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1.
PLoS One ; 19(9): e0309946, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39241030

RESUMEN

Comparative studies reliant on single personality surveys to rate wild primates are scarce yet remain critical for developing a holistic comparative understanding of personality. Differences in survey design, item exclusion, and factor selection impede cross-study comparisons. To address these challenges, we used consistently collected data to assess personality trait structures in wild rhesus (Macaca mulatta), bonnet (M. radiata), and long-tailed (M. fascicularis) macaques that varied in their degree of phylogenetic closeness, species-typical social styles, and anthropogenic exposure in urban or urban-rural environments. We administered 51-item personality surveys to familiar raters, and, after reliability and structure screenings, isolated 4-5 factor solutions among the species. Four consistent factors emerged: Confident, Sociable, Active, and Irritable/Equable. This latter factor had differential expression across species. Item composition of the Irritable/Equable factor was consistent with their anticipated differences in social styles, but confounded by cross-site anthropogenic variation. We also administered a 43-item survey confined to human-primate situations which paralleled our findings of social style variation, while also exhibiting variation that aligned with population differences in human density. Our findings indicate that macaque personality trait structures may be emergent outcomes of evolutionary and/or socioecological processes, but further research is needed to parse these processes' relative contributions.


Asunto(s)
Personalidad , Animales , Personalidad/fisiología , Humanos , Masculino , Femenino , Especificidad de la Especie , Macaca/fisiología , Conducta Animal/fisiología , Conducta Social , Macaca mulatta
2.
Psychol Methods ; 2024 Sep 12.
Artículo en Inglés | MEDLINE | ID: mdl-39264644

RESUMEN

Social and behavioral scientists are increasingly interested the dynamics of the processes they study. Despite the wide array of processes studied, a fairly narrow set of models are applied to characterize dynamics within these processes. For social and behavioral research to take the next step in modeling dynamics, a wider variety of models need to be considered. The reservoir model is one model of psychological regulation that helps expand the models available (Deboeck & Bergeman, 2013). The present article implements the Bayesian reservoir model for both single time series and multilevel data. Simulation 1 compares the performance of the original version of the reservoir model fit using structural equation modeling (Deboeck & Bergeman, 2013) to the proposed Bayesian estimation approach. Simulation 2 expands this to a multilevel data scenario and compares this to the single-level version. The Bayesian estimation approach performs substantially better than the original estimation approach and produces low-bias estimates even with time series as short as 25 observations. Combining Bayesian estimation with a multilevel modeling approach allows for relatively unbiased estimation with sample sizes as small as 15 individuals and/or with time series as short as 15 observations. Finally, a substantive example is presented that applies the Bayesian reservoir model to perceived stress, examining how the model parameters relate to psychological variables commonly expected to relate to resilience. The current expansion of the reservoir model demonstrates the benefits of leveraging the combined strengths of Bayesian estimation and multilevel modeling, with new dynamic models that have been tailored to match the process of psychological regulation. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

3.
Behav Ecol ; 35(5): arae066, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39193469

RESUMEN

In animal social groups, the extent to which individuals consistently win agonistic interactions and their ability to monopolize resources represent 2 core aspects of their competitive regime. However, whether these two aspects are closely correlated within groups has rarely been studied. Here, we tested the hypothesis that hierarchy steepness, which is generally used to represent power differentials between group members, predicts the variation in the distribution of fitness-related benefits (i.e. fecundity, infant survival, mating success, and feeding success) in relation to individual dominance ranks. We tested this hypothesis in primate groups using comparative phylogenetic meta-analytical techniques. Specifically, we reviewed published and unpublished studies to extract data on individual dominance ranks, their access to fitness-related benefits, and hierarchy steepness. We collected and included in our analysis a total of 153 data points, representing 27 species (including 2 chimpanzee sub-species). From these, we used 4 common methods to measure individual dominance ranks and hierarchy steepness, i.e. D ij -based normalized David's scores, randomized Elo-ratings, and David's scores and Elo-ratings estimated in Bayesian frameworks. We found that hierarchy steepness had no effect on the strength of the relationship between dominance rank and access to fitness-related benefits. Our results suggest that hierarchy steepness does not reflect between-group variation in the extent to which individual dominance affects the acquisition of fitness-related benefits in primates. Although the ability to win agonistic encounters is essential, we speculate that other behavioral strategies adopted by individuals may play crucial roles in resource acquisition in animal competitive regimes.

4.
J ECT ; 2024 Aug 22.
Artículo en Inglés | MEDLINE | ID: mdl-39105589

RESUMEN

ABSTRACT: Postictal agitation (PIA) is an adverse effect of electroconvulsive therapy (ECT) and is known to predict other side effects of ECT, but inconsistencies in the literature remain regarding PIA prognostic factors and incidence. Therefore, a systematic review and meta-analysis were conducted (1) to identify prognostic factors for PIA following ECT and (2) to elucidate the diverse incidences of PIA following ECT based on demographic and clinical characteristics. Specifically, electronic databases were searched for retrospective observational studies and randomized controlled trials (RCTs) that objectively reported PIA incidence. Additional inclusion criteria encompassed studies involving patients 18 years or older and allowed for the extraction of PIA prognostic factors. This resulted in the inclusion of 21 articles with 66,047 patients in total. A total of 35 prognostic factors were identified for PIA after ECT, consisting of 8 anesthesia-related, 19 patient-related, and 8 ECT-related prognostic factors. A meta-analysis was conducted for 7 prognostic factors. None of the prognostic factors demonstrated a significant effect on reducing or increasing PIA incidence. Mean PIA was 13.9% (18.0% adjusted) at the patient level and 12.4% (16.5% adjusted) at the session level. Overall risk of bias was generally moderate to low, except in the outcome measurement domain, where 43% of the studies had a high risk of bias. Although none of the prognostic factors in meta-analysis were significant, several other prognostic factors consistently indicated increased or decreased risk, providing direction for future research. A scarcity of (high-quality) data emphasizes the need for additional research on this topic to be conducted.

5.
R Soc Open Sci ; 11(5): 240126, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-39076824

RESUMEN

Mathematical models describing the spatial spreading and invasion of populations of biological cells are often developed in a continuum modelling framework using reaction-diffusion equations. While continuum models based on linear diffusion are routinely employed and known to capture key experimental observations, linear diffusion fails to predict well-defined sharp fronts that are often observed experimentally. This observation has motivated the use of nonlinear degenerate diffusion; however, these nonlinear models and the associated parameters lack a clear biological motivation and interpretation. Here, we take a different approach by developing a stochastic discrete lattice-based model incorporating biologically inspired mechanisms and then deriving the reaction-diffusion continuum limit. Inspired by experimental observations, agents in the simulation deposit extracellular material, which we call a substrate, locally onto the lattice, and the motility of agents is taken to be proportional to the substrate density. Discrete simulations that mimic a two-dimensional circular barrier assay illustrate how the discrete model supports both smooth and sharp-fronted density profiles depending on the rate of substrate deposition. Coarse-graining the discrete model leads to a novel partial differential equation (PDE) model whose solution accurately approximates averaged data from the discrete model. The new discrete model and PDE approximation provide a simple, biologically motivated framework for modelling the spreading, growth and invasion of cell populations with well-defined sharp fronts. Open-source Julia code to replicate all results in this work is available on GitHub.

6.
Eur J Heart Fail ; 26(8): 1736-1744, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-38825743

RESUMEN

AIMS: Heart failure (HF), a global pandemic affecting millions of individuals, calls for adequate predictive guidance for improved therapy. Congestion, a key factor in HF-related hospitalizations, further underscores the need for timely interventions. Proactive monitoring of intracardiac pressures, guided by pulmonary artery (PA) pressure, offers opportunities for efficient early-stage intervention, since haemodynamic congestion precedes clinical symptoms. METHODS: The BioMEMS study, a substudy of the MONITOR-HF trial, proposes a multifaceted approach integrating blood biobank data with traditional and novel HF parameters. Two additional blood samples from 340 active participants in the MONITOR-HF trial were collected at baseline, 3-, 6-, and 12-month visits and stored for the BioMEMS biobank. The main aims are to identify the relationship between temporal biomarker patterns and PA pressures derived from the CardioMEMS-HF system, and to identify the biomarker profile(s) associated with the risk of HF events and cardiovascular death. CONCLUSION: Since the prognostic value of single baseline measurements of biomarkers like N-terminal pro-B-type natriuretic peptide is limited, with the BioMEMS study we advocate a dynamic, serial approach to better capture HF progression. We will substantiate this by relating repeated biomarker measurements to PA pressures. This design rationale presents a comprehensive review on cardiac biomarkers in HF, and aims to contribute valuable insights into personalized HF therapy and patient risk assessment, advancing our ability to address the evolving nature of HF effectively.


Asunto(s)
Biomarcadores , Insuficiencia Cardíaca , Arteria Pulmonar , Humanos , Insuficiencia Cardíaca/fisiopatología , Insuficiencia Cardíaca/sangre , Biomarcadores/sangre , Pronóstico , Arteria Pulmonar/fisiopatología , Femenino , Masculino , Péptido Natriurético Encefálico/sangre , Fragmentos de Péptidos/sangre , Anciano , Presión Esfenoidal Pulmonar/fisiología , Enfermedad Crónica , Persona de Mediana Edad
7.
Eur Heart J ; 45(32): 2954-2964, 2024 Aug 21.
Artículo en Inglés | MEDLINE | ID: mdl-38733175

RESUMEN

BACKGROUND AND AIMS: In patients with chronic heart failure (HF), the MONITOR-HF trial demonstrated the efficacy of pulmonary artery (PA)-guided HF therapy over standard of care in improving quality of life and reducing HF hospitalizations and mean PA pressure. This study aimed to evaluate the consistency of these benefits in relation to clinically relevant subgroups. METHODS: The effect of PA-guided HF therapy was evaluated in the MONITOR-HF trial among predefined subgroups based on age, sex, atrial fibrillation, diabetes mellitus, left ventricular ejection fraction, HF aetiology, cardiac resynchronization therapy, and implantable cardioverter defibrillator. Outcome measures were based upon significance in the main trial and included quality of life-, clinical-, and PA pressure endpoints, and were assessed for each subgroup. Differential effects in relation to the subgroups were assessed with interaction terms. Both unadjusted and multiple testing adjusted interaction terms were presented. RESULTS: The effects of PA monitoring on quality of life, clinical events, and PA pressure were consistent in the predefined subgroups, without any clinically relevant heterogeneity within or across all endpoint categories (all adjusted interaction P-values were non-significant). In the unadjusted analysis of the primary endpoint quality-of-life change, weak trends towards a less pronounced effect in older patients (Pinteraction = .03; adjusted Pinteraction = .33) and diabetics (Pinteraction = .01; adjusted Pinteraction = .06) were observed. However, these interaction effects did not persist after adjusting for multiple testing. CONCLUSIONS: This subgroup analysis confirmed the consistent benefits of PA-guided HF therapy observed in the MONITOR-HF trial across clinically relevant subgroups, highlighting its efficacy in improving quality of life, clinical, and PA pressure endpoints in chronic HF patients.


Asunto(s)
Insuficiencia Cardíaca , Arteria Pulmonar , Calidad de Vida , Humanos , Insuficiencia Cardíaca/terapia , Insuficiencia Cardíaca/fisiopatología , Femenino , Masculino , Anciano , Persona de Mediana Edad , Arteria Pulmonar/fisiopatología , Enfermedad Crónica , Volumen Sistólico/fisiología , Terapia de Resincronización Cardíaca/métodos , Desfibriladores Implantables
8.
Eur J Heart Fail ; 26(7): 1549-1560, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38734980

RESUMEN

AIMS: Despite clear guideline recommendations for initiating four drug classes in all patients with heart failure (HF) with reduced ejection fraction (HFrEF) and the availability of rapid titration schemes, information on real-world implementation lags behind. Closely following the 2021 ESC HF guidelines and 2023 focused update, the TITRATE-HF study started to prospectively investigate the use, sequencing, and titration of guideline-directed medical therapy (GDMT) in HF patients, including the identification of implementation barriers. METHODS AND RESULTS: TITRATE-HF is an ongoing long-term HF registry conducted in the Netherlands. Overall, 4288 patients from 48 hospitals were included. Among these patients, 1732 presented with de novo, 2240 with chronic, and 316 with worsening HF. The median age was 71 years (interquartile range [IQR] 63-78), 29% were female, and median ejection fraction was 35% (IQR 25-40). In total, 44% of chronic and worsening HFrEF patients were prescribed quadruple therapy. However, only 1% of HFrEF patients achieved target dose for all drug classes. In addition, quadruple therapy was more often prescribed to patients treated in a dedicated HF outpatient clinic as compared to a general cardiology outpatient clinic. In each GDMT drug class, 19% to 36% of non-use in HFrEF patients was related to side-effects, intolerances, or contraindications. In the de novo HF cohort, 49% of patients already used one or more GDMT drug classes for other indications than HF. CONCLUSION: This first analysis of the TITRATE-HF study reports relatively high use of GDMT in a contemporary HF cohort, while still showing room for improvement regarding quadruple therapy. Importantly, the use and dose of GDMT were suboptimal, with the reasons often remaining unclear. This underscores the urgency for further optimization of GDMT and implementation strategies within HF management.


Asunto(s)
Progresión de la Enfermedad , Insuficiencia Cardíaca , Sistema de Registros , Volumen Sistólico , Humanos , Insuficiencia Cardíaca/tratamiento farmacológico , Insuficiencia Cardíaca/fisiopatología , Femenino , Masculino , Anciano , Volumen Sistólico/fisiología , Persona de Mediana Edad , Países Bajos , Guías de Práctica Clínica como Asunto , Estudios Prospectivos , Enfermedad Crónica , Antagonistas Adrenérgicos beta/uso terapéutico , Inhibidores de la Enzima Convertidora de Angiotensina/uso terapéutico , Fármacos Cardiovasculares/uso terapéutico , Quimioterapia Combinada
9.
Eur J Heart Fail ; 26(5): 1189-1198, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38560762

RESUMEN

AIMS: Remote haemodynamic monitoring with an implantable pulmonary artery (PA) sensor has been shown to reduce heart failure (HF) hospitalizations and improve quality of life. Cost-effectiveness analyses studying the value of remote haemodynamic monitoring in a European healthcare system with a contemporary standard care group are lacking. METHODS AND RESULTS: A Markov model was developed to estimate the cost-effectiveness of PA-guided therapy compared to the standard of care based upon patient-level data of the MONITOR-HF trial performed in the Netherlands in patients with chronic HF (New York Heart Association class III and at least one previous HF hospitalization). Cost-effectiveness was measured as the incremental cost per quality-adjusted life year (QALY) gained from the Dutch societal perspective with a lifetime horizon which encompasses a wide variety of costs including costs of hospitalizations, monitoring time, telephone contacts, laboratory assessments, and drug changes in both treatment groups. In the base-case analysis, PA-guided therapy increased costs compared to standard of care by €12 121. The QALYs per patient for PA-guided therapy and standard of care was 4.07 and 3.481, respectively, reflecting a gain of 0.58 QALYs. The resulting incremental cost-effectiveness ratio was €20 753 per QALY, which is below the Dutch willingness-to-pay threshold of €50 000 per QALY gained for HF. CONCLUSIONS: The current cost-effectiveness study suggests that remote haemodynamic monitoring with PA-guided therapy on top of standard care is likely to be cost-effective for patients with symptomatic moderate-to-severe HF in the Netherlands.


Asunto(s)
Análisis Costo-Beneficio , Insuficiencia Cardíaca , Monitorización Hemodinámica , Arteria Pulmonar , Años de Vida Ajustados por Calidad de Vida , Humanos , Insuficiencia Cardíaca/fisiopatología , Insuficiencia Cardíaca/terapia , Países Bajos , Monitorización Hemodinámica/métodos , Masculino , Femenino , Arteria Pulmonar/fisiopatología , Anciano , Cadenas de Markov , Calidad de Vida , Persona de Mediana Edad , Enfermedad Crónica
11.
Cartilage ; : 19476035241229026, 2024 Feb 16.
Artículo en Inglés | MEDLINE | ID: mdl-38366391

RESUMEN

OBJECTIVE: Uniformity of reporting is a requisite to be able to compare results of clinical studies on the treatment of osteochondral lesions of the talus (OLT). The primary aim of this study was to evaluate the frequency and quality of reporting of size, morphology, and location of OLTs. DESIGN: A literature search was performed from 1996 to 2023 to identify clinical studies on surgical treatment of OLTs. Screening was performed by 2 reviewers, who subsequently graded the quality using the methodological index for non-randomized studies (MINORS). The primary outcome was the frequency and qualitative assessment of reporting of size, morphology, and location. RESULTS: Of 3,074 articles, 262 articles were included. This comprised a total of 11,785 patients. Size was reported in 248 (95%) of the articles and was described with a measure for surface area in 83%, however, in 56%, definition of measurement is unknown. Intraclass coefficient (ICC) value for the reliability of size measurement was 0.94 for computed tomography (CT) scan and 0.87 for MRI scan. Morphology was reported in 172 (66%) of the articles and using a classification system in 23% of the studies. Location was reported in 220 (84%) of the studies. CONCLUSION: No consensus was found on the reporting of morphology, with non-validated classification systems and different terminologies used. For location, reporting in 9 zones is underreported. Size was well reported and measurements are more reliable for CT compared with MRI. As these prognostic factors guide clinical decision-making, we advocate the development of a standardized and validated OLT classification to reach uniform reporting in literature. LEVEL OF EVIDENCE: Level III, systematic review.

12.
J Pain ; 25(8): 104494, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-38336027

RESUMEN

Pain is an inherently negative perceptual and affective experience that acts as a warning system to protect the body from injury and illness. Pain unfolds over time and is influenced by myriad factors, making it highly dynamic. Despite this, statistical measures often treat any intraindividual variability in pain ratings as noise or error. This is consequential, especially for research on chronic pain, because pain variability is associated with greater pain severity and depression. Yet, differences in pain variability between patients with chronic pain and controls in response to acute pain has not been fully examined-and it is unknown if dispositional factors such as pain catastrophizing (negative cognitive-affective response to potential or actual pain in which attention cannot be diverted away from pain) relate to pain variability. In the current study, we recruited chronic-pain patients (N = 30) and pain-free controls (N = 22) to complete a 30-second thermal pain task where they continually rated a painful thermal stimulus. To quantify pain variability and capture potential dynamics, we used both a traditional intraindividual standard deviation (iSD) metric of variability and a novel derivatives approach. For both metrics, patients with chronic pain had higher variability in their pain ratings over time, and pain catastrophizing significantly mediated this relationship. This suggests patients with chronic pain experience pain stimuli differently over time, and pain catastrophizing may account for this differential experience. PERSPECTIVE: The present study demonstrates (using multiple variability metrics) that chronic pain patients show more variability when rating experimental pain stimuli, and that pain catastrophizing helps explain this differential experience. These results provide preliminary evidence that short-term pain variability could have utility as a clinical marker in pain assessment and treatment.


Asunto(s)
Catastrofización , Dolor Crónico , Dimensión del Dolor , Humanos , Catastrofización/psicología , Dolor Crónico/psicología , Dolor Crónico/fisiopatología , Masculino , Femenino , Adulto , Persona de Mediana Edad , Adulto Joven
13.
Psychophysiology ; 61(6): e14543, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38415824

RESUMEN

Recent studies suggest that the EEG aperiodic exponent (often represented as a slope in log-log space) is sensitive to individual differences in momentary cognitive skills such as selective attention and information processing speed. However, findings are mixed, and most of the studies have focused on just a narrow range of cognitive domains. This study used an archival dataset to help clarify associations between resting aperiodic features and broad domains of cognitive ability, which vary in their demands on momentary processing. Undergraduates (N = 166) of age 18-52 years completed a resting EEG session as well as a standardized, individually administered assessment of cognitive ability that included measures of processing speed, working memory, and higher-order visuospatial and verbal skills. A subsample (n = 110) also completed a computerized reaction time task with three difficulty levels. Data reduction analyses revealed strong correlations between the aperiodic offset and slope across electrodes, and a single component accounted for ~60% of variance in slopes across the scalp, in both eyes-closed and eyes-open conditions. Structural equation models did not support relations between the slope and specific domains tapping momentary processes. However, secondary analyses indicated that the eyes-open slope was related to higher overall performance, as represented by a single general ability factor. A latent reaction time variable was significantly inversely related to both eyes-closed and eyes-open resting exponents, such that faster reaction times were associated with steeper slopes. These findings support and help clarify the relation of the resting EEG exponent to individual differences in cognitive skills.


Asunto(s)
Cognición , Electroencefalografía , Humanos , Adulto Joven , Masculino , Adulto , Adolescente , Femenino , Persona de Mediana Edad , Cognición/fisiología , Atención/fisiología , Tiempo de Reacción/fisiología , Individualidad , Memoria a Corto Plazo/fisiología , Aptitud/fisiología , Desempeño Psicomotor/fisiología
14.
Bone ; 180: 116998, 2024 03.
Artículo en Inglés | MEDLINE | ID: mdl-38184100

RESUMEN

Osteon morphology provides valuable information about the interplay between different processes involved in bone remodelling. The correct quantitative interpretation of these morphological features is challenging due to the complexity of interactions between osteoblast behaviour, and the evolving geometry of cortical pores during pore closing. We present a combined experimental and mathematical modelling study to provide insights into bone formation mechanisms during cortical bone remodelling based on histological cross-sections of quiescent human osteons and hypothesis-testing analyses. We introduce wall thickness asymmetry as a measure of the local asymmetry of bone formation within an osteon and examine the frequency distribution of wall thickness asymmetry in cortical osteons from human iliac crest bone samples from women 16-78 years old. Our measurements show that most osteons possess some degree of asymmetry, and that the average degree of osteon asymmetry in cortical bone evolves with age. We then propose a comprehensive mathematical model of cortical pore filling that includes osteoblast secretory activity, osteoblast elimination, osteoblast embedment as osteocytes, and osteoblast crowding and redistribution along the bone surface. The mathematical model is first calibrated to symmetric osteon data, and then used to test three mechanisms of asymmetric wall formation against osteon data: (i) delays in the onset of infilling around the cement line; (ii) heterogeneous osteoblastogenesis around the bone perimeter; and (iii) heterogeneous osteoblast secretory rate around the bone perimeter. Our results suggest that wall thickness asymmetry due to off-centred Haversian pores within osteons, and that nonuniform lamellar thicknesses within osteons are important morphological features that can indicate the prevalence of specific asymmetry-generating mechanisms. This has significant implications for the study of disruptions of bone formation as it could indicate what biological bone formation processes may become disrupted with age or disease.


Asunto(s)
Osteón , Osteoblastos , Humanos , Femenino , Adolescente , Adulto Joven , Adulto , Persona de Mediana Edad , Anciano , Osteón/anatomía & histología , Huesos , Osteocitos , Hueso Cortical
15.
ESC Heart Fail ; 11(1): 550-559, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-38064176

RESUMEN

AIMS: Current heart failure (HF) guidelines recommend to prescribe four drug classes in patients with HF with reduced ejection fraction (HFrEF). A clear challenge exists to adequately implement guideline-directed medical therapy (GDMT) regarding the sequencing of drugs and timely reaching target dose. It is largely unknown how the paradigm shift from a serial and sequential approach for drug therapy to early parallel application of the four drug classes will be executed in daily clinical practice, as well as the reason clinicians may not adhere to new guidelines. We present the design and rationale for the real-world TITRATE-HF study, which aims to assess sequencing strategies for GDMT initiation, dose titration patterns (order and speed), intolerance for GDMT, barriers for implementation, and long-term outcomes in patients with de novo, chronic, and worsening HF. METHODS AND RESULTS: A total of 4000 patients with HFrEF, HF with mildly reduced ejection fraction, and HF with improved ejection fraction will be enrolled in >40 Dutch centres with a follow-up of at least 3 years. Data collection will include demographics, physical examination and vital parameters, electrocardiogram, laboratory measurements, echocardiogram, medication, and quality of life. Detailed information on titration steps will be collected for the four GDMT drug classes. Information will include date, primary reason for change, and potential intolerances. The primary clinical endpoints are HF-related hospitalizations, HF-related urgent visits with a need for intravenous diuretics, all-cause mortality, and cardiovascular mortality. CONCLUSIONS: TITRATE-HF is a real-world multicentre longitudinal registry that will provide unique information on contemporary GDMT implementation, sequencing strategies (order and speed), and prognosis in de novo, worsening, and chronic HF patients.


Asunto(s)
Insuficiencia Cardíaca , Disfunción Ventricular Izquierda , Humanos , Insuficiencia Cardíaca/tratamiento farmacológico , Calidad de Vida , Volumen Sistólico , Enfermedad Crónica , Calidad de la Atención de Salud
16.
Clin Infect Dis ; 78(2): 312-323, 2024 02 17.
Artículo en Inglés | MEDLINE | ID: mdl-37738676

RESUMEN

BACKGROUND: The use of assays detecting cytomegalovirus (CMV)-specific T cell-mediated immunity may individualize the duration of antiviral prophylaxis after transplantation. METHODS: In this randomized trial, kidney and liver transplant recipients from 6 centers in Switzerland were enrolled if they were CMV-seronegative with seropositive donors or CMV-seropositive receiving antithymocyte globulins. Patients were randomized to a duration of antiviral prophylaxis based on immune monitoring (intervention) or a fixed duration (control). Patients in the control group were planned to receive 180 days (CMV-seronegative) or 90 days (CMV-seropositive) of valganciclovir. Patients were assessed monthly with a CMV ELISpot assay (T-Track CMV); prophylaxis in the intervention group was stopped if the assay was positive. The co-primary outcomes were the proportion of patients with clinically significant CMV infection and reduction in days of prophylaxis. Between-group differences were adjusted for CMV serostatus. RESULTS: Overall, 193 patients were randomized (92 in the immune-monitoring group and 101 in the control group), of whom 185 had evaluation of the primary outcome (87 and 98 patients). CMV infection occurred in 26 of 87 (adjusted percentage, 30.9%) in the immune-monitoring group and in 32 of 98 (adjusted percentage, 31.1%) in the control group (adjusted risk difference, -0.1; 95% confidence interval [CI], -13.0% to 12.7%; P = .064). The duration of prophylaxis was shorter in the immune-monitoring group (adjusted difference, -26.0 days; 95%, CI, -41.1 to -10.8 days; P < .001). CONCLUSIONS: Immune monitoring resulted in a significant reduction of antiviral prophylaxis, but we were unable to establish noninferiority of this approach on the co-primary outcome of CMV infection. CLINICAL TRIALS REGISTRATION: NCT02538172.


Asunto(s)
Infecciones por Citomegalovirus , Trasplante de Órganos , Humanos , Citomegalovirus , Antivirales/uso terapéutico , Monitorización Inmunológica , Infecciones por Citomegalovirus/diagnóstico , Receptores de Trasplantes , Trasplante de Órganos/efectos adversos , Ganciclovir/uso terapéutico
17.
J Pers ; 92(1): 130-146, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-37041673

RESUMEN

OBJECTIVE: Personality changes across the life span. Life events, such as marriage, becoming a parent, and retirement, have been proposed as facilitating personality growth via the adoption of novel social roles. However, empirical evidence linking life events with personality development is sparse. Most studies have relied on few assessments separated by long time intervals and have focused on a single life event. In contrast, the content of life is composed of small, recurrent experiences (e.g., getting sick or practicing a hobby), with relatively few major events (e.g., childbirth). Small, frequently experienced life events may play an important and overlooked role in personality development. METHOD: The present study examined the extent to which 25 major and minor life events alter the trajectory of personality development in a large, frequently assessed sample (Nsample = 4904, Nassessments = 47,814, median retest interval = 35 days). RESULTS: Using a flexible analytic strategy to accommodate the repeated occurrence of life events, we found that the trajectory of personality development shifted in response to a single occurrence of some major life events (e.g., divorce), and recurrent, "minor" life experiences (e.g., one's partner doing something special). CONCLUSION: Both stark role changes and frequently reinforced minor experiences can lead to personality change.


Asunto(s)
Desarrollo de la Personalidad , Personalidad , Humanos , Estudios Longitudinales , Personalidad/fisiología , Trastornos de la Personalidad , Acontecimientos que Cambian la Vida
18.
J Pers Soc Psychol ; 2023 Dec 07.
Artículo en Inglés | MEDLINE | ID: mdl-38059981

RESUMEN

According to the canalization hypothesis of attachment theory (Bowlby, 1973), people's trajectories of attachment security should become increasingly stable and buffered against external pressures as their relationships progress. The present study aimed to examine this hypothesis within the context of romantic relationships. We analyzed longitudinal data collected from 1,741 adults who completed between three and 24 survey assessments (average number of waves analyzed = 6.79, SD = 5.31; median test-retest interval = 35 days). We modeled participants' within-person fluctuations in partner-specific security as a function of their romantic relationship length. Additionally, we examined whether attachment-related events (e.g., conflict with one's partner) predict greater within-person fluctuations in security among people involved in newer versus more established romantic relationships. Our results suggest that people in newer romantic relationships demonstrated greater fluctuations in partner-specific attachment anxiety-both generally and in reaction to attachment-related events-compared to those in well-established romantic relationships. However, neither of these trends was observed for partner-specific attachment avoidance. These results provide partial support for the canalization hypothesis but also suggest that canalization processes may be more nuanced than previously assumed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

19.
R Soc Open Sci ; 10(12): 231001, 2023 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-38077223

RESUMEN

Social network analysis (SNA) is a powerful, quantitative tool to measure animals' direct and indirect social connectedness in the context of social groups. However, the extent to which behavioural sampling methods influence SNA metrics remains unclear. To fill this gap, here we compare network indices of grooming, huddling, and aggression calculated from data collected from three macaque species through two sampling methods: focal animal sampling (FAS) and all-occurrences behaviour sampling (ABS). We found that measures of direct connectedness (degree centrality, and network density) were correlated between FAS and ABS for all social behaviours. Eigenvector and betweenness centralities were correlated for grooming and aggression networks across all species. By contrast, for huddling, we found a correlation only for betweenness centrality while eigenvector centralities were correlated only for the tolerant bonnet macaque but not so for the despotic rhesus macaque. Grooming and huddling network modularity and centralization were correlated between FAS and ABS for all but three of the eight groups. By contrast, for aggression network, we found a correlation for network centralization but not modularity between the sampling methodologies. We discuss how our findings provide researchers with new guidelines regarding choosing the appropriate sampling method to estimate social network metrics.

20.
JSES Int ; 7(4): 550-554, 2023 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-37426911

RESUMEN

Background: A rotator cuff tear (RCT) is a common shoulder diagnosis and its etiology may be acute, traumatic, or chronic degenerative. Differentiation between the 2 etiologies may be important for multiple reasons, but remains difficult based on imaging. Further knowledge about radiographic and magnetic resonance findings to distinguish traumatic from degenerative RCT is needed. Methods: We analyzed magnetic resonance arthrograms (MRAs) of 96 patients with traumatic or degenerative superior RCT, which were matched according their age and the affected rotator cuff muscle into the 2 groups. Patients older than 66 years of age were excluded from the study to avoid including cases with pre-existing degeneration. In the case of traumatic RCT, the time between the trauma and MRA had to be less than 3 months. Various parameters of the supraspinatus (SSP) muscle-tendon unit were assessed (tendon thickness, presence of a remaining tendon stump at the greater tubercle, magnitude of retraction, layer appearance). The retraction of the 2 SSP layers were individually measured to determine the difference of retraction. Additionally, edema of the tendon and muscle, the tangent- and kinking-sign as well as the newly introduced Cobra-sign (bulging of the distal part of the ruptured tendon with slim configuration of the medial part of the tendon) were analyzed. Results: Edema within the SSP muscle (sensitivity 13%, specificity 100%, P = .011) or the tendon (sensitivity 86%, specificity 36%, P = .014) are more frequent in traumatic RCT. The same association was found for the kinking-sign (sensitivity 53%, specificity 71%, P = .018) and the Cobra sign (sensitivity 47%, specificity 84%, P = .001). Even though not statistically significant, tendencies were observed toward thicker tendon stumps in traumatic RCT, and greater difference in retraction between the 2 SSP layers in the degenerative group. The cohorts had no difference in the presence of a tendon stump at the greater tuberosity. Conclusion: Muscle and tendon edema, as well as tendon kinking appearance and the newly introduced cobra-sign are suitable MRA parameters to distinguish between traumatic and degenerative etiology of a superior RTC.

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