if participants also had high IA-2A level (HR 0.50; P = 0.028). CONCLUSIONS: These results suggest the presence of a T1D endotype characterized by HLA DR4-DQ8 and/or elevated IA-2A levels; for those patients with stage 1/2 disease with such an endotype, oral insulin delays the clinical T1D onset.


Asunto(s)
Diabetes Mellitus Tipo 1 , Antígenos HLA-DQ , Antígeno HLA-DR4 , Insulina , Humanos , Diabetes Mellitus Tipo 1/tratamiento farmacológico , Diabetes Mellitus Tipo 1/inmunología , Femenino , Antígenos HLA-DQ/genética , Insulina/uso terapéutico , Insulina/administración & dosificación , Masculino , Administración Oral , Antígeno HLA-DR4/genética , Niño , Autoanticuerpos/sangre , Adolescente , Adulto
17.
Sensors (Basel) ; 24(12)2024 Jun 16.
Artículo en Inglés | MEDLINE | ID: mdl-38931678

RESUMEN

Mental fatigue during driving poses significant risks to road safety, necessitating accurate assessment methods to mitigate potential hazards. This study explores the impact of individual variability in brain networks on driving fatigue assessment, hypothesizing that subject-specific connectivity patterns play a pivotal role in understanding fatigue dynamics. By conducting a linear regression analysis of subject-specific brain networks in different frequency bands, this research aims to elucidate the relationships between frequency-specific connectivity patterns and driving fatigue. As such, an EEG sustained driving simulation experiment was carried out, estimating individuals' brain networks using the Phase Lag Index (PLI) to capture shared connectivity patterns. The results unveiled notable variability in connectivity patterns across frequency bands, with the alpha band exhibiting heightened sensitivity to driving fatigue. Individualized connectivity analysis underscored the complexity of fatigue assessment and the potential for personalized approaches. These findings emphasize the importance of subject-specific brain networks in comprehending fatigue dynamics, while providing sensor space minimization, advocating for the development of efficient mobile sensor applications for real-time fatigue detection in driving scenarios.


Asunto(s)
Conducción de Automóvil , Encéfalo , Electroencefalografía , Humanos , Encéfalo/fisiología , Masculino , Adulto , Electroencefalografía/métodos , Femenino , Fatiga Mental/fisiopatología , Fatiga/fisiopatología , Adulto Joven , Red Nerviosa/fisiología
18.
Ann Fam Med ; 22(4): 301-308, 2024 Jul 22.
Artículo en Inglés | MEDLINE | ID: mdl-38914438

RESUMEN

PURPOSE: Relationship continuity of care has declined across English primary health care, with cross-sectional and longitudinal variations between general practices predicted by population and service factors. We aimed to describe cross-sectional and longitudinal variations across the COVID-19 pandemic and determine whether practice factors predicted the variations. METHODS: We conducted a longitudinal, ecological study of English general practices during 2018-2022 with continuity data, excluding practices with fewer than 750 patients or National Health Service (NHS) payments exceeding £500 per patient. Variables were derived from published data. The continuity measure was the product of weighted responses to 2 General Practice Patient Survey questions. In a multilevel mixed-effects model, the fixed effects were 11 variables' interactions with time: baseline continuity, NHS region, deprivation, location, percentage White ethnicity, list size, general practitioner and nurse numbers, contract type, NHS payments per patient, and percentage of patients seen on the same day as booking. The random effects were practices. RESULTS: Main analyses were based on 6,010 practices (out of 7,190 active practices). During 2018-2022, mean continuity in these practices declined (from 29.3% to 19.0%) and the coefficient of variation across practices increased (from 48.1% to 63.6%). Both slopes were steepest between 2021 and 2022. Practices having more general practitioners and higher percentages of patients seen the same day had slower declines. Practices having higher baseline continuity, located in certain non-London regions, and having higher percentages of White patients had faster declines. The remaining variables were not predictors. CONCLUSIONS: Variables potentially associated with greater appointment availability predicted slower declines in continuity, with worsening declines and relative variability immediately after the COVID-19 lockdown, possibly reflecting surges in demand. To achieve better levels of continuity for those seeking it, practices can increase appointment availability within appointment systems that prioritize continuity.Annals Early Access article.


Asunto(s)
COVID-19 , Continuidad de la Atención al Paciente , Medicina General , SARS-CoV-2 , Medicina Estatal , Humanos , COVID-19/epidemiología , Continuidad de la Atención al Paciente/estadística & datos numéricos , Estudios Longitudinales , Medicina General/estadística & datos numéricos , Estudios Transversales , Inglaterra/epidemiología , Pandemias , Masculino , Femenino , Médicos Generales/estadística & datos numéricos , Persona de Mediana Edad
19.
J Psycholinguist Res ; 53(4): 53, 2024 Jun 06.
Artículo en Inglés | MEDLINE | ID: mdl-38844626

RESUMEN

Researchers tend to use oral- and silent-reading fluency measures interchangeably and to generalize research findings across reading modes, especially from oral to silent reading. In this study, we sought to examine if oral and silent word-reading fluency rely on the same cognitive-linguistic skills. Three hundred and forty-five Greek children (80 from Grade 2, 85 from Grade 4, 91 from Grade 6, and 89 from Grade 10) were assessed on measures of general cognitive ability, speed of processing, phonological awareness, rapid automatized naming, orthographic knowledge, articulation rate, and word-reading fluency (oral and silent). Results of hierarchical regression analyses revealed that phonological awareness was a unique predictor of both reading outcomes in Grade 2 and orthographic knowledge was a unique predictor of both reading outcomes in Grades 4, 6, and 10. However, rapid automatized naming predicted only oral word-reading fluency. These findings suggest that silent and oral word-reading fluency do not necessarily rely on the same cognitive-linguistic skills at the same grade level and we need to exercise some caution when we generalize the findings across reading modes.


Asunto(s)
Lectura , Humanos , Masculino , Niño , Grecia , Femenino , Estudios Transversales , Cognición/fisiología , Fonética , Lenguaje , Lingüística
20.
Cureus ; 16(5): e59637, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38832166

RESUMEN

INTRODUCTION: Anatomical preservation and functional integrity of the facial nerve (FN) are the main concerns of parotid surgery. Even though a variety of anatomical landmarks have been proposed and widely utilized, temporal or permanent postoperative FN palsy is still a significant comorbidity of parotid surgery. Therefore, the literature must fully elucidate the consistency of the anatomical relationship between the FN and the retromandibular vein (RMV). METHODS: We conducted a cadaveric study of 24 hemifaces to map the relationship between the FN and the RMV. Three distinct patterns were identified. Fourteen of the hemifaces were males, and 10 were females. Thirteen cadaveric dissections were performed on the right side and 11 on the left side. RESULTS: Our study found three distinct patterns and proposed a classification system. Type I (66.7%) is when the nerve lies exclusively lateral to the RMV. Type II (29.2%) is when the FN lies superficial to the RMV, but its mandibular branch lies deep to the anterior branch of the RMV, and type III (4.1%) is when the FN lies exclusively medial to the RMV. CONCLUSION: The FN and RMV relationship is not constant, and surgeons should be aware of every anatomical variation. Especially in cases where the FN is estimated to lie more in-depth to the level of the RMV, a retrograde approach may be required to avoid a FN injury.

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