Attachment in individuals with eating disorders compared to community controls: A systematic review and meta-analysis.

OBJECTIVE: Individuals with eating disorders are known to have higher rates of insecure attachment compared to community controls, but the factors underlying this finding are poorly understood. We conducted the first meta-analysis comparing attachment in eating disorder samples compared to community controls that included quality assessment, publication bias and moderation analysis. METHOD: We pre-registered our meta-analysis (CRD42019146799) and followed PRISMA guidelines. We searched PsychINFO, Embase, Medline, CINAHL, and Scopus for publications. Attachment scores were extracted, and Cohen's d calculated for each study using a random effects model. RESULTS: In total, 35 studies were included in the meta-analysis and six studies were summarized in a narrative review. Eating disorder samples showed higher rates of insecure attachment compared to community controls, with a large effect size, across measurement methods and different attachment dimensions. Blinding of assessors moderated effect sizes for attachment interview studies, but no other moderators were significant. DISCUSSION: Risk of insecure attachment is elevated in individuals with eating disorders, albeit heterogeneity is high and largely unexplained. Clinicians may need to take this into account in their work, particularly given the association between attachment insecurity and challenges to therapeutic alliance. Future studies comparing eating disorder samples with community samples should control for general psychopathology. PUBLIC SIGNIFICANCE: Attachment is a broad concept referring to a person's thoughts, feelings and behaviors in relation to close others. This systematic review and meta-analysis found that individuals with eating disorders are lower in attachment security than community controls, regardless of attachment construct or measurement approach. Attachment may be relevant in influencing eating disorder recovery, the development of therapeutic alliance, and potentially clinical outcomes, although more research is needed.

Apego en individuos que padecen trastornos de la conducta alimentaria en comparación con controles comunitarios: una revisión sistemática y metaanálisis. OBJETIVO: Se sabe que las personas que padecen trastornos de la conducta alimentaria tienen tasas más altas de apego inseguro en comparación con los controles comunitarios, pero los factores subyacentes a este hallazgo son poco conocidos. Realizamos el primer metaanálisis que comparó el apego en muestras de personas que padecen trastornos de la conducta alimentaria en comparación con controles comunitarios que incluyeron evaluación de la calidad, sesgo de publicación y análisis de moderación. MÉTODO: Se pre-registró nuestro metaanálisis (CRD42019146799) y seguimos las guías PRISMA. Se realizaron búsquedas de publicaciones en PsychINFO, Embase, Medline, CINAHL y Scopus. Se extrajeron las puntuaciones de apego y se calculó la d de Cohen para cada estudio utilizando un modelo de efectos aleatorios. RESULTADOS: En total, se incluyeron 35 estudios en el metaanálisis y seis estudios se resumieron en una revisión narrativa. Las muestras de personas que padecen trastornos de la conducta alimentaria mostraron tasas más altas de apego inseguro en comparación con los controles comunitarios, con un gran tamaño del efecto, a través de métodos de medición y diferentes dimensiones de apego. El cegamiento de los evaluadores moderó los tamaños del efecto para los estudios de entrevistas de apego, pero ningún otro moderador fue significativo. DISCUSIÓN: El riesgo de apego inseguro es elevado en individuos que padecen trastornos de la conducta alimentaria, aunque la heterogeneidad es alta y en gran medida inexplicable. Los clínicos pueden necesitar tener esto en cuenta en su trabajo, particularmente dada la asociación entre la inseguridad del apego y los desafíos a la alianza terapéutica. Los estudios futuros que comparen muestras de individuos que padecen trastornos de la conducta alimentaria con controles comunitarios deben controlar la psicopatología general.

COVID-19-Associated Pulmonary Aspergillosis (CAPA) in Northern Greece during 2020-2022: A Comparative Study According to the Main Consensus Criteria and Definitions.

Coronavirus disease 2019 (COVID-19)-associated pulmonary aspergillosis (CAPA) has emerged as an important complication among patients with acute respiratory failure due to SARS-CoV-2 infection. Almost 2.5 years since the start of the COVID-19 pandemic, it continues to raise concerns as an extra factor that contributes to increased mortality, which is mostly because its diagnosis and management remain challenging. The present study utilises the cases of forty-three patients hospitalised between August 2020 and February 2022 whose information was gathered from ten ICUs and special care units based in northern Greece. The main aim was to describe the gained experience in diagnosing CAPA, according to the implementation of the main existing diagnostic consensus criteria and definitions, and present the different classification of the clinical cases due to the alternative algorithms.

Influence of AQP1 on cell adhesion, migration, and tumor sphere formation in malignant pleural mesothelioma is substratum- and histological-type dependent.

Malignant pleural mesothelioma (MPM) is an aggressive cancer. MPM cells express aquaporin-1 (AQP1) that in other cancers has been shown to participate in the tumor metastasis processes. However, in MPM patients AQP1 overexpression is an independent prognostic factor favoring survival. In this study we aimed at evaluating the role of AQP1 in cell adhesion, migration, and tumor sphere formation in nonmalignant mesothelial cells (MeT-5A) and in epithelioid (M14K) and sarcomatoid (ZL34) MPM cell lines. We used fibronectin (FN) or homologous cell-derived extracellular martrix (ECM) substratum to investigate the role of AQP1 in these experimental phenotypes, inhibiting AQP1 by 10(-5) M mercury chloride (MC). Deposited ECM during cell culture exhibited significant concentration differences among cell types. ZL34 cell adhesion was significantly higher than MeT-5A or M14K cells on FN and ECM. MeT-5A and M14K cell adhesion on FN was sensitive to AQP1 inhibition, whereas AQP1 inhibition on ECM was limited to M14K cells. Wound healing in ZL34 cells was significantly higher than MeT-5A and M14K cells on FN and ECM. AQP1 inhibition significantly lowered cell migration in ZL34 cells on FN and ECM. Sphere formation was not dependent on FN or ECM in the media. AQP1 inhibition in FN media reduced sphere formation in M14K cells, whereas, in ECM, all three cell types were sensitive to AQP1 inhibition.

Clinical phenotypes related to smoking cessation.

INTRODUCTION: The aim of the current study is the identification of clinical phenotypes of patients visiting a specialized smoking cessation center and the determination of smoking cessation rate for each phenotype, 1 year after the initial evaluation. METHODS: Seven hundred eighty-three smokers who visited the outpatient clinic were included in the study. Demographic data, smoking habits, tobacco dependence and comorbidities were recorded. Smoking cessation rates and carbon monoxide levels were determined 1 year after the initial evaluation. RESULTS: The overall smoking cessation rate 1 year after the initial evaluation was 32.3%. Four distinct phenotypes were identified. The first one included mainly young women with low tobacco dependence and allergic profile. The second and the third ones included mainly men with high tobacco dependence, without comorbidities, treated with varenicline and bupropione SR, respectively. The fourth one included mainly older men with high tobacco dependence and smoking related comorbidities. Smoking cessation rates for each phenotype were 33.8, 39.4, 23.3, and 24.6%, respectively. CONCLUSION: Patients visiting a specialized smoking cessation center can be categorized in different phenotypes. Phenotyping may lead to a more personalized approach concerning smoking cessation.

Two-year mortality of patients with COPD in primary health care: an observational study.

BACKGROUND: Chronic obstructive pulmonary disease (COPD) remains a significant cause of morbidity and mortality, with high rates of underdiagnosis. There are no studies about following up COPD patients in primary health care. The aim of the current study was to estimate two-year mortality for COPD patients in primary care and assess the parameters associated with mortality. METHODS: A total of 263 patients with a new COPD diagnosis were followed up for two years. Follow-up included phone contacts every six months for assessment of vital status, and re-examination visits every year after the initial diagnosis. Visits included performance on spirometry, assessment of smoking status, evaluation of adherence with treatment, and assessment of the number of exacerbations during the previous year. RESULTS: One hundred and eighteen patients with COPD completed the study. The overall mortality was 27.9%. Most patients had quit smoking two years after the initial diagnosis, whereas the percentage of patients showing high adherence with treatment was 68%. Parameters associated with two-year mortality were age and coronary heart disease comorbidity. CONCLUSION: The mortality of patients with COPD in primary care remains significantly high, whereas adherence with treatment remains significant low. Age, smoking status, and a history of depression are major determinants of mortality in primary health care.

Matrix metalloproteinases 2 and 9 increase permeability of sheep pleura in vitro.

BACKGROUND: Matrix metalloproteinases (MMPs) 2 and 9 are two gelatinase members which have been found elevated in exudative pleural effusions. In endothelial cells these MMPs increase paracellular permeability via the disruption of tight junction (TJ) proteins occludin and claudin. In the present study it was investigated if MMP2 and MMP9 alter permeability properties of the pleura tissue by degradation of TJ proteins in pleural mesothelium. RESULTS: In the present study the transmesothelial resistance (RTM) of sheep pleura tissue was recorded in Ussing chambers after the addition of MMP2 or MMP9. Both enzymes reduced RTM of the pleura, implying an increase in pleural permeability. The localization and expression of TJ proteins, occludin and claudin-1, were assessed after incubation with MMPs by indirect immunofluorescence and western blot analysis. Our results revealed that incubation with MMPs did not alter neither proteins localization at cell periphery nor their expression. CONCLUSIONS: MMP2 and MMP9 increase the permeability of sheep pleura and this finding suggests a role for MMPs in pleural fluid formation. Tight junction proteins remain intact after incubation with MMPs, contrary to previous studies which have shown TJ degradation by MMPs. Probably MMP2 and MMP9 augment pleural permeability via other mechanisms.

Pleural transport physiology: insights from biological marker measurements in transudates.

AIMS: The aim of this study was to evaluate the physicochemical properties of the pleural mesothelial barrier and of the biological markers that facilitate or eliminate the passage of molecules through the pleura. METHODS AND MATERIAL: Pleural fluid samples from sixty-five patients with heart failure were analyzed. The biological markers studied were lactate dehydrogenase (LDH), adenosine deaminase (ADA), interleukin-6 (IL-6), C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), carcinoembryonic antigen (CEA), copper/zinc superoxide dismutase (CuZnSOD), matrix metalloproteinase-2 (MMP-2), -3 (MMP-3), -7(MMP-7), -8 (MMP-8) and -9 (MMP-9). Based on the pleural fluid/serum ratio, these molecules were divided into three groups: a) the LDH-like group with a pleural fluid/serum ratio between 0,4 and 0,8 (LDH, CEA, CuZnSOD, ADA, CRP, MMP-8), b) molecules with a pleural fluid/serum ratio less than 0,4 (MMP-7 and MMP-9) and c) molecules with a pleural fluid/serum ratio equal or above 1 (TNF-α, IL-6, MMP-2 and MMP-3). RESULTS: No correlation between the molecular radius and the pleural fluid to serum ratio of the above biological markers was found. CONCLUSIONS: The molecular size is not a major determinant for the passage of molecules through the mesothelial barrier. Several other factors may influence the transport of the above molecules to pleural cavity, such as their charge and shape.

Environmetrics to evaluate marine environment quality.

The environmetric data analysis of analytical datasets from sediment and benthic organisms samples collected from different sampling sites along the coast of Black Sea near to City of Varna, Bulgaria has given some important indications about the bioindication properties of both type of samples. Various multivariate statistical methods like cluster analysis, principal components analysis, source apportioning modeling and partial least square (PLS) modeling were used in order to classify and interpret the parameters describing the chemical content of the coastal sediments (major components, heavy metals and total organic carbon) and benthic organisms (heavy metals). It has been shown that seriously polluted coastal zones are indicated in the same way by all benthic species, although some specificity could be detected for moderate polluted regions' e.g. polychaeta accumulated preferably Co, Cr, Cu, and Pb; crustacea - As, Cd, and Ni; mollusca - Zn. The identified latent factors responsible for the dataset structure are clearly indicated and apportioned with respect to their contribution to the total mass or total concentration of the species in the samples. The linear regression and PLS models indicated that a reliable forecast about the relation between naturally occurring chemical components and polluting species accumulated in the benthic organisms is possible.