Cause Of Death In Adults Research Articles

IMPACTO DO CONDICIONAMENTO FÍSICO DO CORE SOBRE O DESEMPENHO DO EQUILÍBRIO NOS IDOSOS

ABSTRACT Introduction Relevant monitoring data show that falls have become the leading cause of death in adults over 65 years old, especially among elderly people who have no exercise habits. Physiological function decline caused by the aging process can be slowed with specific training. It is believed that exercises focusing on the core muscles can benefit balance ability among the elderly. Objective The paper explores how core muscle training impacts balance performance in the elderly. Methods The article randomly divides elderly volunteers (n=24) into two groups. The experimental group received specific core physical conditioning, and the control group received no intervention. The physical quality indicators of both groups were compared and statistically analyzed after the experiment. Results The physical fitness indicators (weight, aerobic endurance, static balance ability) in the groups differed (P<0.05). Conclusion Core training can improve the elderly´s functional physical ability and static balance capacity. Evidence level II; Therapeutic Studies - Investigating the results.

Mortality in Adults with Sickle Cell Disease: Results from the Sickle Cell Disease Implementation Consortium (SCDIC) Registry

Background. The Sickle Cell Disease Implementation Consortium (SCDIC) was funded at eight sites in the United States by the National Heart Lung and Blood Institute (NHLBI) in 2016 to use implementation science to identify and address barriers to quality care in adolescents and adults with Sickle Cell Disease (SCD). As part of the SCDIC, the centers developed a SCD registry including 2444 persons (~300/site) ages 15-45 years at time of consent. To better understand the cause of death in adults living with SCD, this project assessed clinical co-morbidities among the enrolled adolescents and adults to identify causes of mortality and evaluate whether there are any identifiable clinical phenotypes at enrollment that would predict decreased survival. Methods. At enrollment, data were collected, including patient reported demographics, and from the medical record: SCD phenotype, baseline laboratory values, comorbidities, and medication usage. Patient reported outcome (PRO) data were also collected regarding pain and quality of life. Mortality data were obtained for 84 adults who were enrolled since 2016 in the SCDIC registry. Subjects were followed for a median of 1.76 years. The relationship of clinical co-morbidities to mortality was determined using logistic regression after adjusting for SCD phenotype and age group. Specifically, a separate model was run for each co-morbidity, with SCD phenotype, age group, and the co-morbidity being retained in the model, regardless of significance. Summary statistics were calculated, including frequency and percentage for categorical variables and mean, standard deviation, median, and interquartile range (IQR) for continuous variables. Age was evaluated as a continuous and as a categorical variable (15-24, 25-34, 35-45 years). Results. A total of 2,444 registry participants were included for analysis. Eighty-four patients died over the course of the registry data collection (2017-2022), but six deaths were caused by trauma and were removed from further analysis. Baseline characteristics of the other 78 individuals who died (n=78, 3.2%) and those who are last known to be alive (n=2,360, 96.8%) are presented in Table 1. Several co-morbidities increase the odds of death, after adjusting for genotype and age group Table 2. These include, avascular necrosis in any joint (OR [95% CI], 1.87 [1.101-3.197]), chronic kidney disease (OR [95% CI], 2.14 [1.142-3.867]), end stage renal disease (OR [95% CI], 5.95 [1.856-16.249]), pulmonary arterial hypertension (OR [95% CI], 2.41 [1.385-4.124]), sarcoidosis (OR [95% CI], 18.61 [4.191-82.986]), iron overload (OR [95% CI], 2.95 [1.691-5.348]), chronic refractory pain (OR [95% CI], 2.07 [1.183-3.661]), anxiety (OR [95% CI], 2.05 [1.162-3.523]), depression (OR [95% CI], 2.02 [1.179-3.449]), and increased acute care utilization >10 hospitalizations in year prior to enrollment: 6.48 [2.400-16.998]; >10 visits to day-hospital/infusion center in year prior to enrollment: 5.11 [2.287-12.527]). Importantly, chronic pain, anxiety and depression were reported from the patient's past medical history and not abstracted from the PRO. Current use of hydroxyurea was not significant for the total study population (deaths vs survivors, p=0.0948). Among those who died, use of hydroxyurea was also non-significant for SCD phenotype [Hb SS vs Hb SC: p=0.0758 (current use), 1.000 (use within a year of death)]. Conclusion. SCD continues to reduce life expectancy for affected individuals. These findings support that clinicians and researchers still have much work to do in providing comprehensive and supportive care to prevent end-organ damage, comorbidities and SCD complications that are associated with decreased survival. These data also continue to demonstrate the need for improved mental health resources for this population. Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal

Abstract 11161: Thymic Hemorrhage – A Cause for Cardiac Arrest?

Introduction: Thymic hemorrhage is a rare cause of sudden cardiac death, particularly in adults. We present a 35- year- old with sudden “cardiac” death secondary to thymic hemorrhage. Case: A 35-year-old healthy man presented following witnessed cardiac arrest. CPR was initiated immediately. The initial rhythm was shockable, he was defibrillated, and ROSC was achieved. He was intubated on site and transferred to the hospital. Initial labs were negative for electrolyte derangements and drugs of abuse. His high-sensitivity troponin T was 238 ng/L (nl<23 ng/L) and subsequently trended downward. His electrocardiogram showed non-specific ST-T abnormalities. His echocardiogram showed an ejection fraction of 25 to 29% with global hypokinesis. He was extubated on day 4 and scheduled for coronary angiography. On day 5, when he attempted to get out of bed, he lost consciousness and became pulseless. His initial rhythm was PEA, but with episodes of ventricular fibrillation during CPR, he was shocked accordingly. He had prolonged CPR, therefore, obviating advanced therapies. His autopsy showed only thymic hemorrhage. His coronary arteries were normal, with no signs of myocardial injury or myocarditis. Conclusion: Massive acute thymic hemorrhage is extremely rare in adults but is a rare but recognized cause of sudden death in utero and infants. There are only two reported cases of thymic hemorrhage in adults in the literature. Both the patients were nearly 40-year-old men who presented with chest pain. Initial imaging was consistent with mediastinal widening requiring thoracotomy that demonstrated hemorrhagic thymus. Similar to our patient, the reported cases were young men with no prior history of trauma. In contrast, our patient presented with cardiac arrest, and initial imaging was negative for mediastinal widening. The underlying etiology of cardiac arrest from thymic hemorrhage is poorly understood. Right atrial compression from acute hemorrhage of a benign thymic tumor was postulated as the cause of sudden death in a previously healthy 15-year-old boy. Our patient is a rare case since there are, to our knowledge, no reported cases in the literature of thymic hemorrhage as the cause of death in adults.

Preparing fourth year medical students to care for patients with opioid use disorder: how this training affects their intention to seek addiction care opportunities during residency

ABSTRACT Background & Objectives In 2021, the USA recorded 100,000 annual deaths from drug overdose, representing the most frequent cause of death in adults under age 55. The integration of care for substance use disorders (SUDs) into undergraduate medical education is not well established. It is unclear whether a short course on management of opioid use disorder (OUD) offered to fourth year medical students could increase graduating students’ knowledge and preparedness to treat these disorders. Methods We designed a 2-hour interactive case-based session on patient care for OUD and delivered it virtually as part of a Transition to Residency course. A retrospective pre-/post-test assessment instrument determined the impact of this session on students’ perceived knowledge, confidence, and intention to seek further educational opportunities for OUD. Results Of 144 participants, 58 students (40.3%) completed the retrospective pre-/post- survey. There were statistically significant improvements in perceived knowledge and attitudes on the 12-item survey. The largest gains in perceived knowledge on a 5-point scale occurred in the categories regarding buprenorphine induction (pre 2.9; post 4.22; p < 0.001), managing inpatient opioid withdrawal (pre 2.84; post 4.27; p < 0.001), and the role of methadone in treating withdrawal (pre 3.16; post 4.29; p < 0.001). All (n = 58) survey respondents would recommend the training to a colleague and felt that the session would benefit their professional practice. Over 90% (93.1%) of respondents planned on seeking additional SUD learning opportunities during residency. Conclusions A 2-hour interactive case-based teaching session delivered to medical students improved perceived knowledge, attitudes, and future interest in obtaining education around OUD. As the opioid epidemic shows no sign of abating, we would advocate for the inclusion SUD education as part of Transition to Residency courses.

26.1 The Adverse Childhood Experiences (ACE) Study and Subsequent Studies and the Relationship of ACEs to Long-Term Chronic Disease and Mental Health Issues

The first study to explore the relationship between deleterious childhood exposures that lead to chronic diseases that underlie many of the leading causes of death in adults was led by Vincent Felitti, MD, who will review this research.

Management Patterns of Various Hepato-Pancreatic Diseases in Gastroenterology Department at a Tertiary Care Hospital.

Hepato-pancreatic diseases are the leading cause of deaths in adults globally. Proper disease management with various approaches can reduce the risk of mortality and providing more efficacious therapies for the patients is one of the most urgent needs hence, the present study is intended to observe and analyze the management patterns of hepato- pancreatic diseases in patients with and without complications and the impact of invasive procedures in management of hepato-pancreatic diseases. A prospective observational study was conducted for a period of 6 months from September 2018- February 2019 after obtaining permission from the Institutional Ethical committee of CMR College of Pharmacy. A total of 3 hepatic and 2 pancreatic diseases were taken this study out of which 36 were Alcoholic liver disease cases(ALD), 15 were Chronic liver disease cases(CLD), 8 were Liver abscess cases(LA), 36 were Chronic pancreatitis(CP) cases and 25 were acute pancreatitis(AP) cases. These cases were observed predominance of males can be seen in our study which can be correlated with the fact that, alcohol consumption is the major cause for hepato-pancreatic diseases and its complications as alcohol consumption causes epigenetic changes that contribute to alcohol induced liver and pancreatic damage. The data were collected according to the inclusion criteria and the final analysis was done based on various parameters. Data analysis showed that pharmacological management was applied in most of the cases (97%) and it was found to be effective instead of invasive procedures that were employed only in 3% of cases along with pharmacological management thereby reducing the burden of hospital on patients.&#x0D;

Anti tumour efficacy of curcumin/chitosan-coated iron oxide nanoparticles in human lung cell line (L132) In an In Vitro study

Cancer may be a major public ill health, with significant associated death and disability. It is the second leading explanation for death in developed countries and is one among the three leading causes of death for adults in developing countries. Cancer which causes the morbidity and mortality in worldwide, approximately 14 million new cases in 2012.The number of latest cases is predicted to rise by about 70% over the next 2 decades. The present work was aimed to investigate the effect of curcumin/chitosan-coated iron oxide nanoparticles for topical application on L132 cells, for example, cytotoxicity, Reactive oxygen species (ROS) and induction of apoptosis. Diseases resulting from dermal exposure may have a big impact on human health. Cytotoxic potential of curcumin/chitosan-coated iron oxide nanoparticles was measured by tetrazolium bromide (MTT assay) in L132 cells. ROS assay and cell cycle were used to confirm the basis of apoptosis. Apoptosis was investigated by Annexin V with the Propidium iodide method in Flow cytometryanalysis.

423-P: Predictors of Epicardial Adipose Thickness in Overweight and Obese Youth with Type 1 Diabetes

Objectives: Cardiovascular disease (CVD) is the leading cause of death in adults with type 1 diabetes mellitus (T1D) and risk factors for CVD are present early in the disease course. Epicardial adipose thickness (EAT) , a novel independent marker of CVD, is significantly increased in children with T1D compared to healthy controls. Obesity, a known CVD risk factor, is increasingly prevalent in the pediatric population and may confer additional risk in youth with T1D. The purpose of this study was to examine EAT in overweight/obese pediatric patients with T1D. Methods: This was a single-center, cross-sectional study of 37 youth with T1D and BMI &amp;gt; 85th percentile (BMI percentile=93.1±4.3, age 13.5y±3.4, 62.1% female) . Waist circumference, blood pressure, HbA1C and a 2D echocardiogram measuring EAT were obtained. Insulin resistance was calculated via estimated glucose disposal rate (eGDR) . Results: EAT was correlated with age (r=0.45, P=0.006) , BMI (r=0.58, P=0.0001) , waist circumference (r=0.64, P=0.0001) , and diastolic BP (r=0.37, P=0.023) , while inversely correlated with eGDR (r=-0.49, P 0.002) and most recent HDL level (r=-0.43, P=0.027) . There were no significant correlations between EAT and HbA1C (r=-0.01, P=0.9) or duration of diabetes (r=0.16, P=0.4) . After multivariate regression analysis, age and BMI were independent predictors explaining 43.7% of the variance in EAT (P=0.001) . Conclusions: EAT is associated with measures of adiposity and CVD risk, however, only age and BMI were independent predictors of EAT among overweight and obese youth with T1D. In addition to a focus on tight glycemic control to prevent CVD in overweight and obese youth with T1D, further studies are needed to investigate the impact of BMI lowering interventions on EAT. Disclosure L.Cielonko: None. M.Olson: None. A.A.Sabati: None. M.Chambers: None. D.Newbern: None. V.Chakravarthy: None. J.Schmidt: None. J.Mullen: None. N.Lutz: None. G.Q.Shaibi: None.

Evaluation of Optic Nerve Diameter Measurement :According to Bleeding Subtypes in Patients with Non-Traumatic Intracranial Hemorrhage in the Emergency Department

Objective: Nontraumatic intracranial hemorrhage is an important cause of adult death and disability. The optic nerve sheath is surrounded by cerebrospinal fluid. Therefore, the increase in intracranial pressure; causes a diameter change in the optic nerve sheath. In this direction, to determine the changes in optic nerve diameter measurements according to the bleeding subtypes of patients diagnosed with non-traumatic intracranial hemorrhage in the emergency department. Thus, it is aimed to assist in early diagnosis and treatment.Methods: The study is retrospective and includes 136 patients diagnosed with non-traumatic intracranial hemorrhage, who applied to the 3rd level university hospital emergency department between January 01/ 2015 and June 01/ 2017. The parameters of each patient at the time of first admission and at eight hours were checked. These were subtypes of bleeding in brain tomography, amount of bleeding, optic nerve diameter measurements, Glasgow coma scales and demographic characteristics.Results: 136 patients were included in the study. The mean age of the patients was 64.5 ± 17.8 years, 47.1% were female (n=64), 52.9% were male (n=72). Intracranial hemorrhage was 64.7% (n=88), subdural hemorrhage was 29.4% (n=40), and epidural hemorrhage was 5.9% (n=8) (p&amp;lt;0.001). In addition, the patients showed a significant increase in both the right and left optic nerve diameter at the 8th hour (p&amp;lt;0.001). Bleeding diameter increased in parallel with the increase in right and left optic nerve diameter. Similarly, a significant decrease was observed in Glasgow Coma Scales at the 8th hour (13.0 (2)) compared to the first admission (14.0 (1)) (p&amp;lt;0.001).Conclusion: When evaluating brain tomography of patients with nontraumatic intracranial hemorrhage; In addition to the existing parameters, it is recommended to look at the optic nerve diameter change.

Decoding neural activity preceding balance loss during standing with a lower-limb exoskeleton using an interpretable deep learning model

Objective: Falls are a leading cause of death in adults 65 and older. Recent efforts to restore lower-limb function in these populations have seen an increase in the use of wearable robotic systems; however, fall prevention measures in these systems require early detection of balance loss to be effective. Prior studies have investigated whether kinematic variables contain information about an impending fall, but few have examined the potential of using electroencephalography (EEG) as a fall-predicting signal and how the brain responds to avoid a fall. Approach: To address this, we decoded neural activity in a balance perturbation task while wearing an exoskeleton. We acquired EEG, electromyography (EMG), and center of pressure (COP) data from seven healthy participants during mechanical perturbations while standing. The timing of the perturbations was randomized in all trials. Main results: We found perturbation evoked potentials (PEP) components as early as 75–134 ms after the onset of the external perturbation, which preceded both the peak in EMG (∼180 ms) and the COP (∼350 ms). A convolutional neural network trained to predict balance perturbations from single-trial EEG had a mean F-score of 75.0 ± 4.3. Clustering GradCAM-based model explanations demonstrated that the model utilized components in the PEP and was not driven by artifacts. Additionally, dynamic functional connectivity results agreed with model explanations; the nodal connectivity measured using phase difference derivative was higher in the occipital-parietal region in the early stage of perturbations, before shifting to the parietal, motor, and back to the frontal-parietal channels. Continuous-time decoding of COP trajectories from EEG, using a gated recurrent unit model, achieved a mean Pearson’s correlation coefficient of 0.7 ± 0.06. Significance: Overall, our findings suggest that EEG signals contain short-latency neural information related to an impending fall, which may be useful for developing brain-machine interface systems for fall prevention in robotic exoskeletons.

Centers for Disease Control and Prevention Investments in Adverse Childhood Experience Prevention Efforts

Centers for Disease Control and Prevention Investments in Adverse Childhood Experience Prevention Efforts

Probing the potential interactions between two protein vaccine candidates from Nontypeable Haemophilus influenzae

Nontypeable Haemophilus influenzae (NTHi) is the leading cause of AOM (acute otitis media) among children in the US, and NTHi infections contribute to the $6 billion in AOM‐related medical costs each year. NTHi is also a leading cause of COPD (Chronic Obstructive Pulmonary Disease), the third leading cause of death in adults in the US, underlining the need for a vaccine to protect us against NTHi. Two well studied protein vaccine candidates from NTHi are OMP26 and Protein D. In preliminary studies, mice produced a robust antibody response to OMP26 and Protein D when injected individually. However, when both proteins were mixed in a single solution, Protein D antibody production was significantly suppressed. We hypothesized that an interaction between the proteins prevented Protein D’s interaction with immune cells thus suppressing antibody production. Here, we discuss our biochemical approaches to study the potential OMP26‐Protein D interaction, including native mass spectrometry. Preliminary results from those studies suggest OMP26 and Protein D do not form a complex in vitro.

Targeting C-C Chemokine Receptor 5: Key to Opening the Neurorehabilitation Window After Ischemic Stroke.

Stroke is the world’s second major cause of adult death and disability, resulting in the destruction of brain tissue and long-term neurological impairment; induction of neuronal plasticity can promote recovery after stroke. C–C chemokine receptor 5 (CCR5) can direct leukocyte migration and localization and is a co-receptor that can mediate human immunodeficiency virus (HIV) entry into cells. Its role in HIV infection and immune response has been extensively studied. Furthermore, CCR5 is widely expressed in the central nervous system (CNS), is engaged in various physiological activities such as brain development, neuronal differentiation, communication, survival, and learning and memory capabilities, and is also involved in the development of numerous neurological diseases. CCR5 is differentially upregulated in neurons after stroke, and the inhibition of CCR5 in specific regions of the brain promotes motor and cognitive recovery. The mechanism by which CCR5 acts as a therapeutic target to promote neurorehabilitation after stroke has rarely been systematically reported yet. Thus, this review aims to discuss the function of CCR5 in the CNS and the mechanism of its effect on post-stroke recovery by regulating neuroplasticity and the inflammatory response to provide an effective basis for clinical rehabilitation after stroke.

A novel simple traumatic brain injury mouse model

BackgroundTraumatic brain injury, one of the leading causes of death in adults under 40 years of age in the world, is frequently caused by mechanical shock, resulting in diffuse neuronal damage and long-term cognitive dysfunction. Many existing TBI animal models revival with expensive equipment or special room are needed or the processes of operations are complex and not easy to be widely used. Therefore, a simpler TBI model needs to be designed.MethodsOur TBI model is an innovation of the modeling method through air guns shutting rubber bullets. A core facet is the application of our designed rubber bullet impact device. It could focus the hitting power to the fixed site of the brain, thus triggering a mild closed head injury. Moreover, the degree of damage can be adjusted by the times of shots.ResultsOur model induced blood-brain barrier leakage and diffused neuronal damage. Besides, it led to an increased level of Tau phosphorylation and resulted in cognitive dysfunction within several weeks post-injury.ConclusionOur TBI model is not only simple and time-saving but also can simulate mild brain injuries in clinical. It is suitable for exploring pathobiological mechanisms as well as a screening of potential therapies for TBI.

Injury burden in individuals aged 50 years or older in the Eastern Mediterranean region, 1990–2019: a systematic analysis from the Global Burden of Disease Study 2019

SummaryBackgroundInjury poses a major threat to health and longevity in adults aged 50 years or older. The increased life expectancy in the Eastern Mediterranean region warrants a further understanding of the ageing population's inevitable changing health demands and challenges. We aimed to examine injury-related morbidity and mortality among adults aged 50 years or older in 22 Eastern Mediterranean countries.MethodsDrawing on data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we categorised the population into adults aged 50–69 years and adults aged 70 years and older. We examined estimates for transport injuries, self-harm injuries, and unintentional injuries for both age groups, with sex differences reported, and analysed the percentage changes from 1990 to 2019. We reported injury-related mortality rates and disability-adjusted life-years (DALYs). The Socio-demographic Index (SDI) and the Healthcare Access and Quality (HAQ) Index were used to better understand the association of socioeconomic factors and health-care system performance, respectively, with injuries and health status in older people. Healthy life expectancy (HALE) was compared with injury-related deaths and DALYs and to the SDI and HAQ Index to understand the effect of injuries on healthy ageing. Finally, risk factors for injury deaths between 1990 and 2019 were assessed. 95% uncertainty intervals (UIs) are given for all estimates.FindingsEstimated injury mortality rates in the Eastern Mediterranean region exceeded the global rates in 2019, with higher injury mortality rates in males than in females for both age groups. Transport injuries were the leading cause of deaths in adults aged 50–69 years (43·0 [95% UI 31·0–51·8] per 100 000 population) and in adults aged 70 years or older (66·2 [52·5–75·5] per 100 000 population), closely followed by conflict and terrorism for both age groups (10·2 [9·3–11·3] deaths per 100 000 population for 50–69 years and 45·7 [41·5–50·3] deaths per 100 000 population for ≥70 years). The highest annual percentage change in mortality rates due to injury was observed in Afghanistan among people aged 70 years or older (400·4% increase; mortality rate 1109·7 [1017·7–1214·7] per 100 000 population). The leading cause of DALYs was transport injuries for people aged 50–69 years (1798·8 [1394·1–2116·0] per 100 000 population) and unintentional injuries for those aged 70 years or older (2013·2 [1682·2–2408·7] per 100 000 population). The estimates for HALE at 50 years and at 70 years in the Eastern Mediterranean region were lower than global estimates. Eastern Mediterranean countries with the lowest SDIs and HAQ Index values had high prevalence of injury DALYs and ranked the lowest for HALE at 50 years of age and HALE at 70 years. The leading injury mortality risk factors were occupational exposure in people aged 50–69 years and low bone mineral density in those aged 70 years or older.InterpretationInjuries still pose a real threat to people aged 50 years or older living in the Eastern Mediterranean region, mainly due to transport and violence-related injuries. Dedicated efforts should be implemented to devise injury prevention strategies that are appropriate for older adults and cost-effective injury programmes tailored to the needs and resources of local health-care systems, and to curtail injury-associated risk and promote healthy ageing.FundingBill & Melinda Gates Foundation.

Infarto agudo de miocardio: revisión sobre factores de riesgo, etiología, hallazgos angiográficos y desenlaces en pacientes jóvenes

ResumenLa enfermedad cardiovascular persiste como primera causa mundial de muerte en los adultos. La población de adultos jóvenes ha cursado con cambios en el estilo de vida con el paso de las décadas, favoreciendo la aparición de ateroesclerosis en etapas más tempranas y como consecuencia la aparición de eventos cardiovasculares de manera más prematura. Se ha identificado que dentro de los factores de riesgo más comunes, la mayoría de ellos son potencialmente modificables. En comparación con adultos mayores, se ha identificado con mayor prevalencia la presencia de etiologías no ateroescleróticas de infarto de miocardio, como la disección coronaria espontánea, alteraciones anatómicas, embolia y espasmo coronarios. Los hallazgos angiográficos y desenlaces son diferentes de acuerdo con el grupo de edad y el sexo. Por dicho motivo realizamos una búsqueda en PubMed de los estudios y registros publicados para el estudio del infarto agudo de miocardio en paciente jóvenes. Con dicha información realizamos la presente revisión con el objetivo de una mejor comprensión de los hallazgos comunes en este grupo y realizar su comparación con grupos de mayor edad.

Protein interaction networks provide insight into fetal origins of chronic obstructive pulmonary disease

BackgroundChronic obstructive pulmonary disease (COPD) is a leading cause of death in adults that may have origins in early lung development. It is a complex disease, influenced by multiple factors including genetic variants and environmental factors. Maternal smoking during pregnancy may influence the risk for diseases during adulthood, potentially through epigenetic modifications including methylation.MethodsIn this work, we explore the fetal origins of COPD by utilizing lung DNA methylation marks associated with in utero smoke (IUS) exposure, and evaluate the network relationships between methylomic and transcriptomic signatures associated with adult lung tissue from former smokers with and without COPD. To identify potential pathobiological mechanisms that may link fetal lung, smoke exposure and adult lung disease, we study the interactions (physical and functional) of identified genes using protein–protein interaction networks.ResultsWe build IUS-exposure and COPD modules, which identify connected subnetworks linking fetal lung smoke exposure to adult COPD. Studying the relationships and connectivity among the different modules for fetal smoke exposure and adult COPD, we identify enriched pathways, including the AGE-RAGE and focal adhesion pathways.ConclusionsThe modules identified in our analysis add new and potentially important insights to understanding the early life molecular perturbations related to the pathogenesis of COPD. We identify AGE-RAGE and focal adhesion as two biologically plausible pathways that may reveal lung developmental contributions to COPD. We were not only able to identify meaningful modules but were also able to study interconnections between smoke exposure and lung disease, augmenting our knowledge about the fetal origins of COPD.

Modifying a cognitive behavioral suicide prevention treatment for adults with schizophrenia spectrum disorders in community mental health

Suicide is among the leading causes of death for adults with schizophrenia spectrum disorders. Given a paucity of evidence-based interventions tailored for psychosis, we sought to modify a promising Cognitive-Behavioral Suicide Prevention for psychosis (CBSPp) treatment for adults in US community mental health (CMH) settings using community-based participatory research methods. This article presents our modification methodology, stakeholder data and scholarly expert input, and CBSPp adaptations prior to future intervention testing. Stakeholder data (n = 25) were collected from clients, providers, and peer advocates in a CMH setting in Michigan. Findings were subsequently presented to a panel of scholarly experts in the fields of suicide and psychosis research, intervention research, and implementation science for input. Emerging themes from stakeholders include logistic, perceptual, and clinical challenges in the process of introducing this treatment in a CMH setting. Consistent with literature, buy-in and support for the delivery of a new treatment emerged as important factors in modifying and implementing CBSPp. A final modification list is presented in this paper and collaborations among stakeholders, researchers, and scholarly experts are essential to navigate psychosocial treatment innovation barriers with an overall goal of improving access, feasibility, and quality of this suicide prevention treatment.

The effects of Kaatsu training on an acute angiogenic response in post-interventional rehabilitation of peripheral arterial disease patients

Abstract Funding Acknowledgements Type of funding sources: None. Background Atherosclerosis as the main cause of death in adults is one of the greatest challenges of modern medicine. Peripheral arterial disease (PAD) is a condition with worldwide increasing occurrence affecting more than 20% of Europeans and North Americans in the age group&amp;gt; 55 years, and in the group&amp;gt; 70 years of age affects as much as 60% of the population. Among many treatment forms the endovascular treatment remains the most common treatment method, however the most non-invasive, but still effective is rehabilitation by physical training. Recently, innovative solutions have been introduced concerning this form of treatment by combining anaerobic interval exercises with venous blood flow restriction (BFR) and cooling. Purpose The aim of the research is to evaluate the endothelial and angiogenic response to the aforementioned type of exercise. Methods Study was divided into 2 stages: with healthy volunteers and non-CLI patients. 35 healthy volunteers were enrolled into the 1st stage. They performed a 21-minute interval training using a cross trainer with cooling liquid pressure cuffs (arms: 40 mmHg; legs: 65 mmHg) providing vein occlusion and cooling seat. Angiogenic processes and endothelial functions were monitored by laboratory parameters - vascular endothelial growth factor (VEGF), clusters of differentiation (CD31, CD34) as well as imaging examinations – flow mediated dilatation (FMD), stiffness index (SI), reflexion index (RI), reactive hyperaemia index (RHI) and augmentation index (AI). All measurements were performed before, as well as 20 to 30 minutes after the training. Results All of the laboratory parameters were significantly elevated after the BFRT- CD34 (ΔCD34: 0.13 vs 0.01 p &amp;lt; 0,001), CD31 (ΔCD31: 1.11 vs 0.37 p &amp;lt; 0,001) and VEGFR (ΔVEGFR: 6.35 vs 2.86 p &amp;lt; 0.001).Only FMD and RI of all endothelial imaging parametrs significantly changed after BFRT compared to regular training (FMD: 8.9% vs 7.41 p &amp;lt; 0,001 ΔFMD: 2.89 vs 1.33 p &amp;lt; 0,01; RI: 63.43 vs 69.49 p &amp;lt; 0,001, ΔRI: 4.0 vs 2.0, p &amp;gt; 0,001). RHI and AI weren’t significantly influenced by any exercise type. Conclusions BFR training successfully stimulates acute angiogenic response and moderately influences certain endothelial functions. This 1st stage results are being now implemented into the 2nd part of project involving PAD patients.

A laboratory and simulation platform to integrate individual life history traits and population dynamics.

Understanding populations is important because they are a fundamental level of biological organization. Individual traits such as aging and lifespan interact in complex ways to determine birth and death and thereby influence population dynamics. However, we lack a deep understanding of the relationships between individual traits and population dynamics. To address this challenge, we established a laboratory population using the model organism C. elegans and an individual-based computational simulation informed by measurements of real worms. The simulation realistically models individual worms and the behavior of the laboratory population. To elucidate the role of aging in population dynamics, we analyzed old age as a cause of death and showed, using computer simulations, that it was influenced by maximum lifespan, rate of adult culling, and progeny number/food stability. Notably, populations displayed a tipping point for aging as the primary cause of adult death. Our work establishes a conceptual framework that could be used for better understanding why certain animals die of old age in the wild.