RESUMO
OBJECTIVE: Chronic stress adversely affects mental and physical well-being. However, health outcomes vary among people experiencing the same stressor. Individual differences in physical and emotional well-being may depend on mitochondrial biology, as energy production is crucial for stress regulation. This study investigated whether mitochondrial respiratory capacity corresponds to individual differences in dementia spousal caregivers' mental and physical health. METHODS: Spousal caregivers of individuals with Alzheimer's disease and related dementias ( N = 102, mean age = 71, 78% female, 83% White) provided peripheral blood samples and completed self-report questionnaires on quality of life, caregiver burden, and a 7-day affect scale. Multiple and mixed linear regressions were used to test the relationship between mitochondrial biology and well-being. RESULTS: Spare respiratory capacity ( b = 12.76, confidence interval [CI] = 5.23-20.28, p = .001), maximum respiratory capacity ( b = 8.45, CI = 4.54-12.35, p < .0001), and ATP-linked respiration ( b = 10.11, CI = 5.05-15.18, p = .0001) were positively associated with physical functioning. At average ( b = -2.23, CI = -3.64 to -0.82, p = .002) and below average ( b = -4.96, CI = -7.22 to 2.70, p < .0001) levels of spare respiratory capacity, caregiver burden was negatively associated with daily positive affect. At above average levels of spare respiratory capacity, caregiver burden was not associated with positive affect ( p = .65). CONCLUSIONS: Findings suggest that higher mitochondrial respiratory capacity is associated with better psychological and physical health-a pattern consistent with related research. These findings provide some of the earliest evidence that cellular bioenergetics are related to well-being.
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Cuidadores , Demência , Metabolismo Energético , Mitocôndrias , Humanos , Feminino , Masculino , Cuidadores/psicologia , Idoso , Pessoa de Meia-Idade , Demência/fisiopatologia , Metabolismo Energético/fisiologia , Mitocôndrias/metabolismo , Qualidade de Vida , Doença de Alzheimer/fisiopatologia , Afeto/fisiologia , Idoso de 80 Anos ou mais , Nível de Saúde , Sobrecarga do Cuidador , Cônjuges/psicologia , Estresse Psicológico/metabolismo , Estresse Psicológico/fisiopatologiaRESUMO
OBJECTIVE: Sleep quality is an important health-protective factor. Psychosocial factors, including attachment orientation, may be valuable for understanding who is at risk of poor sleep quality and associated adverse health outcomes. High attachment anxiety is reliably associated with adverse health outcomes, whereas high attachment avoidance is associated with adverse health outcomes when co-occurring with poor self-regulatory capacity, indexed by heart rate variability (HRV). We examined the associations between attachment anxiety, attachment avoidance, HRV, and sleep quality. METHODS: Using longitudinal data from a sample of 171 older adults measured four times over 1 year ( M = 66.18 years old; 67.83% women), we separated the between-person variance (which we call "trait") and within-person variance (which we call "state") for attachment anxiety, attachment avoidance, and HRV (via the root mean square of successive differences). Sleep quality was measured with the Pittsburgh Sleep Quality Index. RESULTS: Higher trait attachment anxiety was associated with poorer global sleep quality ( B = 0.22, p = .005). Higher state attachment avoidance was associated with poorer sleep quality ( B = -0.13, p = .01), except for those with higher trait HRV. Higher state attachment anxiety was associated with poorer sleep quality ( B = -0.15, p = .002), except for those with higher or mean trait HRV. Higher trait attachment anxiety was associated with poorer sleep quality ( B = -0.31, p = .02), except for those with higher trait HRV. CONCLUSIONS: High trait HRV mitigated the adverse effects of attachment insecurity on sleep quality. Our results suggest that people with high trait HRV had greater self-regulation capacity, which may enable them to enact emotion regulation strategies effectively.
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Ansiedade , Frequência Cardíaca , Apego ao Objeto , Qualidade do Sono , Humanos , Feminino , Frequência Cardíaca/fisiologia , Masculino , Idoso , Ansiedade/fisiopatologia , Pessoa de Meia-Idade , Estudos LongitudinaisRESUMO
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic demonstrates the need for accurate and convenient approaches to diagnose and therapeutically monitor respiratory viral infections. We demonstrated that self-sampling with mid-nasal foam swabs is well-tolerated and provides quantitative viral output concordant with flocked swabs. Using longitudinal home-based self-sampling, we demonstrate that nasal cytokine levels correlate and cluster according to immune cell of origin. Periods of stable viral loads are followed by rapid elimination, which could be coupled with cytokine expansion and contraction. Nasal foam swab self-sampling at home provides a precise, mechanistic readout of respiratory virus shedding and local immune responses.
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COVID-19 , Vírus , Humanos , SARS-CoV-2 , Cinética , Reprodutibilidade dos Testes , COVID-19/diagnóstico , CitocinasRESUMO
Higher or lower incubation temperature may impose some degree of stress on developing poultry embryos. This study was designed to delineate the effects of prenatal thermal stress on serum levels of acute-phase proteins (APPs), namely ceruloplasmin (CPN) and alpha-1-acid glycoprotein (AGP), the regulation of brain mRNA levels of heat shock protein (Hsp) 70, and serum levels of corticosterone (CORT) in embryos and neonatal chicks. Hatching eggs were subjected to three thermal treatments; (i) standard optimum temperature throughout (SS: 37.8 °C and 56 % RH), (ii) heat stress for 12 h daily (HS: 40.0 °C and 56 % RH), and (iii) cold stress for 12 h daily 18 (CS: 30.2 °C and 56 % RH). The heat and cold stress treatments were imposed from the 10th to the 18th day of incubation (ED). Results showed that thermal stress had a negligible effect on hatchability rate and body temperatures of neonatal chicks. The CS treatment was detrimental to embryonic growth. The HS treatment elevated AGP (ED 16, ED 18, and post-hatch day 1), CPN (on post-hatch day 1), and CORT (ED 14). On the contrary, the CS embryos had reduced AGP (ED14, ED16, ED18, and post-hatch day 1), CPN (ED 16), and CORT (ED 14, ED 16, ED 18). The brain mRNA levels of Hsp70 were upregulated throughout the experimental period in both the HS and CS embryos and chicks. Based on these modifications, AGP, together with Hsp70 mRNA expression, could be considered effective biomarkers useful to evaluate the magnitude and the time response of embryos and neonatal chicks to prenatal thermal stress. It is concluded that developing chicken embryos have the ability to evoke APPs, Hsp70 and CORT reactions which are important to cope with thermal stress.
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Corticosterona , Proteínas de Choque Térmico HSP70 , Proteínas de Fase Aguda/metabolismo , Animais , Ceruloplasmina/metabolismo , Embrião de Galinha , Galinhas/fisiologia , Corticosterona/metabolismo , Glicoproteínas/metabolismo , Proteínas de Choque Térmico HSP70/genética , Proteínas de Choque Térmico HSP70/metabolismo , RNA Mensageiro/genéticaRESUMO
OBJECTIVES: To determine if a policy of universal fetal echocardiography (echo) in pregnancies conceived by in-vitro fertilization (IVF) is cost-effective as a screening strategy for congenital heart defects (CHDs) and to examine the cost-effectiveness of various other CHD screening strategies in IVF pregnancies. METHODS: A decision-analysis model was designed from a societal perspective with respect to the obstetric patient, to compare the cost-effectiveness of three screening strategies: (1) anatomic ultrasound (US): selective fetal echo following abnormal cardiac findings on detailed anatomic survey; (2) intracytoplasmic sperm injection (ICSI) only: fetal echo for all pregnancies following IVF with ICSI; (3) all IVF: fetal echo for all IVF pregnancies. The model initiated at conception and had a time horizon of 1 year post-delivery. The sensitivities and specificities for each strategy, the probabilities of major and minor CHDs and all other clinical estimates were derived from the literature. Costs, including imaging, consults, surgeries and caregiver productivity losses, were derived from the literature and Medicare databases, and are expressed in USA dollars ($). Effectiveness was quantified as quality-adjusted life years (QALYs), based on how the strategies would affect the quality of life of the obstetric patient. Secondary effectiveness was quantified as number of cases of CHD and, specifically, cases of major CHD, detected. RESULTS: The average base-case cost of each strategy was as follows: anatomic US, $8119; ICSI only, $8408; and all IVF, $8560. The effectiveness of each strategy was as follows: anatomic US, 1.74487 QALYs; ICSI only, 1.74497 QALYs; and all IVF, 1.74499 QALYs. The ICSI-only strategy had an incremental cost-effectiveness ratio (ICER) of $2 840 494 per additional QALY gained when compared to the anatomic-US strategy, and the all-IVF strategy had an ICER of $5 692 457 per additional QALY when compared with the ICSI-only strategy. Both ICERs exceeded considerably the standard willingness-to-pay threshold of $50 000-$100 000 per QALY. In a secondary analysis, the ICSI-only strategy had an ICER of $527 562 per additional case of major CHD detected when compared to the anatomic-US strategy. All IVF had an ICER of $790 510 per case of major CHD detected when compared with ICSI only. It was determined that it would cost society five times more to detect one additional major CHD through intensive screening of all IVF pregnancies than it would cost to pay for the neonate's first year of care. CONCLUSION: The most cost-effective method of screening for CHDs in pregnancies following IVF, either with or without ICSI, is to perform a fetal echo only when abnormal cardiac findings are noted on the detailed anatomy scan. Performing routine fetal echo for all IVF pregnancies is not cost-effective. © 2020 International Society of Ultrasound in Obstetrics and Gynecology.
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Fertilização in vitro , Cardiopatias Congênitas/diagnóstico por imagem , Injeções de Esperma Intracitoplásmicas , Análise Custo-Benefício , Árvores de Decisões , Ecocardiografia/economia , Feminino , Cardiopatias Congênitas/economia , Humanos , Gravidez , Qualidade de Vida , Ultrassonografia Pré-Natal/economia , Estados UnidosRESUMO
1. A vaccination regime is a schedule for the administration of vaccines which may vary according to country or even by farm. This study aimed to measure the production and health performance of broilers treated with different vaccination regimes. 2. A total of 108 Cobb 500 broiler birds were randomly divided into three treatment groups, with six replicates consisting of six birds per replicate. Each treatment group was administered with different vaccination regimes against Newcastle Disease (ND), Infectious Bronchitis (IB) and Infectious Bursal Disease (IBD). Treatment 1 (T1) broilers were vaccinated against ND+IB and IBD on days 7 and 14 of age, respectively (control); Treatment 2 (T2) broilers were vaccinated against ND+IB on days 3 and 7 of age, and IBD on day 14; and Treatment 3 (T3) broilers were vaccinated against ND+IB on days 7 and 21 and IBD on day 14. Throughout the 42-day study period, data and samples were collected to determine the growth performance, immune status, carcase characteristics and meat quality. 3. There were significant differences (P < 0.05) on growth performance (body weight, body weight gain, feed intake and cumulative feed conversion ratio), white blood cell count (heterophils percentage, lymphocytes percentage and heterophils to lymphocytes ratio), carcase characteristics (kill-out weight, de-feathered weight, dressing percentage, drumsticks and gastrointestinal tract weight) and meat quality (cooking loss and drip loss) between treatments. T1 broilers showed better growth, white blood cell count, carcase characteristics and meat quality compared to T2 and T3 broilers. 4. Based on findings from the current work, vaccination against ND+IB and IBD on days 7 and 14 proved to be the best vaccination regime for broiler production, due to the better production performance and health status of broilers.
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Ração Animal , Galinhas , Doença de Newcastle , Vacinação , Animais , Carne , Doença de Newcastle/prevenção & controle , Vacinação/veterináriaRESUMO
PURPOSE: Positron emission tomography using ligands targeting prostate specific membrane antigen has recently been introduced. Positron emission tomography imaging with (68)Ga-PSMA-HBED-CC has been shown to detect metastatic prostate cancer lesions at a high rate. In this study we compare multiparametric magnetic resonance imaging and prostate specific membrane antigen positron emission tomography of the prostate with whole mount ex vivo prostate histopathology to determine the true sensitivity and specificity of these imaging modalities for detecting and locating tumor foci within the prostate. MATERIALS AND METHODS: In a prospective clinical trial setting 20 patients with localized prostate cancer and a planned radical prostatectomy were recruited. All patients underwent multiparametric magnetic resonance imaging and positron emission tomography before surgery, and whole mount histopathology slides were directly compared to the images. European Society of Urogenital Radiology guidelines for reporting magnetic resonance imaging were used as a template for regional units of analysis. The uropathologist and radiologists were blinded to individual components of the study, and the final correlation was performed by visual and deformable registration analysis. RESULTS: A total of 50 clinically significant lesions were identified from the whole mount histopathological analysis. Based on regional analysis the sensitivity, specificity, positive predictive value and negative predictive value for multiparametric magnetic resonance imaging were 44%, 94%, 81% and 76%, respectively. With prostate specific membrane antigen positron emission tomography the sensitivity, specificity, positive predictive value and negative predictive value were 49%, 95%, 85% and 88%, respectively. Prostate specific membrane antigen positron emission tomography yielded a higher specificity and positive predictive value. CONCLUSIONS: A significant proportion of cancers are potentially missed and underestimated by both imaging modalities. Prostate specific membrane antigen positron emission tomography may be used in addition to multiparametric magnetic resonance imaging to help improve local staging in those patients undergoing retropubic radical prostatectomy.
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Imageamento por Ressonância Magnética/métodos , Tomografia por Emissão de Pósitrons/métodos , Próstata/diagnóstico por imagem , Neoplasias da Próstata/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Neoplasias da Próstata/metabolismo , Reprodutibilidade dos TestesRESUMO
AIM: To compare the performance of axial images of the ankle joint on three-dimensional (3D) volume isotropic turbo spin echo acquisition (VISTA) with that of two-dimensional (2D) fast spin echo (FSE) T2-weighted images for the diagnosis of anterior talofibular ligament (ATFL) injury. MATERIALS AND METHODS: This retrospective study included 101 patients who underwent both 2D FSE T2-weighted and 3D VISTA magnetic resonance imaging (MRI) of the ankle. The signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of both sequences were measured. The anatomical identification score and diagnostic performances of both sequences were evaluated by two radiologists. The diagnostic performances of 3D VISTA and 2D FSE images were analysed in terms of sensitivity, specificity, and accuracy for diagnosing ATFL injury. Surgically or clinically confirmed diagnoses were used as reference standards. RESULTS: The margin sharpness scores on 3D VISTA were significantly inferior to those of 2D FSE (p<0.001). Other scores (entire length, entire width) were not significantly different between the two imaging methods. The SNRs and CNRs of 3D VISTA were significantly higher than those of 2D FSE (p<0.001). When diagnoses were classified as normal and abnormal, the specificity of the 3D VISTA images for the diagnosis of ATFL injury was 95.7%, significantly superior to 2D FSE (84.3-85.7%). There were no significant differences between 3D VISTA and 2D FSE images in sensitivity or accuracy for diagnosis (p=0.227-1.000), with the exception of accuracy by reader 1 (p=0.039). CONCLUSION: 3D VISTA imaging has a diagnostic performance comparable to that of 2D FSE for the diagnosis of ATFL injury, although 3D VISTA is inferior to 2D FSE for the evaluation of margin sharpness. Replacing axial and coronal images with 3D VISTA can save imaging time without negatively impacting the diagnostic ability for ATFL injury.
Assuntos
Traumatismos do Tornozelo/diagnóstico , Articulação do Tornozelo/patologia , Imageamento Tridimensional , Ligamentos Laterais do Tornozelo/lesões , Ligamentos Laterais do Tornozelo/patologia , Imageamento por Ressonância Magnética/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Sensibilidade e Especificidade , Razão Sinal-Ruído , Adulto JovemRESUMO
PURPOSE: Nonalcoholic fatty liver disease (NAFLD) is associated with various metabolic abnormalities that can increase the risk of an osteoporotic fracture. Across the few previous studies of the association between NAFLD and bone mineral density (BMD), the association was not consistent. We examined the association between BMD and NAFLD in generally healthy adults. METHODS: The subjects who visited the Seoul National University Hospital for health checkup between 2005 and 2015 were included. Men aged more than 40 and postmenopausal women were included. Lumbar spine and femoral neck (FN) BMD were measured using dual-energy X-ray absorptiometry. Liver ultrasonography was conducted to evaluate the extent of fatty changes. After excluding subjects with a secondary cause of liver disease such as heavy drinking or viral hepatitis, multivariable linear regression analysis adjusted for possible cofactors was performed to investigate the association between BMD and NAFLD. RESULTS: A total of 6634 subjects was included in this study (men:women = 3306:3328). Multivariate regression analysis revealed a significant negative association between FN BMD and NAFLD in men (ß = -0.013, p = 0.029). However, there was a positive correlation between lumbar spine BMD and NAFLD in postmenopausal women (ß = 0.022, p = 0.005). CONCLUSIONS: Moderate or severe NAFLD exerted a detrimental effect on FN BMD in men. However, moderate or severe NAFLD had a positive effect on lumbar spine BMD in postmenopausal women. Potential sex-specific differences of the effect of NAFLD on BMD need to be elucidated further.
Assuntos
Hepatopatia Gordurosa não Alcoólica/fisiopatologia , Osteoporose/complicações , Absorciometria de Fóton , Adulto , Biomarcadores/análise , Biomarcadores/sangue , Densidade Óssea , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Hepatopatia Gordurosa não Alcoólica/etiologia , Osteoporose/metabolismo , República da Coreia/epidemiologia , Fatores de Risco , UltrassonografiaRESUMO
BACKGROUND: Junctional (flat) naevi predominate on the extremities, whereas dermal (raised) naevi are found primarily on the head, neck and trunk. Few studies have investigated the anatomical site prevalence of melanocytic naevi categorized using dermoscopy. OBJECTIVES: To identify the prevalence of dermoscopic patterns and structures of naevi from the back and legs of adolescents. METHODS: Dermoscopic images of acquired melanocytic naevi were obtained from the back and legs of students from a population-based cohort in Framingham, Massachusetts. Naevi were classified into reticular, globular, homogeneous or complex dermoscopic patterns. Multinomial logistic regression modelling assessed the associations between dermoscopic pattern and anatomical location. RESULTS: In total 509 participants (mean age 14 years) contributed 2320 back naevi and 637 leg naevi. Compared with homogeneous naevi, globular and complex naevi were more commonly observed on the back than the legs [odds ratio (OR) 29·39, 95% confidence interval (CI) 9·53-90·65, P < 0·001 and OR 6·8, 95% CI 2·7-17·14, P < 0·001, respectively], whereas reticular lesions were less likely to be observed on the back than on the legs (OR 0·67, 95% CI 0·54-0·84, P = 0·001). Naevi containing any globules were more prevalent on the back than on the legs (25% vs. 3·6%, P < 0·001). Naevi containing any network were more prevalent on the legs than on the back (56% vs. 40·6%, P < 0·001). CONCLUSIONS: These findings add to a robust body of literature suggesting that dermoscopically defined globular and reticular naevi represent biologically distinct naevus subsets that differ in histopathological growth pattern, age- and anatomical-site-related prevalence, molecular phenotype and aetiological pathways.
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Nevo Pigmentado/patologia , Neoplasias Cutâneas/patologia , Adolescente , Dorso , Estudos Transversais , Dermoscopia/métodos , Feminino , Cor de Cabelo/fisiologia , Humanos , Perna (Membro) , Estudos Longitudinais , Masculino , Nevo Pigmentado/etnologia , Estudos Prospectivos , Grupos Raciais/etnologia , Neoplasias Cutâneas/etnologia , Pigmentação da Pele/fisiologiaRESUMO
AIM: To evaluate the usefulness and diagnostic accuracy of oblique coronal MRI of the calcaneofibular ligament (CFL) view for diagnosis of CFL injury. MATERIAL AND METHODS: This retrospective study included 91 patients who were suspected to have CFL injury who underwent CFL view imaging. Anatomical identification of the CFL on orthogonal MRI sequences and CFL views was evaluated. Two radiologists evaluated the CFL based on an entire length view, an entire width view, and margin sharpness using a four-point scale. Diagnostic accuracy using orthogonal and CFL views was evaluated by calculating sensitivity, specificity, and accuracy. Arthroscopic or clinical findings were used as the reference standard. RESULTS: Both readers found identification of lesions using the entire length, entire width, and sharp margin from CFL view images to be superior to that based on orthogonal images. The sensitivity and accuracy of diagnosing CFL injury were significantly higher when using the CFL view compared to the orthogonal view, although specificity was not significantly different between the CFL view and orthogonal view images. CONCLUSIONS: CFL view imaging enables better anatomical evaluation and improved sensitivity and accuracy of diagnosis of CFL injury. CFL view images should therefore be used to evaluate potential CFL injuries.
Assuntos
Traumatismos do Tornozelo/patologia , Articulação do Tornozelo/patologia , Ligamentos Laterais do Tornozelo/lesões , Ligamentos Laterais do Tornozelo/patologia , Imageamento por Ressonância Magnética/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Feminino , Humanos , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Estudos Retrospectivos , Sensibilidade e Especificidade , Adulto JovemRESUMO
Many organisms have intimate associations with beneficial microbes acquired from the environment. These host-symbiont associations can be specific and stable, but they are prone to lower partner specificity and more partner-switching than vertically transmitted mutualisms. To investigate partner specificity in an environmentally acquired insect symbiosis, we used 16S rRNA gene and multilocus sequencing to survey the bacterial population in the bacteria-harbouring organ (crypts) of 49 individuals across four sympatric broad-headed bug species (Alydus calcaratus, A. conspersus, A. tomentosus and Megalotomus quinquespinosus). Similar to other insect-bacteria associations, Burkholderia spp. were the most common residents of the crypts in all four insect species (77.2% of recovered sequences). Burkholderia presence was associated with prolonged survival to adulthood in A. tomentosus, suggesting a beneficial role of these specialized associations. Burkholderia were also found in environmental reservoirs in the insects' habitat, which may facilitate acquisition by insects by increasing Burkholderia-insect encounters. Symbiont establishment could also be facilitated by resistance to insect defences; zone of inhibition assays demonstrated that Burkholderia and other bacteria isolated from crypts are resistant to insect defences that limit growth of Escherichia coli. Alternatively, the insects' defences may not efficiently kill a broad range of bacteria. Although the symbiosis is targeted to Burkholderia, the insects' crypts housed other bacteria, including non-Burkholderiaceae species. There is no significant effect of host insect species on Burkholderia distribution, suggesting a lack of strong partner specificity at finer scales. The presence of frequent partner-switching between sympatric insects and their symbionts likely prevents tight co-evolutionary dynamics.
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Burkholderia/classificação , Heterópteros/microbiologia , Simbiose , Simpatria , Animais , Técnicas de Tipagem Bacteriana , Burkholderia/genética , Burkholderia/isolamento & purificação , DNA Bacteriano/genética , Sistema Digestório/microbiologia , Ecossistema , Dados de Sequência Molecular , Tipagem de Sequências Multilocus , Filogenia , RNA Ribossômico 16S/genética , Microbiologia do SoloRESUMO
AIM: To evaluate the clinical utility of the meniscal width to transverse diameter ratio (L/M ratio) of the lateral meniscus in the diagnosis of incomplete discoid lateral meniscus (IDLM) as compared with the arthroscopic diagnosis, meniscal width to tibial diameter ratio (L/T ratio) and conventional lateral meniscus width criteria. MATERIALS AND METHODS: This retrospective study sample included 41 patients with IDLM who underwent knee magnetic resonance imaging (MRI) and arthroscopy, as well as 50 controls with normal lateral menisci. MRI examinations were interpreted independently by two radiologists, both of whom were blinded to clinical information and radiological reports. Assessment of meniscal width (L), maximal transverse diameter of the lateral meniscus (M), and transverse diameter of the tibia (T) was carried out on central coronal sections that were observed to pass through the medial collateral ligament. L/M and L/T ratios were calculated. These results were correlated with arthroscopic findings and analysed statistically using categorical regression analysis and non-parametric correlation analysis. Using arthroscopic findings as the standard of reference, sensitivity and specificity were calculated for: (1) 12, 13, 14, and 15 mm meniscal width thresholds; (2) 40%, 50%, 60%, and 70% L/M ratio thresholds; and (3) 15%, 18%, 20%, and 25% L/T ratio thresholds. RESULTS: The mean L/M ratio of the IDLM was approximately 67% and was statistically significantly higher than the control (44%). The best diagnostic discrimination was achieved using a threshold of 50%. The mean L/T ratio of the IDLM was approximately 23% and was statistically significant. The best diagnostic discrimination was achieved using a threshold of 18%. The threshold of 13 mm of meniscal width also showed high sensitivity and high specificity. CONCLUSION: The use of the L/M ratio or L/T ratio in combination with meniscal width criteria may be a useful method for evaluating IDLM.
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Artroscopia , Traumatismos do Joelho/diagnóstico , Imageamento por Ressonância Magnética , Meniscos Tibiais/patologia , Tíbia/patologia , Adolescente , Adulto , Feminino , Humanos , Traumatismos do Joelho/patologia , Masculino , Meniscos Tibiais/anormalidades , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Padrões de Referência , República da Coreia/epidemiologia , Estudos Retrospectivos , Sensibilidade e Especificidade , Tíbia/anormalidadesRESUMO
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Força da Mão , Infecções por Mycobacterium não Tuberculosas , Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Estudos de Casos e Controles , Infecções por Mycobacterium não Tuberculosas/epidemiologia , República da Coreia/epidemiologia , Idoso , Estudos Prospectivos , Comportamento Sedentário , Pneumopatias/fisiopatologia , Pneumopatias/microbiologia , Exercício Físico/fisiologia , AdultoRESUMO
INTRODUCTION: Understanding changes in vaccine hesitancy, overall and by sociodemographic characteristics, may highlight sub-populations for whom more intensive efforts are needed to increase vaccine uptake and confidence. METHODS: We analyzed data using the CDC's Research and Development Survey (RANDS), a nationally representative survey of U.S. adults ≥18 years, collected from 17 May 2021-30 June 2021 (n = 5,458) and 3 November 2022-12 December 2022 (n = 6,821). We assessed changes in vaccine hesitancy, changes in vaccine attitudes and attitudes, and factors associated with hesitancy toward both vaccines in general and COVID-19 vaccines among a nationally representative sample of U.S. adults. RESULTS: Although COVID-19 vaccination (≥1 dose) increased from 67.2% (2021) to 74.7% (2022), COVID-19 vaccine hesitancy increased from 40.7% to 44.6% during the same period. During the same period, hesitancy toward both COVID-19 vaccines and vaccines in general increased among those who were aged ≥65 years and who were non-Hispanic White. However, COVID-19 vaccine hesitancy decreased among non-Hispanic Black adults. Current or former smokers were more hesitant toward vaccines in general (aPR = 1.13, 95%CI: 1.03-1.24) and toward COVID-19 vaccines (aPR = 1.08, 95%CI: 1.01-1.16) compared to never smokers. Among adults who did not receive any COVID-19 vaccines, COVID-19 vaccine hesitancy increased from 86.6% in 2021 to 92.4% in 2022. Furthermore, belief in the overall social benefit of the COVID-19 vaccine decreased from 47.5% to 25.1%. CONCLUSION: This study highlights concerning trends in vaccine hesitancy and uptake of the COVID-19 and other recommended vaccines. We found that some high-risk groups (e.g. smokers) and population subgroups have become more vaccine hesitant, suggesting the need for improved and intensified strategies to increase vaccine confidence and uptake. Future research may focus on qualitative inquiry to understand specific concerns and determinants contributing to increased hesitancy among these groups to help inform interventions and communication campaigns to support vaccination.
COVID-19 vaccine hesitancy increased from 40.7% in 2021 to 44.6% in 2022.During the same period, hesitancy regarding both the COVID-19 vaccine and vaccines in general increased among those who were ≥65 years and non-Hispanic White while hesitancy toward COVID-19 vaccines decreased among non-Hispanic Black adults.Belief in the overall social benefit of the COVID-19 vaccine decreased from 47.5% to 25.1%, suggesting need to frame messaging on benefits such as protection from severe disease outcomes.
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Vacinas contra COVID-19 , COVID-19 , Hesitação Vacinal , Humanos , Vacinas contra COVID-19/administração & dosagem , Masculino , Hesitação Vacinal/estatística & dados numéricos , Hesitação Vacinal/psicologia , Adulto , Feminino , Estados Unidos/epidemiologia , Pessoa de Meia-Idade , COVID-19/prevenção & controle , COVID-19/epidemiologia , Idoso , Adulto Jovem , Adolescente , Conhecimentos, Atitudes e Prática em Saúde , SARS-CoV-2 , Inquéritos e Questionários , Vacinação/psicologia , Vacinação/estatística & dados numéricosRESUMO
Feed restriction could induce physiological stress in broiler chickens, leading to welfare issues. Prenatal stimulation could improve stress-coping mechanisms in poultry. The present study aimed to elucidate the effects of subjecting developing embryos to auditory stimulation on physiological stress response to feed restriction in broiler chickens at market age. A total of 423 hatching eggs of Cobb 500 (Gallus domesticus) were subjected to the following auditory treatments: 1) no additional sound treatment other than the background sound of the incubator's compressors at 40 dB (CONTROL), 2) exposure to pre-recorded traffic noise at 90 dB (NOISE), and 3) exposure to Mozart's Sonata for Two Pianos in D Major, K 488 at 90 dB) (MUSIC). The NOISE and MUSIC treatments were for 20 min/h for 24 h (a total of 8 h/d), starting from embryonic days (ED) 12 to hatching. On d 42, an equal number of birds from each prenatal auditory stimulation (PAS) group were subjected to either ad libitum feeding (AL) or 30-h of feed restriction (FR) in a completely randomised design. The FR chickens exhibited significantly higher serum levels of corticosterone (CORT), and heat shock protein (HSP) 70 compared to those of AL. Prenatal auditory stimulation, particularly NOISE, led to lower serum levels of CORT and alpha-1-acid glycoprotein (AGP) levels compared to the CONTROL group. Additionally, NOISE significantly increased brain mRNA glucocorticoid receptor and HSP70 gene expression. The cecal population of E. coli and Lactobacillus spp. was not significantly affected by prenatal auditory stimulation. In conclusion, our findings suggest that prenatal auditory stimulation, particularly NOISE, positively impacts broiler chickens' ability to cope with feed restriction.
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Limited understanding of the immunopathogenesis of human herpesvirus 6B (HHV-6B) has prevented its acceptance as a pulmonary pathogen after hematopoietic cell transplant (HCT). In this prospective multicenter study of patients undergoing bronchoalveolar lavage (BAL) for pneumonia after allogeneic HCT, we test blood and BAL fluid (BALF) for HHV-6B DNA and mRNA transcripts associated with lytic infection and perform RNA-seq on paired blood. Among 116 participants, HHV-6B DNA is detected in 37% of BALs, 49% of which also have HHV-6B mRNA detection. We establish HHV-6B DNA viral load thresholds in BALF that are highly predictive of HHV-6B mRNA detection and associated with increased risk for overall mortality and death from respiratory failure. Participants with HHV-6B DNA in BALF exhibit distinct host gene expression signatures, notable for enriched interferon signaling pathways in participants clinically diagnosed with idiopathic pneumonia. These data implicate HHV-6B as a pulmonary pathogen after allogeneic HCT.
Assuntos
Transplante de Células-Tronco Hematopoéticas , Herpesvirus Humano 6 , Pneumonia , Infecções por Roseolovirus , Humanos , Herpesvirus Humano 6/genética , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Estudos Prospectivos , Infecções por Roseolovirus/genética , Transcriptoma , DNA , Pneumonia/complicações , RNA MensageiroRESUMO
Dementia spousal caregivers are at risk for adverse mental and physical health outcomes. Caregiver burden, anticipatory grief, and proinflammatory cytokine production may contribute to depressive symptoms among caregivers. People who report childhood trauma are more likely to have exaggerated stress responses that may also contribute to depressive symptoms in adulthood. This study aimed to test whether the relationship between whole-blood cytokine production and depressive symptoms is strongest in caregivers who report high levels of childhood trauma. METHODS: A sample of 103 dementia spousal caregivers provided self-report data on demographics, health information, caregiver burden, anticipatory grief, and depressive symptoms. We also determined lipopolysaccharide-induced whole-blood cytokine production as the primary measure of immune cell reactivity. We measured interleukin-1ß (IL-1ß), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and interleukin-10 (IL-10) and converted z-scores of each cytokine into a composite panel. We regressed depressive symptoms on proinflammatory cytokine production, caregiver burden, and anticipatory grief, adjusting for demographic and health-related covariates. RESULTS: Whole-blood cytokine production and childhood trauma were associated with depressive symptoms. Childhood trauma moderated the relationship between whole-blood cytokine production and depressive symptoms. Whole-blood cytokine production was only associated with depressive symptoms at mean and high levels of childhood trauma, but not at low levels of childhood trauma. The main effects of burden and anticipatory grief on depressive symptoms were strongest for caregivers reporting high levels of childhood trauma. DISCUSSION: Childhood trauma has lasting impacts on psychosocial experiences later in life and has effects that may confer susceptibility to inflammation-related depression. Our findings contribute to ongoing efforts to identify risk factors for adverse mental health in dementia spousal caregivers.
Assuntos
Cuidadores , Citocinas , Demência , Depressão , Cônjuges , Humanos , Feminino , Cuidadores/psicologia , Masculino , Depressão/psicologia , Idoso , Citocinas/sangue , Citocinas/metabolismo , Cônjuges/psicologia , Pessoa de Meia-Idade , Lipopolissacarídeos , Fator de Necrose Tumoral alfa/sangue , Interleucina-6/sangue , Pesar , Interleucina-10/sangue , Interleucina-1beta/sangue , Sobrecarga do Cuidador/psicologia , Experiências Adversas da Infância , Idoso de 80 Anos ou mais , Estresse Psicológico/psicologiaRESUMO
OBJECTIVE: Given fibromyalgia (FM) frequently co-occurs with autoimmune disease, this study was initiated to objectively evaluate FM in a multiracial/ethnic cohort of patients with systemic lupus erythematosus (SLE). METHODS: Patients with SLE were screened for FM using the 2016 FM classification criteria during an in-person rheumatologist visit. We evaluated hybrid Safety of Estrogens in Lupus National Assessment (SELENA)-SLE Disease Activity Index (SLEDAI) scores, SLE classification criteria, and Systemic Lupus International Collaborating Clinics damage index. We compared patients with and without FM and if differences were present, compared patients with FM with patients with non-FM related chronic pain. RESULTS: 316 patients with SLE completed the FM questionnaire. 55 (17.4%) met criteria for FM. The racial composition of patients with FM differed from those without FM (P = 0.023), driven by fewer Asian patients having FM. There was no difference in SLE disease duration, SELENA-SLEDAI score, or active serologies. There was more active arthritis in the FM group (16.4%) versus the non-FM group (1.9%) (P < 0.001). The Widespread Pain Index and Symptom Severity Score did not correlate with degree of SLE activity (r = -0.016; 0.107) among patients with FM or non-FM chronic pain (r = 0.009; -0.024). Regarding criteria, patients with FM had less nephritis and more malar rash. Systemic Lupus International Collaborating Clinics damage index did not differ between groups. CONCLUSION: Except for arthritis, patients with SLE with FM are not otherwise clinically or serologically distinguishable from those without FM, and Widespread Pain Index and Symptom Severity Score indices do not correlate with SLEDAI. These observations support the importance of further understanding the underlying biology of FM in SLE.
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BACKGROUND: Borderline personality disorder (BPD) is the prototypical disorder of emotion dysregulation. We have previously shown that patients with BPD are impaired in their capacity to engage cognitive reappraisal, a frequently employed adaptive emotion regulation strategy. METHODS: Here, we report on the efficacy of longitudinal training in cognitive reappraisal to enhance emotion regulation in patients with BPD. Specifically, the training targeted psychological distancing, a reappraisal tactic whereby negative stimuli are viewed dispassionately as though experienced by an objective, impartial observer. At each of 5 sessions over 2 weeks, 22 participants with BPD (14 female) and 22 healthy control participants (13 female) received training in psychological distancing and then completed a widely used picture-based reappraisal task. Self-reported negative affect ratings and functional magnetic resonance imaging data were acquired at the first and fifth sessions. In addition to behavioral analyses, we performed whole-brain pattern expression analyses using independently defined patterns for negative affect and cognitive reappraisal implementation for each session. RESULTS: Patients with BPD showed a decrease in negative affect pattern expression following reappraisal training, reflecting a normalization in neural activity. However, they did not show significant change in behavioral self-reports. CONCLUSIONS: To our knowledge, this study represents the first longitudinal functional magnetic resonance imaging examination of task-based cognitive reappraisal training. Using a brief, proof-of-concept design, the results suggest a potential role for reappraisal training in the treatment of patients with BPD.