MI Effect Research Articles

Effectiveness of Motivational Interviewing to Facilitate Behavioral Change among Community Health Workers at Kaiwara – An interventional study

Aims: To assess effectiveness of MI to facilitate behavioral change among community health workers at Kaiwara. Settings and Design: Randomized Controlled Trial was conducted among health workers of Primary Health Centre area with 40 subjects in two groups. Materials and Methods: A validated questionnaire was used to collect data regarding their demographics and for pre and post assessment of study participants. Principal Investigator (PI), as trained MI Interventionist conducted the MI sessions among study group (MI Group) and delivered conventional Health Education (HE) among control group (HE group). Statistical Analysis Used: Intervention outcome at first, second and third month were Repeated Measure ANOVA, Paired t test and Unpaired t test. Results: The present study showed there was improvement in the mean score in MI and HE groups from baseline to follow up which was statistically significant (P<0.001). At baseline there was no statistically significant difference in mean scores between MI and HE groups (P>0.05). Conclusions: The present study showed MI to be an effective approach to facilitate behavioral change among health workers to incorporate oral health information in their general health promoting activities as compared to conventional HE method.

MCKIBBIN INDEX AND FEMORAL VERSION NOT PREDICTIVE OF IHOT12 CHANGE AT TWO YEARS IN PATIENTS UNDERGOING ISOLATED PERIACETABULAR OSTEOTOMY

Adult hip dysplasia AHD is a complex 3D pathology of lateral coverage, version and/or volume and is often associated with increased femoral anteversion. The Mckibbin index MI is the combination of acetabular version AV and femoral version FV and is used as a measure of anterior hip Stability/ Impingement(1). The Bernese Periacetabular osteotomy PAO is a powerful tool in treating AHD, but it does not address FV. De-rotational femoral osteotomies FO increases risk of complications, operative time and might condemn the patient to Secondary osteotomies to balance the gait. We aim to investigate the effect of MI and FV on PROMs in patients undergoing PAO only.593 PAOs identified on the Local Hip preservation registry between 01/2013 and 7/2023. PAOs for retroversion, residual Perthes and those combined with FO were excluded. Patients with no available PROMS at 2 years were excluded. Independent variables were collected from E-notes and imaging including MI and FV. A multiple linear regression analysis was performed against preoperative iHot12, and iHot12 change at 2years.The mean FV was 18.86± 12.4 SD. Mean MI was 36.07, SD 15.36. Mean preop iHot12 score was 29.83 ± 17.38 SD. Mean change in iHot12 at 2 years was+36.47 ± 28.44 SD. Females and a higher BMI were statistically correlated to a lower preoperative iHot12. A lower preop iHot12 score and a higher preop AI were correlated to a bigger change in iHot12 at 2years with statistical significance. MI and FV were not found to have a statistically significant correlation with Outcome measures,An increased Mckibbin index and femoral anteversion were not correlated with worse outcomes at two years. PAO alone in the presence of increased femoral anteversion avoids risks associated with FO which can be performed later if required.

The Effect of GSI and mi on the Stability of 3D Twin Tunnel in Limestone

The Generalised Hoek-Brown (GHB) failure criterion is one of the most used criteria to study the behaviour of the rocks; affected parameters of the Hoek-Brown equation are Geological Strength Index (GSI), intact rock constant (mi), and Disturbance factor (D). GSI is one of the rock classification systems used to evaluate jointed rocks. In light of this equation, this paper studies the stability of unsupported twin tunnels in a weak rock by changing the mentioned parameters (GSI, mi) to find the relation between the stability and these parameters under different distances between the centres of the tunnels (L). The tunnels have a circular cross-section with a diameter (B), and they have been modelled in three dimensions using Rocscience software package (RS3). The results showed that the stability of the tunnels, which was represented by the strength reduction factor (SRF), increased as a result of increasing L/B or GSI in the studied range; for mi , the modelling results showed that the SRF value increased while mi value was increased.

Evaluation of Enamel Surfaces Treated with a Desensitizing Agent Containing CPP-ACP Before or After In-Office Bleaching.

To evaluate the effects of desensitizing MI Varnish (GC America) applied before or after bleaching on the mineral component of enamel and surface topography. The coronal portions of 10 freshly extracted bovine teeth were segmented for a total of 40 specimens. Enamel specimens obtained from each tooth were randomly divided into four groups (n = 10): Group A = no bleaching; Group B = bleaching with 40% hydrogen peroxide (HP); Group C = MI Varnish applied before bleaching; and Group D = MI Varnish applied after bleaching. The calcium (Ca) and phosphorus (P) levels of the specimens in each group were determined by energy dispersive spectroscopy (EDS). Morphologic changes were observed using scanning electron microscopy (SEM). One-way ANOVA and Tukey HSD tests were used for statistical analyses (α = .05). The mean Ca content of Group B was significantly lower than those of Groups A, C, and D (P < .05). The mean Ca content of Group C was significantly lower than that of Group A (P < .05). There was no significant difference in Ca content between the other groups (P > .05). The mean P content of Group A was significantly higher than those of Groups B to D (P < .05). There was no significant difference in P content between Groups B to D (P > .05). Application of MI Varnish before or after in-office bleaching was effective in reducing mineral loss. However, applying MI Varnish after bleaching was more effective.

Tetrahydrocurcumin ameliorates postinfarction cardiac dysfunction and remodeling by inhibiting oxidative stress and preserving mitochondrial function via SIRT3 signaling pathway

BackgroundMyocardial infarction (MI) often leads to sudden cardiac death. Persistent myocardial ischemia increases oxidative stress and impairs mitochondrial function, contributing significantly to postinfarction cardiac dysfunction and remodeling, and the subsequent progression to heart failure (HF). Tetrahydrocurcumin (THC), isolated from the rhizome of turmeric, has antioxidant properties and has been shown to protect against cardiovascular diseases. However, its effects on HF after MI are poorly understood. PurposeThe objective was the investigation of the pharmacological effects of THC and its associated mechanisms in the pathogenesis of HF after MI. MethodsA total of 120 mice (C57BL/6, male) were used for the in vivo experiments. An MI mouse model was created by permanent ligation of the left anterior descending coronary artery. The mice received oral dose of THC at 120 mg/kg/d and the effects on MI-induced myocardial injury were evaluated by assessment of cardiac function, histopathology, myocardial oxidative levels, and mitochondrial function. Molecular mechanisms were investigated by intraperitoneal injection of 50 mg/kg of the SIRT3 selective inhibitor 3-TYP. Meanwhile, mouse neonatal cardiomyocytes were isolated and cultured in a hypoxic incubator to verify the effects of THC in vitro. Lastly, SIRT3 and Nrf2 were silenced using siRNAs to further explore the regulatory mechanism of key molecules in this process. ResultsThe mouse hearts showed significant impairment in systolic function after MI, together with enlarged infarct size, increased myocardial fibrosis, cardiac hypertrophy, and apoptosis of cardiomyocytes. A significant reversal of these changes was seen after treatment with THC. Moreover, THC markedly reduced reactive oxygen species generation and protected mitochondrial function, thus mitigating oxidative stress in the post-MI myocardium. Mechanistically, THC counteracted reduced Nrf2 nuclear accumulation and SIRT3 signaling in the MI mice while inhibition of Nrf2 or SIRT3 reversed the effects of THC. Cell experiments showed that Nrf2 silencing markedly reduced SIRT3 levels and deacetylation activity while inhibition of SIRT3 signaling had little impact on Nrf2 expression. ConclusionThis is the first demonstration that THC protects against the effects of MI. THC reduced both oxidative stress and mitochondrial damage by regulating Nrf2-SIRT3 signaling. The results suggest the potential of THC in treating myocardial ischemic diseases.

What we imagine learning from watching others: how motor imagery modulates competency perceptions resulting from the repeated observation of a juggling action.

Although motor learning can occur from observing others perform a motor skill (action observation; AO), observers' confidence in their own ability to perform the skill can be falsely increased compared to their actual ability. This illusion of motor competence (i.e., 'over-confidence') may arise because the learner does not gain access to sensory feedback about their own performance-a source of information that can help individuals understand their veridical motor capabilities. Unlike AO, motor imagery (MI; the mental rehearsal of a motor skill) is thought to be linked to an understanding of movement consequences and kinaesthetic information. MI may thus provide the learner with movement-related diagnostic information, leading to greater accuracy in assessing ability. The present study was designed to evaluate the effects of MI when paired with AO in assessments of one's own motor capabilities in an online observation task. Two groups rated their confidence in performing a juggling task following repeated observations of the action without MI (OBS group; n = 45) or with MI following observation (OBS+MI; n = 39). As predicted, confidence increased with repeated observation for both groups, yet increased to a greater extent in the OBS relative to the OBS+MI group. The addition of MI appeared to reduce confidence that resulted from repeated AO alone. Data support the hypothesis that AO and MI are separable and that MI allows better access to sensory information than AO. However, further research is required to assess changes in confidence that result from MI alone and motor execution.

The Role of Female Reproductive Hormones in the Association between Migraine and Breast Cancer: An Unanswered Question.

Accumulating epidemiological studies have investigated a possible interconnection between migraine (Mi) and breast cancer (BC) because of the strong link between these diseases and female reproductive hormones. This review aims to consolidate findings from epidemiological studies and explore biologically plausible hypothetical mechanisms related to hormonal pathways. Current evidence suggests a protective role of Mi in BC development, particularly in case-control studies but not in cohort ones. The inconsistency among studies may be due to several reasons, including diagnostic criteria for Mi and the age gap between the development of these two diseases. Furthermore, recent research has challenged the concept of a net beneficial effect of Mi on BC, suggesting a more complex relationship between the two conditions. Many polymorphisms/mutations in hormone-related pathways are involved in at least one of the two conditions. The most promising evidence has emerged for a specific alteration in the estrogen receptor 1 gene (rs2228480). However, the possible specific mutation or polymorphism involved in this association has not yet been identified. Further studies with robust methodologies are needed to validate the protective role of Mi in BC and fully elucidate the precise nature of this causal relationship.

The Effects of Motor Imagery on Pain in Lower Limb Sports Injuries: A Systematic Review and Meta-Analysis.

This review evaluated the efficacy of Motor Imagery intervention in athletes with lower limb sports injuries that could affect their pain levels during rehabilitation. We carried out a thorough research of the scientific literature for RCT studies in athletes with lower limb musculoskeletal sports injuries including search terms Motor Imagery AND pain, Motor Imagery AND sport injuries, Motor Imagery AND lower limb. We searched 3 major databases, PubMed, Scopus, and ScienceDirect, with the search period ranging from their inception until May 2022. We assessed the quality of the studies using the PEDro Scale and the data was recorded and extracted with the use of Mendeley software. The search criteria resulted in a pool of 10.107 possible articles. Upon completion of the selection procedure, only 3 RCT studies met the inclusion criteria with a total of 60 injured athletes (n = 18 with ankle sprain and n = 42 with ACL injuries). The meta-analysis showed no statistically significant positive effects of MI intervention on pain intensity after lower limb sports injuries (n = 60; MD = -1.57; 95% CI: -3.60 to 0.46; I2 = 50%; p = 0.13). The limited number of studies could justify the statistically insignificant effect of MI, but although the methodological quality of the studies was moderate to high, the heterogeneity of them was also relatively high. More RCT's are required to explore the effect of MI on pain in athletes with lower limb injuries in order to address psychophysiological processes during rehabilitation.

Joint effect of myocardial infarction and obesity on the risk of venous thromboembolism: The Tromsø Study

BackgroundMyocardial infarction (MI) is associated with an increased risk of venous thromboembolism (VTE). Obesity is a recognized risk factor for both MI and VTE. Whether obesity further increases the risk of VTE in MI patients is scarcely investigated. AimTo study the joint effect of MI and obesity on the risk of VTE. MethodsStudy participants (n = 29 410) were recruited from three surveys of the Tromsø Study (conducted in 1994–1995, 2001, and 2007–2008) and followed up through 2014. All incident MI and VTE cases during follow‐up were recorded. Cox regression models with MI as a time‐dependent variable were used to estimate hazard ratios (HRs) of VTE (adjusted for age and sex) by combinations of MI exposure and obesity status. Joint effects were assessed by calculating relative excess risk and attributable proportion (AP) due to interaction. ResultsDuring a median of 19.6 years of follow‐up, 2090 study participants experienced an MI and 784 experienced a VTE. Among those with MI, 55 developed a subsequent VTE, yielding an overall incidence rate (IR) of VTE of 5.3 per 1000 person‐years (95% confidence interval [CI]: 4.1–6.9). In the combined exposure group (MI+/Obesity+), the IR was 11.3 per 1000 person‐years, and the adjusted HR indicated a 3‐fold increased risk of VTE (HR 3.16, 95% CI: 1.99–4.99) compared to the reference group (MI−/Obesity−). The corresponding AP was 0.46 (95% CI: 0.17–0.74). ConclusionsThe combination of MI and obesity yielded a supra‐additive effect on VTE risk of which 46% of the VTE events were attributed to the interaction.

An analytical approach to the ultimate bearing capacity of smooth and rough strip foundations on rock mass considering three-dimensional (3D) strength

An analytical approach to the ultimate bearing capacity qu of strip foundations on rock mass under both smooth and rough base conditions is presented. To consider the three-dimensional (3D) stress state, a 3D version of the Hoek-Brown (HB) criterion is combined with equilibrium equations to derive the governing equations by using the characteristics method. Then, a finite difference-based approach is used to solve the stresses below the foundation. Finally, integration of the vertical stress on the foundation base is performed to determine the qu of a strip foundation with different base conditions. Validation of the proposed approach is performed through comparisons with model test results and the effect of 3D strength is investigated by comparing the proposed approach with a two-dimensional HB criterion-based solution. Finally, parametric analyses are conducted to study the effects of rock constant mi, unconfined compression strength of intact rock, geological strength index, Poisson’s ratio of rock mass, and foundation width on the qu, failure zone, and vertical stress on the base. The results show that ignoring 3D strength and unit weight of rock leads to underestimations of qu and it is important to consider the different factors when designing a strip foundation on rock mass.

Decontamination of a siloxane impression material by using 5-aminolevulinic acid activated by photodynamic therapy, microwave irradiation, and hydrogen peroxide

AimThe present study was intended to evaluate the antimicrobial effect of PDT, H2O2, and MI on the contact angle, strain-in-compression, and tear strength of siloxane impression material formerly colonized with E. coli, S.aureus and S.mutans. Material and methodsOne hundred and twenty disk-shaped specimens (diameter 10 mm and thickness 2 mm) were prepared by polyvinylsiloxane impression material and inoculated by the American Type Culture Collection (ATCC) of E.coli, S.mutans, and S.aureus in an in-vitro situation. The specimens were broadly divided into six groups then exposed to the various disinfection approaches for 3 min per each group: group 1: Control (no treatment), group 2:PDT 5-ALA, group 3: H2O2, group 4: MI, group 5: H2O2 + MI, group 6: PDT + MI. After disinfection, assessment of mechanical properties (contact angle, strain-in-compression, and tear strength) of impression materials were instigated. Statistical analysis was executed for CFU/mL (log10) for exposed E. coli, S.aureus, and S.mutans, by two-way ANOVA and Tukey's honestly significant test (p>0.05). ResultsThe highest anti-microbial values against all inspected microbial colonies were unveiled when disinfection was performed in combination i.e., H2O2 + MI and PDT + MI and the least cleansing of impression material was seen by the control group as no treatment was provided. Solo application of MI was more effective than control, H2O2 and 5-ALA activated by PDT but less active when used in combination method H2O2 with MI and PDT with MI. PDT and control group showed the least antimicrobial effectiveness against E. coli (p<0.05) ConclusionDisinfection of impression materials with combination therapies including photodynamic therapy with microwave irradiation and hydrogen peroxide with microwave irradiation displayed highest antimicrobial efficacies against E. coli, S. aureus, and S. mutans with no adverse effects on mechanical properties of impression material.

Динамика показателей качества жизни при проведении хирургической реваскуляризации миокарда

Coronary heart disease (CHD), being one of the most common cardiovascular diseases, has a negative impact on patients’ quality of life. The purpose of the work was to study the dynamics of quality of life indicators in patients with CHD during surgical revascularization of myocardium depending on the presence or absence of old myocardial infarction. 68 patients with CHD were examined, including 57 (83.8%) patients with old myocardial infarction (old MI) and 11 (16.2%) patients in the absence of old MI. There was a statistically significant improvement in quality of life, both in the physical and psychoemotional spheres, in patients with stable coronary heart disease including those with a history of myocardial infarction. No effect of old MI on quality of life in patients after myocardial revascularization surgery was observed.

Динамика показателей качества жизни при проведении хирургической реваскуляризации миокарда

Coronary heart disease (CHD), being one of the most common cardiovascular diseases, has a negative impact on patients’ quality of life. The purpose of the work was to study the dynamics of quality of life indicators in patients with CHD during surgical revascularization of myocardium depending on the presence or absence of old myocardial infarction. 68 patients with CHD were examined, including 57 (83.8%) patients with old myocardial infarction (old MI) and 11 (16.2%) patients in the absence of old MI. There was a statistically significant improvement in quality of life, both in the physical and psychoemotional spheres, in patients with stable coronary heart disease including those with a history of myocardial infarction. No effect of old MI on quality of life in patients after myocardial revascularization surgery was observed.

Small-scale agricultural grassland management can affect soil fungal community structure as much as continental scale geographic patterns.

ABSTRACTA European transect was established, ranging from Sweden to the Azores, to determine the relative influence of geographic factors and agricultural small-scale management on the grassland soil microbiome. Within each of five countries (factor ‘Country’), which maximized a range of geographic factors, two differing growth condition regions (factor ‘GCR’) were selected: a favorable region with conditions allowing for high plant biomass production and a contrasting less favorable region with a markedly lower potential. Within each region, grasslands of contrasting management intensities (factor ‘MI’) were defined: intensive and extensive, from which soil samples were collected. Across the transect, ‘MI’ was a strong differentiator of fungal community structure, having a comparable effect to continental scale geographic factors (‘Country’). ‘MI’ was also a highly significant driver of bacterial community structure, but ‘Country’ was clearly the stronger driver. For both, ‘GCR’ was the weakest driver. Also at the regional level, strong effects of MI occurred on various measures of the soil microbiome (i.e. OTU richness, management-associated indicator OTUs), though the effects were largely regional-specific. Our results illustrate the decisive influence of grassland MI on soil microbial community structure, over both regional and continental scales, and, thus, highlight the importance of preserving rare extensive grasslands.

Magnetoimpedance of CoFeCrSiB Ribbon-Based Sensitive Element with FeNi Covering: Experiment and Modeling.

Soft magnetic materials are widely requested in electronic and biomedical applications. Co-based amorphous ribbons are materials which combine high value of the magnetoimpedance effect (MI), high sensitivity with respect to the applied magnetic field, good corrosion stability in aggressive environments, and reasonably low price. Functional properties of ribbon-based sensitive elements can be modified by deposition of additional magnetic and non-ferromagnetic layers with required conductivity. Such layers can play different roles. In the case of magnetic biosensors for magnetic label detection, they can provide the best conditions for self-assembling processes in biological experiments. In this work, magnetic properties and MI effect were studied for the cases of rapidly quenched Co67Fe3Cr3Si15B12 amorphous ribbons and magnetic Fe20Ni80/Co67Fe3Cr3Si15B12/Fe20Ni80 composites obtained by deposition of Fe20Ni80 1 μm thick films onto both sides of the ribbons by magnetron sputtering technique. Their comparative analysis was used for finite element computer simulations of MI responses with different types of magnetic and conductive coatings. The obtained results can be useful for the design of MI sensor development, including MI biosensors for magnetic label detection.

The Influence of AC Driving Current on Magnetoimpedance in [Ni80Fe20/Cu]x/Cu/[Ni80Fe20/Cu]6-x Multilayers

The phenomenon of magnetoimpedance in the multilayer configuration of [Ni80Fe20/Cu]x/Cu/[Ni80Fe20/Cu]6-x with x = 1, 2, and 3 has been successfully investigated. The electrodeposition method used for the multilayer film preparation on the meander pattered of Cu PCB. The obtained multilayer samples were evaluated the MI effect at room temperature with a frequency of 100 kHz. Here, the MI effects were evaluated for a variation of the AC driving current i.e. IAC = 4 mA, 8 mA, 12 mA, 16 mA, and 20 mA. The MI measurement results show that the multilayer x = 3 has the largest MI ratio and the multilayer with x = 1 was the smallest one. It is indicated that interlayer coupling contributes to the MI effect. Whereas the skin depth also confirms to contribute the MI ratio that showed the MI ratio increase with the increase of the I&lt;sub&gt;AC&lt;/sub&gt;.

NUMERICAL AND EXPERIMENTAL RESEARCH OF ROCK FAILURE MECHANISM AND ITS DEPENDENCE ON mi HOEK-BROWN FAILURE CRITERION

Rock failure mechanism is one of the most important issues in rock mechanics engineering which plays a key role in the stability analysis of various structures. Therefore, different failure criteria have been proposed to understand the failure mechanism of rocks. One of the most commonly used rock failure criteria is the Hoek-Brown criterion, in which there is a parameter called mi, which is very important to the response provided by this criterion. Due to the importance of conducting extensive studies on this parameter, in this current research, by performing a series of experimental triaxial compressive strength test and numerical simulating in PFC-2D code, the effect of the Hoek-Brown constant mi on the failure mechanism and crack growth of different rocks has been studied. Based on the results of this study, it was found that the effect of parameter mi on the failure mechanism of different rocks varied according to the type of rocks, and the greatest effect of this parameter was on the peak strength of rocks. In addition, it was found that under higher lateral pressures, there are less destructive cracks in rocks, and as a result, they show more ductile behaviour.

Motivational Interviewing and Self-Care in Type 1 Diabetes: A Randomized Controlled Clinical Trial Study Protocol.

BackgroundType 1 diabetes is a disease with complex therapeutic recommendations that require day-to-day lifestyle changes. Motivational Interviewing is a communication tool that has proved effective in changing behaviors in people with addictions, obesity and type 2 diabetes. Our objective is to evaluate the effects of a Motivational Interviewing intervention in people with type 1 diabetes.MethodsSixty-six patients with type 1 diabetes and hemoglobin A1c >= 8% have been included and randomly assigned (computer-generated sequence, sealed envelopes, ratio 1:1) either to the intervention or to the control group. In the intervention group, appointments every 4 months with the endocrinologist include Motivational Interviewing; in the control group, the appointments proceed as usual. Patients will be followed for 16 months. The primary outcome will be self-care behaviors, assessed by a validated questionnaire, the Diabetes Self-Care Inventory-Revised Version. Secondary outcomes include: HbA1c, motivation for self-care, self-efficacy, health-related quality of life, satisfaction with professional-patient relationship, and fulfillment of patients’ own objectives. The practitioners receive training in Motivational Interviewing in order to help them promote adherence to self-care, encourage patient motivation and improve the doctor-patient relationship. The Motivational Interviewing intervention will be evaluated by two psychologists, blinded to the assigned treatment, through video recordings of the sessions and the administration of a purpose-built questionnaire, the EVEM 2.0 scale.DiscussionThere is evidence that MI can improve self-care in type 2 diabetes. In this study, we aim to evaluate the effect of MI on self-care and HbA1c in people with type 1 diabetes.Clinical Trial Registration https://clinicaltrials.gov/ct2/show/NCT03906786, identifier NCT03906786.

Magnesium Isoglycyrrhizinate Induces an Inhibitory Effect on Progression and Epithelial-Mesenchymal Transition of Laryngeal Cancer via the NF-κB/Twist Signaling.

BackgroundMagnesium isoglycyrrhizinate (MI) was extracted from roots of the plant Glycyrrhiza glabra, which displays multiple pharmacological activities such as anti-inflammation, anti-apoptosis, and anti-tumor. Here, we aimed to investigate the effect of MI on the progression and epithelial–mesenchymal transition (EMT) of laryngeal cancer.MethodsForty laryngeal cancer clinical samples were used. The role of MI in the proliferation of laryngeal cancer cells was assessed by MTT assay, Edu assay and colony formation assay. The function of MI in the migration and invasion of laryngeal cancer cells was tested by transwell assays. The effect of MI on apoptosis of laryngeal cancer cells was determined by cell apoptosis assay. The impact of MI on tumor growth in vivo was analyzed by tumorigenicity analysis using Balb/c nude mice. qPCR and Western blot analysis were performed to measure the expression levels of gene and protein, respectively.ResultsWe identified that EMT-related transcription factor Twist was significantly elevated in the laryngeal cancer tissues. The expression of Twist was also enhanced in the human laryngeal carcinoma HEP-2 cells compared with that in the primary laryngeal epithelial cells. The high expression of Twist was remarkably correlated with poor overall survival of patients with laryngeal cancer. Meanwhile, our data revealed that MI reduced cell proliferation, migration and invasion and enhanced apoptosis of laryngeal cancer cells in vitro. Moreover, MI decreased transcriptional activation and the expression levels of NF-κB and Twist, and alleviated EMT in vitro and in vivo. MI remarkably inhibited tumor growth and EMT of laryngeal cancer cells in vivo.ConclusionMI restrains the progression of laryngeal cancer and induces an inhibitory effect on EMT in laryngeal cancer by modulating the NF-κB/Twist signaling. Our finding provides new insights into the mechanism by which MI inhibits laryngeal carcinoma development, enriching the understanding of the anti-tumor function of MI.

Cardiometabolic disease, comorbidities and risk of death: findings using data from large-scale electronic health records

Abstract Background Myocardial infarction (MI), stroke and diabetes are separately associated with increased risk of mortality but it is uncertain if their combined effects are proportional, amplified or less than the expected risk of each disease individually. In addition, patients with these conditions tend to also have other long-term comorbidities. How the relationship between cardiometabolic disease and risk of death is modified by the presence of comorbidity is unclear. Purpose We investigated the separate and combined effects of MI, stroke and diabetes on all-cause mortality, and examined the impact of comorbidity on these associations. Methods We selected a patient cohort of 2,007,731 (51% women) aged ≥16 years at registration with their general practice, using large-scale UK primary care electronic health records that were linked to the national death registry. We identified patients with a recorded diagnosis of MI, stroke, diabetes or none before 2005 (baseline), and classified the patient cohort into mutually exclusive categories of their baseline disease status. For each group, we also extracted information on another major 53 long-term conditions prior to baseline. The cohort was followed until death, deregistration from the practice or censored at the end of study (31 Dec 2014). We used Cox regression, and tested for departure from additivity and multiplicativity to assess interaction. Results At baseline, the mean age of the cohort was 51 (SD=18) years and 7% (N=145,910) had a cardiometabolic disease. Over an average follow-up of 7 (SD=3) years, 270,036 died (mean age of death=79 years). After adjusting for baseline age and sex, the hazard ratio (HR) (95% confidence interval [CI]), relative to those without cardiometabolic disease, were as follows: diabetes=1.53 (1.51 to 1.55), MI=1.54 (1.51 to 1.56), stroke=1.87 (1.84 to 1.90), diabetes and MI=2.16 (2.09 to 2.23), MI and stroke=2.39 (2.28 to 2.49), diabetes and stroke=2.56 (2.47 to 2.65), and all three=3.17 (2.95 to 3.41). After adjusting for the 53 comorbidities, the HR (95% CI) were attenuated: diabetes=1.37 (1.35 to 1.39), MI=1.25 (1.23 to 1.27), stroke=1.49 (1.46 to 1.52), diabetes and MI=1.60 (1.55 to 1.65), MI and stroke=1.52 (1.45 to 1.59), diabetes and stroke=1.91 (1.84 to 1.98), and all three=1.77 (1.64 to 1.91). The results did not materially changed with adjustment for smoking and deprivation level. Test for interaction revealed some minor synergistic effects when cardiometabolic disease co-occurred but excess risks were lower than expected for two combined vs individual disease effects; no significant interaction was seen for all three vs individual disease effects. Conclusion MI, stroke and diabetes are associated with excess mortality, which was partly due to associated chronic conditions. We found no evidence that the co-occurrence of these three conditions contribute to a higher excess mortality than expected from each of them separately. Funding Acknowledgement Type of funding source: Public Institution(s). Main funding source(s): NIHR Oxford Biomedical Research Centre; Oxford Martin School, University of Oxford