Changes In Status Research Articles

Paraneoplastic neurological syndrome and its impact on the treatment outcomes of small-cell lung cancer: A single-center retrospective analysis.

Paraneoplastic neurological syndrome (PNS) is associated with small-cell lung cancer (SCLC). However, the frequency and characteristics of PNS and the efficacy of anticancer treatment for these patients have not been investigated in the Japanese/Asian population previously. Therefore, we aimed to better understand PNS by evaluating real-world data from patients with PNS complicated by SCLC. Patients diagnosed with Stage II-IV SCLC at a single center between August 2007 and April 2021 were retrospectively analyzed. The primary outcome was the incidence of PNS. The secondary outcomes were the change in performance status (PS) after treatment commencement and outcomes following anticancer treatment, including objective response rate (ORR), progression-free survival (PFS), and overall survival (OS). A total of 318 patients were evaluated; PNS was present in 2.8% (n = 9) of the overall population. All patients with PNS exhibited poor Eastern Cooperative Oncology Group PS (≥2); moreover, 78% of patients had a PS score of 3-4. An improvement in PS was observed in 56% (n = 5) of patients. Patients with PNS exhibited treatment efficacies similar to patients without PNS (ORR: 89% vs. 83%, p = 1.0; PFS: 7.6 vs. 5.7 months, p = 0.69; OS: not reached vs. 15.6 months, p = 0.23). A total of 2.8% of patients had SCLC complicated by PNS, with poor PS observed. However, anticancer therapy led to an improvement in PS and comparable ORR, as well as PFS and OS similar to those observed in patients without PNS. Thus, anticancer therapy should be considered in patients with PNS.

Perceiving Low Social Mobility Induces Zero-Sum Beliefs About Social Hierarchies.

Individuals may consider socioeconomic status (SES) change from an absolute or relative standpoint. Across five studies and supplementary analyses of secondary data, we found that individuals who perceive SES as being unlikely to change (i.e., low perceived social mobility) tend to consider SES change from a relative standpoint-i.e., one person's gain in SES occurs at the expense of another's loss in SES-reflecting that they harbor zero-sum beliefs regarding social hierarchies. In other words, the extent to which individuals believe that society is mobile predicts how they consider the nature of social mobility. This relationship is mediated by a scarcity mindset and further predicts the tendency for aggression. The findings held when we controlled for variables such as perceived economic inequality, income, and education.

The spatiotemporal evolution characteristics and influencing factors of habitat quality in the typical region of the Lunan Economic Belt: a case study of Donggang District, Rizhao.

Habitat quality is a key indicator for evaluating the biodiversity of a region. This study aims to assess the current status and characteristic changes of habitat quality in Donggang District, Rizhao while analyzing the potential factors influencing the quality of the habitat. The study employed the Integrated Valuation of Ecosystem Services and Tradeoffs Habitat Quality (InVEST-HQ) mode to assess the spatiotemporal variations in habitat quality in the Donggang District from 2008 to 2022. GeoDetector was utilized to investigate the impact of various factors on the spatial differentiation characteristics of habitat quality. The potential correlation between economic development and habitat quality was further explored using the Spearman correlation coefficient and Grayscale Association Analysis. The results reveal that habitat quality in Donggang District is highest in the east and lowest in the west, with significant correlations to land use and vegetation coverage. The study highlights a decline in habitat quality over the period, linked to rapid economic growth and industrial expansion. These insights are crucial for balancing urban biodiversity with economic development.

Plasma and serum volume remain unchanged following a 12-h fast from food and drink despite changes in blood and urinary hydration markers.

The effect of mild dehydration on plasma and serum volume has not been well established. Furthermore, the ability of urinary and blood biomarkers to monitor small hydration changes have not been solidified. There were two objectives of this research: 1. Determine if mild dehydration affects plasma and serum volume; 2. Determine if mild dehydration can be detected better by urinary or blood biomarkers. 47 subjects were recruited; 10 subjects were removed from the study and 37 subjects (27% male) completed the study. This was a crossover study design such that each subject underwent all protocols in a counterbalanced order. Protocols consisted of 12-h dehydration, 12-h hydration, and control. Neither plasma volume (p = 0.914), plasma volume status (p = 0.649), nor serum volume (p = 0.273) were different among protocols. Body mass (p < 0.001) was lower following the dehydration protocol. Urine color (p < 0.001), urine osmolality (p < 0.001), urine specific gravity (p < 0.001), serum osmolality (p < 0.001), and plasma osmolality (p < 0.001) were all lower following the hydration protocol. Hematocrit (p = 0.842) and hemoglobin concentration (p = 0.558) were not different among protocols. Dehydration did not affect plasma or serum volume. Therefore, a 12-h fast from food and water as done in this study will not likely affect laboratory test results of biomarker concentration. All 3 urinary measures were able to detect changes in hydration status, whereas only 2 blood measures were able to detect changes in hydration status. This may indicate that urinary measures are best at detecting small changes in hydration status.

Understanding characteristics and trajectories of patients experiencing early death after interhospital transfer.

Twenty- to fifty-thousand patients die annually within 72 h of interhospital transfer (early death after transfer; EDAT). The characteristics and trajectories of these patients are ill-defined. In this retrospective cohort study, we characterized EDAT at three representative major referral centers. Primary outcomes included the presence and timing of goals of care (GOC) and/or prognostic discussions. Among 190 medical patients experiencing EDAT, 95 (50.0%) were >65 years, 115 (60.5%) male, and 137 (72.6%) White; 140 (73.7%) patients traveled >50 miles from home, and 174 (91.6%) were referred for specialty care. Whereas GOC were documented pretransfer for 40 patients (21.1%) and unknown for 97 patients (51%); 152 (80.0%) had posttransfer discussions, often within 24 h of death (125; 82.2%). Transfer >50 miles was associated with death ≤24 h after transfer and with posttransfer changes in code status. Further research is needed to evaluate disparities and describe the potential burdens of transfer at end-of-life. Infrequent pretransfer discussions of GOC suggest potential targets for improvement.

Updating assembly parameters for spacecraft assembly process state changes: based on data fusion method

Thermal protection systems (TPSs) are important components of reusable spacecraft, and their assembly quality has a crucial impact on flight safety. Owing to the complex assembly process and variable states of spacecraft thermal protection systems, assembly parameters may vary under different assembly states. Therefore, to obtain assembly parameters accurately and efficiently under different assembly states, in this study, 3D point cloud data and fiber optic sensor data were fused to develop an assembly parameter update method for assembly process state changes. Firstly, based on the measured data of thermal protection components and load-bearing structure, the gap, flush and matching parameters solution model are proposed. Secondly, to address the deformation problem of the load-bearing structure caused by changes in assembly status, a fusion method based on laser scanning and sensor detection was devised to achieve deformation prediction of the assembly structure during the assembly process. Thirdly, based on the assembly parameter solution model and point cloud prediction model, a constraint-based assembly parameter optimisation model was established, and an improved quantum particle swarm optimisation (LQPSO) algorithm was employed to achieve assembly parameter updates oriented toward changes in assembly status. Finally, an experimental system for array-based thermal protection structure simulation was established to validate the proposed method. The results show that the proposed parameter update method can achieve ideal results for different assembly state simulation components.

Sex-specific socioeconomic risk factors for spontaneous subarachnoid hemorrhage-a case-control study during the 5 years before ictus.

There is a difference in the incidence of spontaneous subarachnoid hemorrhage (SAH) between sexes, with the majority of cases occurring in female patients. Although this phenomenon has been studied from a medical perspective, the reasons for the predominance of female cases are still unclear. Non-medical factors, such as a patient's socioeconomic situation, can differ between female and male patients, with health implications. The aim of the study was to identify socioeconomic profiles for both sexes that may be vulnerable to developing SAH. This information could potentially be used for active preventive health efforts. This study was based on a 7-year consecutive cohort of 890 patients with SAH treated at Uppsala University Hospital, along with a sex- and age-matched 5:1 control group from Statistics Sweden. The collected information included demographic data, income that was analyzed through "earnings" (EAs), which is defined as the sum of income and other economic compensations related to work, and "disposable income" (DI), which is the net amount that an individual can use. Pension and sickness-related absence from work were measured using early pension (EP), old age pension (OAP), sickness absence (SA), and disability pension (DP). Univariate and multivariate analyses were used. Among the women, the socioeconomic risk profile for SAH included lower education, unemployment, being registered as living single, residing in a sparsely populated municipality, and increased age. For the men, the risk profile included residing in a sparsely populated municipality and changes in civil status. Both women and men with SAH had lower EAs and DI compared to the controls. Notably, a significantly higher proportion of the women with SAH received DP compared to the controls. Residing in a sparsely populated area was associated with an increased risk for SAH for both women and men. The women with SAH were more economically vulnerable, whereas the men faced a different type of vulnerability related to changes in civil status. We suggest that healthcare organizations use this information to identify individuals at risk and actively implement preventive measures according to stroke guidelines for both groups.

Oral Health Status at Age 60 and 72 Years-A Longitudinal Study.

This study investigated oral health status in 60-year-old individuals over 12 years. Data were obtained from The Swedish National Study on Aging and Care (SNAC). One hundred nineteen 60-year-old individuals (48% females) underwent a clinical and radiographic baseline examination (2001-2003) and follow-up examination in 2013-2015. For statistical analyses, paired t-tests and McNemar's test were performed. Statistical significance was determined at p < 0.05. At the 12-year follow-up, the mean number of teeth and the proportion of individuals having ≥ 20 teeth decreased (p < 0.001). The mean number of teeth with buccal/lingual and approximal caries lesions increased (p < 0.029 and p < 0.031). Individuals with a distance from the cement-enamel junction to the bone of ≥ 5 mm increased in total (p < 0.002) and in males (p < 0.006). The prevalence of gingivitis increased in total (p < 0.001). The prevalence of periodontitis showed a significant increase in total (p < 0.043) and in females (p < 0.039). The present study indicates that oral health status in 60-year-old individuals deteriorates over 12 years. However, the deteriorations were minor in terms of tooth loss, caries lesions, and changes in periodontal status.

The impact of Scotland's minimum unit pricing for alcohol policy on people accessing services for alcohol dependence: A difference-in-difference structured interview study.

A minimum unit price (MUP) for alcohol of £0.50 per unit (1 UK unit = 10 mL/8 g alcohol) was introduced in Scotland in May 2018. Few previous studies have examined the impact of alcohol pricing policies on people who are alcohol dependent. This study aimed to evaluate the effect of MUP on people who are alcohol dependent including changes in alcohol consumption and health status, as well as potential unintended consequences. Three waves of cross-sectional data were collected in Scotland (intervention) and Northern England (control) at 0-6 months pre-implementation then 3-9 months and 18-22 months post-implementation. The sample was N = 706 people receiving treatment related to their alcohol use. We collected structured interview data including recent drinking information via a 7-day timeline-follow-back drinking diary. Difference-in-difference analyses estimated change in indicators in Scotland compared to England at both post-implementation timepoints. The proportion of participants consuming alcohol costing on average <£0.50 per unit in Scotland decreased from 60.6% at 0-6 months prior to MUP implementation to 6.3% at 3-9 months post-implementation (p < 0.0004). There was no significant change in the indicators for alcohol consumption, severity of dependence, health status, other substance use, deprivation level or parenting. The introduction of MUP in Scotland was associated with increases in the prices paid for alcohol by people with dependence and presenting to treatment services. There was no evidence of changes in their alcohol consumption or health status. There was also no evidence of harmful unintended consequences for this population.

Differential Longitudinal Associations Between Depressive Symptoms and Cognitive Status by Living Situation in Older Adults.

This study explores whether living situation modifies longitudinal associations between depressive symptoms and changes in cognitive status across ten years in generally healthy, community-dwelling older adults. Participants (N = 687, Mage = 73.92years) from the no-contact control condition of a multisite longitudinal study completed the Mini-Mental State Examination, Center for Epidemiological Studies Depression scale, and self-reported living situation. Multilevel models revealed that for older adults living alone, having clinically meaningful depressive symptoms was associated with greater decline in MMSE over ten years. However, reporting clinically meaningful depressive symptoms was not associated with decline in MMSE for adults who were living with others. These results suggest that living situation may be a modifying factor of cognitive change over time for older adults with clinically meaningful depressive symptoms. This highlights the need for targeted interventions for adults who may be at a greater risk of cognitive decline across older adulthood.

Deficit Irrigation Regime Improves Phytosanitary Status of Cultivar Arbosana Grown in a Super High-Density Olive Orchard

Super high-density (SHD) planting systems are very efficient in terms of production and water use. In these orchards, water-saving irrigation strategies are used precisely to keep the best sustainability compared to traditional orchards. With agro-climatic and eco-physiological parameter monitoring, the SHD planting system has become even more efficient. SHD orchards, however, could also be more so affected by other pests and diseases than traditional systems, but field responses are still unknown when olive trees are grown in SHD groves. The goal of this two-year field research was to investigate the seasonal changes of the phytosanitary status of ‘Arbosana’ grown in an SHD orchard under both regulated deficit (RDI) and full irrigation regimes (FI). This study investigated the influence of the two different irrigation regimes on the infections of three olive tree key diseases: cercosporiosis (Pseudocercospora cladosporioides), cycloconium (Fusicladium oleagineum), and olive knot (Pseudomonas savastanoi pv. savastanoi). RDI significantly reduced the severity of cercosporiosis in 2020 compared to FI but not in 2021. Cycloconium was observed only as a latent infection during the two studied years and olive knot was not influenced by irrigation but only by weather conditions. These findings suggest that irrigation management can play a key role in controlling cercosporiosis effectively in SHD olive orchards, but also that weather conditions have an even higher impact on the tree key diseases.

Health status assessment of pump station units based on spatio-temporal fusion and uncertainty information

An effective health status assessment (HSA) for pump station units (PSUs) is crucial for accurately determining their real status and providing technical support for safe operational decisions. Due to the limitations of existing data-driven HSA methods, which primarily focus on the temporal dependencies of monitoring signals and fail to explore the complex interconnections among signals comprehensively. Moreover, when constructing performance degradation indices based on linear differences, these methods do not effectively integrate heterogeneous signals, resulting in an incomplete and inaccurate assessment of the overall system degradation. This paper proposes a real-time comprehensive HSA method for PSUs based on multi-source heterogeneous uncertainty information. Initially, a health benchmark model (HBM) is built using CrossGNN, which possesses cross-scale and cross-variable interaction capabilities, to precisely capture the temporal dependencies and dynamic relationships among variables in monitoring signals. Subsequently, key measurement points that reflect the operational status of the PSUs are identified through correlation analysis to establish multi-source evaluation indices. Then, considering the uncertainty in signal changes, a novel health degradation index (HDI) is developed using Mahalanobis distance (MD) and the Gaussian Cloud Model (GCM) to analyze changes in unit status. Furthermore, a weighting calculation method based on the non-dominated sorting genetic algorithm (NSGA-II) is proposed to establish a real-time comprehensive health index (RCHDI) for a thorough assessment of PSUs status. Finally, the effectiveness of the proposed method is validated through a case study using data from a pump station in the South-to-North Water Diversion Project in China. The results show that, compared to other studies, the proposed method significantly improves the stability and smoothness of the state assessment curve, with increases of 21.5% and 47.1% respectively, providing a new perspective for comprehensively assessing the health status of PSUs.V

Technical Approaches for Coil Embolization of Unruptured Small Anterior Choroidal Artery Aneurysms: A Focus on Anatomical Flow Preservation of the Anterior Choroidal Artery.

The anterior choroidal artery (AChA) supplies the corticospinal tract related to the motor function of the upper and lower limbs. Aneurysms arising at the AChA are not common and exhibit various patterns of involvement of the AChA. Hence, managing an AChA aneurysm poses a high risk of neurological deficits. We report technical issues related to the outcome of coil embolization for unruptured AChA aneurysms. We obtained Institutional Review Board approval for this study. In the past 2 years, 18 consecutive patients (6 males and 12 females, aged 32-68) with unruptured AChA aneurysms were treated using embolization. We present technical details, pre- and post-procedural patient statuses, angiographic outcomes, and recurrence during a mean follow-up period of 12 months (range 3-25). The patients with AChA (n=18) underwent stent-assisted coiling (n=14), coiling (n=2), or stenting only (n=2). The technical strategy for aneurysm embolization included a low-lying approach into the aneurysm, stent-strut abutting (protecting) coil framing to block inflow and avoid compromising AChA flow, and direct intra-aneurysmal angiography via a microcatheter. Angiographic results showed complete occlusion (n=11), neck remnant (n=5), and sac remnant (n=2). During the follow-up, there were 2 recurrences, and 1 of them required a re-procedure. All patients showed no change in clinical status (modified Rankin scale score=0) and did not experience any ischemic or hemorrhagic events during the follow-up period. AChA aneurysms can be managed through embolization using various techniques. Such technical concepts may enhance the safety and improve the outcomes of AChA aneurysm embolization.

Laboratory medicine and sports: where are we now?

Laboratory medicine in sport and exercise has significantly developed during the last decades with the awareness that physical activity contributes to improved health status, and is present in monitoring both professional and recreational athletes. Training and competitions can modify concentrations of a variety of laboratory parameters, so the accurate laboratory data interpretation includes controlled and known preanalytical and analytical variables to prevent misleading interpretations. The paper represents a comprehensive summary of the lectures presented during the 35th Annual Symposium of the Croatian Society of Medical Biochemistry and Laboratory Medicine. It describes management of frequent sport injuries and sums up current knowledge of selected areas in laboratory medicine and sports including biological variation, changes in biochemical parameters and glycemic status. Additionally, the paper polemicizes sex hormone disorders in sports, encourages and comments research in recreational sports and laboratory medicine. In order to give the wider view, the connection of legal training protocols as well as monitoring prohibited substances in training is also considered through the eyes of laboratory medicine.

Event-free survival in neuroblastoma with MYCN amplification and deletion of 1p or 11q may be associated with altered immune status

BackgroundNeuroblastoma exhibits substantial heterogeneity, which is intricately linked to various genetic alterations. We aimed to explore immune status in the peripheral blood and prognosis of patients with neuroblastoma with different genetic characteristics.MethodsWe enrolled 31 patients with neuroblastoma and collected samples to detect three genetic characteristics. Peripheral blood samples were tested for immune cells and cytokines by fluorescent microspheres conjugated with antibodies and flow cytometry. Event-free survival (EFS) was analyzed using the Kaplan‒Meier method.ResultsTwenty-two patients had genetic aberrations, including MYCN amplification in 6 patients, chromosome 1p deletion in 9 patients, and chromosome 11q deletion in 14 patients. Two genetic alterations were present in seven patients. The EFS was worse in patients with MYCN amplification or 1p deletion than in the corresponding group, whereas 11q deletion was a prognostic factor only in patients with unamplified MYCN. Changes in immune status revealed a decrease in the proportion of T cells in blood, and an increase in regulatory T cells and immunosuppression-related cytokines such as interleukin (IL)-10. The EFS of the IL-10 high-level group was lower than that of the low-level group. Patients with concomitant genetic alterations and a high level of IL-10 had worse EFS than other patients.ConclusionsPatients with neuroblastoma characterized by these genetic characteristics often have suppressed T cell response and an overabundance of immunosuppressive cells and cytokines in the peripheral blood. This imbalance is significantly associated with poor EFS. Moreover, if these patients show an elevated levels of immunosuppressive cytokines such as IL-10, the prognosis will be worse.

Changes in work status after cancer diagnosis and their associations with depressive symptoms among cancer survivors: findings from the Korean longitudinal study of ageing1

PurposeCancer survivors encounter significant psychological suffering and are prone to develop depressive symptoms. Work contributes to personal fulfillment and social connections, and by doing so, enhances a cancer survivor’s resilience against adversities. However, maintaining employment can be challenging for some cancer survivors. This research aimed to identify the association between changes in work status and depressive symptoms among cancer survivors in South Korea.MethodsThis study used the panel data from the Korean Longitudinal Study of Ageing (KLoSA) and included 199 cancer survivors–799 observations–aged 65 or younger, between 2005 and 2018. Changes in work status consisted of continuous unemployment or employment, quitting a job, and getting a job. We defined depressive symptoms as a CES-D-10 score of 10 or higher and a cut-off of 4 was utilized for sensitivity analysis. Multivariable generalized estimating equation was employed to estimate the odds ratio (OR), adjusting for the number of household members, education level, sex, age, marital status, occupations, cancer treatment, cancer type, catastrophic healthcare expenditure (CHE), and survivorship. Subgroup analysis and interaction between changes in work and cancer types were further explored.ResultsFor depressive symptoms, the OR of the continuous unemployment group was 2.27 (95% CI = 1.10–4.69), and the OR of the group that quit a job was 2.20 (95% CI = 1.03–4.72), compared to the continuous employment group. As survivorship increased, the odds of depressive symptoms decreased (OR = 0.94, 95% CI = 0.89–1.00). CHE was associated with depressive symptoms (OR = 2.23, 95% CI = 1.18–4.20). In cancer types with a low tendency to depression, continuous unemployment was associated with depressive symptoms (OR = 3.19, 95% CI = 1.12–9.06). In sensitivity analysis, changes in work, survivorship, and CHE were consistently associated with depressive symptoms.ConclusionsCancer survivors who quit a job or continued unemployment were more likely to experience depressive symptoms. The findings of this study imply that assistance for cancer survivors to continue a job or return to employment, including adjustment of workload and hours, may be helpful. Psychological care may be crucial, particularly in the early stage of cancer survivorship. Furthermore, support may be needed to alleviate the burden of healthcare expenditure.

Effect of gut microbiota intervention on inflammatory responses and cellular immune function in hepatocellular carcinoma patients undergoing radiotherapy

ObjectiveTo analyze the changes in nutritional status, inflammatory response and cellular immune status of Hepatocellular Carcinoma (HCC) patients who received radiotherapy under GMB intervention and to clarify the effect of GMB intervention on HCC. MethodsNinety-two patients with HCC receiving radiotherapy were randomized into study and observation groups, 46 in each group. The control group used conventional radiotherapy, and the study group used the gut microbiota intervention. The gut microbiota before and after radiotherapy, and the liver function, clinical efficacy, inflammatory response, cellular immunity, and nutritional status before and after treatment were compared. ResultsCompared with the control group, the number of lactobacillus and Bifidobacterium increased significantly, the clinical efficacy was significantly enhanced, the liver function, cellular immunity and nutritional status were significantly improved, and the inflammatory response was significantly reduced, with statistically significant differences (P < 0.05). Conclusiongut microbiota intervention can improve the effect of radiotherapy and improve liver function in patients, and the mechanism is related to regulating cellular immune function of patients and inhibiting inflammatory response in patients.

Proteomics Reveals Divergent Cardiac Inflammatory and Metabolic Responses After Inhalation of Ambient Particulate Matter With or Without Ozone.

Inhalation of ambient particulate matter (PM) and ozone (O3) has been associated with increased cardiovascular morbidity and mortality. However, the interactive effects of PM and O3 on cardiac dysfunction and disease have not been thoroughly examined, especially at a proteomic level. The purpose of this study was to identify and compare proteome changes in spontaneously hypertensive (SH) rats co-exposed to concentrated ambient particulates (CAPs) and O3, with a focus on investigating inflammatory and metabolic pathways, which are the two major ones implicated in the pathophysiology of cardiac dysfunction. For this, we measured and compared changes in expression status of 9 critical pro- and anti-inflammatory cytokines using multiplexed ELISA and 450 metabolic proteins involved in ATP production, oxidative phosphorylation, cytoskeletal organization, and stress response using two-dimensional electrophoresis (2-DE) and mass spectrometry (MS) in cardiac tissue of SH rats exposed to CAPs alone, O3 alone, and CAPs + O3. Proteomic expression profiling revealed that CAPs alone, O3 alone, and CAPs + O3 differentially altered protein expression patterns, and utilized divergent mechanisms to affect inflammatory and metabolic pathways and responses. Ingenuity Pathway Analysis (IPA) of the proteomic data demonstrated that the metabolic protein network centered by gap junction alpha-1 protein (GJA 1) was interconnected with the inflammatory cytokine network centered by nuclear factor kappa beta (NF-kB) potentially suggesting inflammation-induced alterations in metabolic pathways, or vice versa, collectively contributing to the development of cardiac dysfunction in response to CAPs and O3 exposure. These findings may enhance understanding of the pathophysiology of cardiac dysfunction induced by air pollution and provide testable hypotheses regarding mechanisms of action.

Changes in depression symptoms over 10 years after TBI; a long-term prospective study

ABSTRACT Objective Evaluate the prevalence and risk factors associated with depression symptoms at 10 years after traumatic brain injury (TBI) and compare with results at 10 weeks and 1 year. Methods A large cohort of prospective admissions with TBI were followed up for 10 years. Depression using HADS (Hospital Anxiety and Depression Scale) score > 8 was measured. Several injury and demographic features were examined for association with depression. Results Over 4 years, 1130 individuals were recruited of whom 916 attended at 1 year; after 10 years, 552 attended and 210 had died. 154 (17%) of the cohort was lost to follow-up. The prevalence of depression at 10 weeks was 56.3% [95%CI 52.2–60.5], at 1 year was 42.4% [95%CI 38.3–46.5] and 10 years 38.4% [95%CI 34.3–42.5]. There was considerable change in individual scores over time in both directions. A multivariable analysis identified the independent predictors of 10-year depression score as lower GCS, social deprivation, female gender, past psychiatric history, alcohol intoxication and unemployment. Age, ethnicity, social support, TBI etiology, CT abnormality and medical comorbidity were insignificant. Conclusions While the overall level of symptoms at 10-year post-TBI remains high, there is considerable change in individual depression status over time. The predictors identified may allow the targeting of vulnerable sub-populations.

Genetic Variation and Metabolic Basis of Kidney Cancer: New Opportunities for Targeted Therapy

Renal cell carcinoma (RCC) has previously been considered as a single disease. However, it is currently characterized as a heterogeneous group of tumors that differ in histological features, genetic abnormalities, and variable clinical course. In normal cells, energy is produced by the cleavage of chemical bonds in nutrients through the oxidation of fats, proteins, or carbohydrates. Mutational alterations in genes associated with RCC, including VHL, FLCN, PTEN and SDH, lead to abnormal cellular adaptation to changes in oxygen status, iron metabolism and nutrients. The present paper reviews the known genetic abnormalities observed in RCC and their impact on metabolic alterations. Understanding the genetic and metabolic mechanisms underlying RCC is crucial for the development of effective therapies. Targeting specific genetic abnormalities or metabolic pathways represents a promising approach to the RCC treatment. In addition, studies into the metabolic basis of RCC contribute to the development of new biomarkers for early diagnosis and monitoring of the disease. Moreover, investigating the role of VHL, FLCN, PTEN, and SDH genes in the development of RCC provides valuable information on the molecular mechanisms behind the disease. As a result, it may lead to the development of new treatment strategies aimed at restoring the normal function of these genes or compensating for their abnormalities. Overall, an integrated approach to the study of RCC that considers genetic, metabolic, and clinical aspects will ensure that more effective treatments are developed and prognosis for patients with this disease are improved.