Reactivity Scores Research Articles

Adsorption of Phenothiazine Derivatives on Graphene – DFT, Docking and MD Simulation

Impurity-related detection and certification cycle assumes significance in drug production and this study provides theoretical structural and spectral characterization of phenothiazine analogues, acepromazine (P1), amitriptyline (P2) and chlorpromazine HCl (P3) and their adsorption with graphene. Reactivity scores suggest these molecule’s properties are adequate, leading to the consideration of potential drug agents. MD simulations could identify P1, P2, P3 and complex with graphene has better binding energy and is more stable in simulation. Enhancement for different wavenumbers are seen in the graphene complex-molecules assembly.

A CROSS-SECTIONAL STUDY ON MENTAL HEALTH AND CARDIOVASCULAR REACTIVITY AMONG FRESH RESIDENT DOCTORS DURING COVID19 PANDEMIC IN INDIA

Objective: The adverse psychological impact in doctors battling the Corona Virus Disease 2019 (COVID 19) epidemic arise from various social and administrative issues like excessive workload, inadequate interpersonal communications, biased work culture and lack of social support thus raising a warning of the mental health in doctors. The present study was done to assess the mental health and stress reactivity among the resident doctors who have been working for a prolonged duration during covid 19 pandemic in India.
 Methods: The subjects included 162 young resident doctors both males and females, of age group between 25-30 y, among which 92 were posted in covid wards on a rotation basis from 1st April 2020 to 31st December 2020 and 70 were doing duty in regular non-covid wards or not had done even a single duty in covid ward during the above period. All participants completed an online questionnaire that included the Beck Anxiety Inventory (BAI), the Beck Depression Inventory (BDI)–II, Connor-Davidson resilience scale (CDRISC) and Social Support Rating Scale (SSRS) followed by a cold pressor test to assess stress reactivity.
 Results: There were significant differences in the mental health and stress reactivity scores with lower resilience scores, lower social support rating scores, increased anxiety and depression in Covid ward doctors (p=0.001).
 Conclusion: The findings suggested high levels of training, resilience helpful social support and unbiased work culture were necessary to health care workers engaged in public health emergence.

Evaluating the Reaction to a Complex Rotated Object in the American Quarter Horse (Equus caballus).

Simple SummaryHorses are prey animals and exhibit behaviors that help them adapt and survive in their environment. These reactions are often referred to as spooking and they have the potential to be dangerous to the horse, handler and rider. Spooking consists of avoidance reactions that include suddenly moving away or running away from the perceived danger. It is dangerous for both riders and horses when a horse suddenly startles. Sometimes horses do this in familiar environments because familiar objects may look different when rotated. The purpose of this study was to determine whether horses that had been habituated to a complex object (children’s playset) would react to the object as novel when rotated 90 degrees. Twenty young horses were led past the playset 15 times by a handler. Next, the rotated group was led past the rotated playset 15 times. Each time the horse was led by the object was counted as a pass. An increasing reactivity scale was used to quantify behavioral responses. Being aware of potential reactions to changes in the orientation of previously familiar objects can help keep the handler safer. It is dangerous for both riders and horses when a horse suddenly startles. Sometimes horses do this in familiar environments because familiar objects may look different when rotated. The purpose of this study was to determine whether horses that had been habituated to a complex object (children’s playset) would react to the object as novel when rotated 90 degrees. Twenty young horses were led past the playset 15 times by a handler. Next, the rotated group was led past the rotated playset 15 times. Each time the horse was led by the object was a pass. The behavioral responses observed and analyzed were ears focused on the object, nostril flares, neck raising, snort, avoid by stopping, avoid by moving feet sideways, and avoid by flight. An increasing reactivity scale was used to quantify behavioral responses. A two-sample t-test was performed on the reactivity scores comparing the first pass by the novel object to the first pass by the rotated object. The horses in the rotated group reacted to the rotated orientation similarly to the first exposure (p = 0.001, α < 0.05). Being aware of potential reactions to changes in previously familiar environments can help keep the handler safer.

81 Cannabidiol in the horse: Effects on movement and reactivity

A growing body of research supports the investigation of cannabidiol (CBD) for treatment of conditions involving inflammation, pain, and anxiety. Exploration of CBD supplementation has occurred in rats, canines, felines, and humans. However, few trials exist on CBD efficacy in the horse. This project investigated effects of extended CBD treatment on reactivity and movement in horses. Seventeen Quarter Horse geldings were randomly assigned to a control (CON; n = 8) or treatment (TXT; n = 9) group. Treatment horses received a 100 mg oral dose of full-spectrum CBD pellets once daily for 6 wk. Reactivity and movement evaluation occurred pre- and 6 wk post-treatment. Reactivity was evaluated through a novel object test (NOT). To elicit a startle response, an umbrella was opened as the horse and handler traveled around a barn corner. A previously published rubric was used to rate reaction scores from 1 (no reaction) to 5 (flee attempted) based on the reaction exhibited. Heart rate monitors were attached during the NOT. Videos for movement evaluation were taken as horses were hand walked and jogged past 6 cones. Dartfish 360, a video analysis program, was used to measure aspects of stride completion. This included stride length and duration of stance and swing phase. Measurements were completed on a 3-stride sequence for each limb within the 9.14 m between cones 3 and 4. Chi-squared analysis was completed via the PROC FREQ procedure of SAS to determine the relationship between CBD treatment and reactivity. Effects of treatment on initial heart rate (IHR), stimulus heart rate (SHR), and final heart rate (FHR) were analyzed through the PROC MIXED procedure of SAS. Statistical analyses were completed for stride length (SL) and time spent in stance (ST) or swing phase (SW) for walk and trot using PROC MIXED procedure of SAS. An average of the 4 limbs was calculated for each horse for each parameter. Treatment horses received a lower frequency of moderate (3) to high (4, 5) reactivity scores compared with CON (TXT = 24; CON = 37; P = 0.0018). Statistical significance was not observed for IHR, SHR, or FHR. Further investigation is needed to accurately characterize the role of CBD in alterations of equine behavior. In walk, TXT horses spent longer in ST (TXT = 0.57 s, CON = 0.51 s; P < 0.01) and SW (TXT = 0.38 s, CON = 0.36 s; P < 0.01). Both groups demonstrated a reduction in trot SL (Pre = 1.68 m, Post = 1.55 m; P = 0.03) and stride completion (STPre = 0.30 s, STPost = 0.26 s; P < 0.01; SWPre = 0.37 s, SWPost = 0.33 s, P < 0.01). Results on stride kinematics were relatively inconclusive. Future studies could benefit from the observation of equine subjects with a targeted physical ailment or increased CBD dosage.

Effects of positive reinforcement training for heifers on responses to a subcutaneous injection

Cattle are subjected to routine procedures that require restraint and close contact to humans, which are both potentially aversive to the animal. Positive reinforcement training techniques may affect how animals perceive and respond to these procedures. The objectives of the current study were to describe a positive reinforcement regimen used to train cattle to stand still for a sham injection, and to assess the effects of this training on the responses to an actual injection. Eight "agency" heifers were trained, over an average of 85 ± 4.6 sessions, with positive reinforcement (i.e., animals received a grain reinforcer for desired behaviors) to enter a headlock, and they were habituated with counterconditioning and desensitization to a sham injection (i.e., animals were gradually exposed to the sensation of the sham injection, paired with access to grain). The headlock remained open at all times to allow heifers to leave. Eight "habituation" heifers were exposed to the treatment area and headlock for an equal number of sessions and duration as agency heifers, and 7 "naïve" heifers were provided no exposure to the treatment area. Once agency heifers tolerated the sham injection, all animals received a 1-mL subcutaneous injection of 0.9% NaCl while in the head lock (habituation and naïve heifers were locked in but agency heifers were free to withdraw). Immediate responses to the injection, starting with tenting of the skin, were video recorded and summarized as a reactivity score, which included the number of steps, head tosses, and backing-up movements; we also recorded the latency to approach the treatment area and headlock for 3 d after the injection. Of the agency heifers, 5 remained standing for the actual injection, whereas 3 heifers moved out of the headlock for a brief period (1, 3, and 5 s, respectively). Habituation heifers had a higher reactivity score [17.5 (10.5-28); median (IQR)] than agency [6 (2-13.5)] and naïve heifers [6 (5-7)]. Averaged over the 3 d after injection, agency heifers showed lower latencies to come to the treatment area [8.7 (7.2-24.2) s] than did habituation [50.5 (28-60) s] and naïve [53.7 (18-60) s] heifers. Agency heifers voluntarily entered the headlock within 1.3 (1-1.5) s but, with one exception, none of the other heifers did so within the allowed 15 s. These results indicate that dairy heifers can be trained with positive reinforcement and counterconditioning to voluntarily accept a painful procedure, and that training can reduce avoidance behaviors during and after the procedure.

The Associations between Imageability of Positive and Negative Valence Words and Fear Reactivity

This study investigated the associations of imageability with fear reactivity. Imageability ratings of four word classes: positive and negative (i) emotional and (ii) propriosensitive, neutral and negative (iii) theoretical and (iv) neutral concrete filler, and fear reactivity scores—degree of fearfulness towards different situations (Total Fear (TF) score) and total number of extreme fears and phobias (Extreme Fear (EF) score), were obtained from 171 participants. Correlations between imageability, TF and EF scores were tested to analyze how word categories and their valence were associated with fear reactivity. Imageability ratings were submitted to recursive partitioning. Participants with high TF and EF scores had higher imageability for negative emotional and negative theoretical words. The correlations between imageability of negative emotional words and negative theoretical words for EF score were significant. Males showed stronger correlations for imageability of negative emotional words for EF and TF scores. High imageability for positive emotional words was associated with lower fear reactivity in females. These findings were discussed with regard to negative attentional bias theory of anxiety, influence on emotional systems, and gender-specific coping styles. This study provides insight into cognitive functions involved in mental imagery, semantic competence for mental imagery in relation to fear reactivity, and a potential psycholinguistic instrument assessing fear reactivity.

The use of laboratory parameters and computed tomography score to determine intensive care unit requirement in COVID-19

Abstract Objectives It is vital to determine the intensive care unit (ICU) requirement at an early stage to reduce the mortality rate in COVID-19 patients. The aim of the study was to find reliable predictive markers to determine the ICU requirement. Methods We retrospectively reviewed the clinical and laboratory records of 151 COVID-19 patients. The predictive abilities of biochemical parameters and computed tomography (CT) score were evaluated to determine of ICU requirement. Results The area under curve (AUC) values for procalcitonin, D-Dimer, C reactive protein (CRP), glucose, lactate dehydrogenase (LDH) and CT score were found higher than those for other parameters in the prediction of ICU requirement. The negative predictive values of these markers were higher than their positive predictive values. CT score was found to be highly correlated with fibrinogen and CRP. The glucose levels [odd ratio (OR): 95% CI; 1.07, p-value: 0.014] and CT score [OR: 95% CI; 1.05, p-value: 0.022] were associated with ICU requirement in COVID-19 patients. Conclusions CT score, procalcitonin, D-Dimer, CRP, glucose, and LDH are potential predictors to rule out ICU requirement on hospital admission. Fibrinogen and CRP can be used to follow up and predict lung damages in patients with COVID-19.

Correlation of Biomarkers with Endoscopic Score: Ulcerative Colitis Endoscopic Index of Severity (UCEIS) in Patients with Ulcerative Colitis in Remission.

Background and Objectives: Ulcerative colitis is a disease with an unpredictable evolution, often highlighted endoscopically, that is associated with persistent inflammation affecting the patient’s quality of life. An attempt was made to discover surrogate markers to evaluate the endoscopic remission of the disease in order to increase the patient’s quality of life and also their adherence to the treatment and monitoring plan. One such marker is fecal calprotectin (FC). To confirm the correlation between biomarkers and endoscopic disease activity and to define the optimal cut off value to detect clinical and endoscopic remission in a center of Romania. Materials and Methods: This was a prospective study that included 59 patients diagnosed with ulcerative colitis at the Department of Internal Medicine III, University Emergency Hospital of Bucharest. Patients had fecal calprotectin measurements and colonoscopy/rectosigmoidoscopy performed during baseline, 6 and 12 months. For endoscopic activity the Ulcerative Colitis Endoscopic Index of Severity (UCEIS) was used. Results: During the study, relapses have occurred in 35.6% of patients, the median age was 47 years (21–77). During the study, the FC measurement was significantly increased at 3 months (median, range µg/g; 715, 14–4000) and at 6 months (median, range µg/g; 650, 4.5–3000) (p ≤ 0.05). Another inflammatory biomarker studied was CRP, which showed increased values at 3 months (median, range, mg/dL; 1.86, 0.14–58.9), at 6 months (median, range, mg/dL; 2.36, 0.12–45.8) and at 9 months (median, range, mg/dL; 2, 0.12–25.9) compared to the baseline (p = 0.01). Patients with recurrence of the disease also associated an increase in the values of clinical evaluation scores (SCCAI; p = 0.00001), but also endoscopic (UCEIS; p = 0.0006) Conclusion: A relapse is associated independently with younger age, the extension of the disease (E2-E3), increased FC level, C reactive protein, hemoglobin concentration, SCCAI index and UCEIS score.

Emotional and behavioural problems of children and adolescents who stutter: Comparison with typically developing peers

Purpose There are several studies showing contradictory results on concurrent emotional and behavioural problems of children and adolescents who stutter (CAWS). This study aimed to identify whether there is a difference between Turkish-speaking CAWS and their typically developing peers (TDP) in emotional and behavioural problems. Methods The study group consisted of 45 CAWS, aged between 3.40 and 15.92 years, and the control group consisted of 45 TDP, aged between 3.15 and 16.80 years. Participants were divided into three age groups: early childhood (0–6 years), middle childhood (7–11 years) and adolescence (12–18 years). CAWS and TDP were compared separately in each age group with Mann–Whitney U tests. Assessments of emotional and behavioural problems were conducted with the Child Behaviour Checklist (CBCL) for Ages 1.5–5 and the CBCL for Ages 6–18. Results In early childhood, CAWS had significantly higher emotional reactivity, anxiety/depression, somatic complaints, withdrawal, sleep problems, attention problems and aggressive behaviour scores than TDP. In middle childhood and adolescence, CAWS had significantly higher anxiety/depression, withdrawal/depression, social problems, attention problems, rule-breaking behaviour and aggressive behaviour scores compared to TDP. In adolescence, somatic problems and thought problems scores were also significantly higher in AWS than TDP. Conclusions We concluded that emotional and behavioural problems associated with stuttering are noticeable from early childhood to adolescence. Cooperation with mental health professionals may be needed to improve the quality of speech therapy in CAWS.

Alcohol Use Disorder and Cannabis Use Disorder Symptomatology in Adolescents and Aggression: Associations With Recruitment of Neural Regions Implicated in Retaliation

BackgroundAlcohol and cannabis are commonly used by adolescents in the United States. Both alcohol use disorder (AUD) and cannabis use disorder (CUD) have been associated with an increased risk of aggression. One form of aggression seen during retaliation is reactive aggression to social provocation. This study investigated the association between AUD and CUD symptom severity and recruitment of neural regions implicated in retaliation. MethodsIn this study, 102 youths aged 13–18 years (67 male; 84 in residential care) completed self-report measures of aggression-related constructs and participated in a retaliation task during functional magnetic resonance imaging to investigate the association between relative severity of AUD/CUD and atypical recruitment of regions implicated in retaliation. ResultsAUD Identification Test scores were positively associated with irritability and reactive aggression scores. CUD Identification Test scores were positively associated with callous-unemotional traits and both proactive and reactive aggression scores. In functional magnetic resonance imaging analyses, only AUD Identification Test (not CUD Identification Test) scores were associated with an exaggerated recruitment of regions implicated in retaliation (dorsomedial frontal, anterior insula cortices, caudate, and, to a lesser extent, periaqueductal gray). ConclusionsThese data suggest that relative severity of AUD is associated with a disinhibited, exaggerated retaliation response that relates to an increased risk for reactive aggression. Similar findings were not related to severity of CUD.

Lower preseason reactive strength index scores are associated with injury in female collegiate volleyball players but not male collegiate basketball players

ObjectivesFunctional tests are used by sports medicine professionals to discriminate injury risk in athletes. One test that has shown promise is the drop vertical jump (DVJ); however, it is primarily used to evaluate measures associated with anterior cruciate ligament injury. The DVJ test can also be used to calculate the reactive strength index (RSI); a measure used to assess an athlete’s power. The ability of the RSI to discriminate injury risk is unknown. The purpose of this study was to prospectively evaluate the ability of preseason RSI scores to identify athletes at risk for a noncontact time-loss injury to the low back or lower extremities. DesignProspective cohort. MethodsOne hundred and fifty-five male collegiate basketball (BB) players and 117 female collegiate volleyball (VB) players were recruited for this study. DVJ tests were performed in a motion capture lab. ResultsFemale VB players with a RSI 0.9125m/s or less (30.48cm box) were 4 times (relative risk=4.2 [95% CI: 1.0, 17.7]; p-value=0.024) more likely to be injured. There was no association between preseason scores and injury in the male BB athletes. ConclusionRSI scores should be collected for female collegiate VB players as part of a preseason screen.

Diagnostic and Pathologic Value of Programmed Death-Ligand 1 Expression in Colon Carcinoma

Objectives: To evaluate the diagnostic value of programmed death-ligand1 expression in colon carcinoma cells and its correlation with different pathological features. Methods: An immunohistochemical study was conducted on 50 cases diagnosed as colon carcinoma over a one year period from October 2018 to October 2019.The paraffin blocks were received from the Pathology Departments, Faculty of Medicine, Cairo University and Misr University for Science and Technology (MUST). The diagnosis of colon carcinoma for all cases was revised using H&amp;E stain. The immunohistochemical expression of programmed death- ligand1 was assessed using immune reactive score method. The personal data, clinical details and pathological diagnosis were recorded and correlated with programmed death-ligand1 expression. Results: This study included 50 cases of colon carcinoma. There was a male predominance with female to male ratio 1:1.08.The age of patients was ranged from 30 years to 76 years with mean age 53.3± 11.2 years. The majority of cases (44%) were invasive adenocarcinoma followed by invasive adenocarcinoma with mucoid activity (18%), invasive adenocarcinoma with neuroendocrine differentiation (16%), invasive signet ring carcinoma (14%) and invasive mucinous carcinoma (8%). Immune reactive score for programmed death-ligand1 had a Mean ± Standard Deviation of 8.4 ± 4.2. Strong immune reactive score was represented by 58% of cases, moderate immune reactive score was represented by 24% of cases and only one case (2%) had mild immune reactive score. The remaining 16% of cases were negative. Correlation between immune reactive score of programmed death-ligand1and tumor type, size and lymph-vascular invasion was statistically significant. Cases with marked immune reactive score for programmed death-ligand1 showed highest predilection for invasive adenocarcinoma with neuroendocrine differentiation, large sized tumors and lymph-vascular invasion.Conclusion: The expression of programmed death-ligand1 using immune reactive score method can estimate the growth of colon carcinoma, invasive adenocarcinoma with neuroendocrine differentiation and lymph-vascular spread. Further large scale studies utilizing programmed death-ligand 1can aid in identifying the prognosis and therapeutic possibilities for patients with colon cancer.

Molecular profiling of post-pembrolizumab muscle-invasive bladder cancer (MIBC) reveals unique features that may inspire new seguential therapies in pathologically-nonresponders

In the PURE-01 study, a proportion of patients (pts) with muscle-invasive bladder cancer (MIBC; T2-4N0M0) had residual invasive disease (ypT2-4) at radical cystectomy (RC) after neoadjuvant pembrolizumab (pembro). The pembro-induced alterations in immunotherapy-resistant tumors remain largely unstudied. We aimed to investigate the biological characteristics of pembro-resistant tumors in comparison to neoadjuvant chemotherapy (NAC)-resistant tumors. Gene expression profiling was performed on 26 RC samples from pts with ypT2-4 disease post-pembro, of which 22 had matched pre-pembro transurethral resection of the bladder tumor (TURBT) samples. Matched cases were analyzed by differential gene expression, hallmark signatures, and molecular subtyping (Decipher Bladder, TCGA, Consensus and Lund classifiers). Unsupervised consensus clustering (CC) was used to compare the 26 post-pembro samples with 133 post-NAC samples and to 21 samples collected from the former tumor bed of NAC-treated patients (scar tissue), all derived from RC specimens. Molecular subtyping of the pre- and post-pembro samples revealed significant ‘subtype switching’ with only 41% of samples having concordant subtypes using the Decipher Bladder classifier. The post-pembro samples did not cluster with scar tissues on clustering but were highly associated with immune-infiltrated cases from the post-NAC cohort. Two major groups of post-pembro tumors were identified, the first defined by markedly higher immune, stromal, angiogenesis and epithelial-to-mesenchymal signature scores and the second by higher tumor purity, KRAS and reactive oxygen species signature scores. Checkpoint inhibitor genes (CD274, PDCD1LG2) were consistently expressed in both groups. This study expands our knowledge of pembro-resistant tumors finding the molecular characteristics of these tumors is strikingly different from NAC-resistant tumors. Two distinct clusters of tumors were identified post-pembro, neither of which were characterized as having a scar-like character. A larger cohort will be required to further understand the clinical implications of these findings.

Persistent Aortic Stiffness and Left Ventricular Hypertrophy in Children of Diabetic Mothers

BackgroundFetuses of diabetic mothers develop left ventricular (LV) hypertrophy and are at increased long-term risk of cardiovascular disease. In our previous longitudinal study from midgestation to late infancy we showed persistence of LV hypertrophy and increased aortic stiffness compared with infants of healthy mothers, the latter of which correlated with third trimester maternal hemoglobin A1c. In the present study, we reexamined the same cohort in early childhood to determine if these cardiovascular abnormalities persisted. MethodsHeight, weight, and right arm blood pressure were recorded. A full functional and structural echocardiogram was performed with offline analysis of LV posterior wall and interventricular septal diastolic thickness (IVSd), systolic and diastolic function, and aortic pulse wave velocity. Vascular reactivity was assessed using digital thermal monitoring. Participants also completed a physical activity questionnaire. ResultsTwenty-five children of diabetic mothers (CDMs) and 20 children from healthy pregnancies (mean age, 5.6 ± 1.7 and 5.3 ± 1.3 years, respectively; P = not significant) were assessed. Compared with controls, IVSd z score was increased in CDMs (1.2 ± 0.6 vs 0.5 ± 0.3, respectively; P = 0.006), with one-fifth having a z score of more than +2.0. Aortic pulse wave velocity was increased in CDMs (3.2 ± 0.6 m/s vs 2.2 ± 0.4 m/s; P = 0.001), and correlated with IVSd z score (R2 = 0.81; P = 0.001) and third trimester maternal A1c (R2 = 0.65; P < 0.0001). Body surface area, height, weight, blood pressure, vascular reactivity, and physical activity scores did not differ between groups. Our longitudinal analysis showed that individuals with greater IVSd, and aortic stiffness in utero, early and late infancy also tended to have greater measures in early childhood (P < 0.001 and P < 0.0001, respectively). ConclusionsCDMs show persistently increased interventricular septal thickness and aortic stiffness in early childhood.

Evaluation of the time to desensitization of the larynx of cats following topical lidocaine application.

The objective of this study was to evaluate the time to decreased reactivity of the arytenoid cartilages in cats after application of topical lidocaine. One hundred and ten mixed-breed cats were randomly assigned to one of five groups based on the time between application of lidocaine and stimulation of the larynx: 5 (T5), 15 (T15), 30 (T30), 45 (T45) or 60 (T60) s. Cats were premedicated with dexmedetomidine, ketamine and buprenorphine. Anesthesia was induced with propofol to effect. Lidocaine 2% (2 mg/kg) was applied topically to the vocal cords using a catheter attached to a syringe under direct laryngoscopy. After lidocaine application, the designated time elapsed and the vocal cords were stimulated with the patient end of an endotracheal tube. Severity of reaction was reported as none, mild, moderate or severe. All cats were intubated after the reactivity score was recorded. Anesthesia was maintained with isoflurane and 100% oxygen while cats were spayed or castrated. Cats were monitored in recovery for signs of respiratory complications and pain. There was a significant difference in overall reactivity score between T5 and T45 (P = 0.0038). Also, there was a significant difference in the number of cats with no reaction compared with cats with any reaction between T5 and T30 (P = 0.03), as well as between T5 and T45 (P = 0.0028). No cat had a severe reactivity score at T45 or T60. All cats were successfully intubated. There were no complications during intubation, maintenance of anesthesia or recovery. As the lowest overall reactivity score occurred at T45, it is recommended to wait at least 45 s after application of topical lidocaine before attempting tracheal intubation.

Prognostic value of CT perfusion and permeability imaging in traumatic brain injury.

Currently established prognostic models in traumatic brain injury (TBI) include noncontrast computed tomography (CT) which is insensitive to early perfusion alterations associated with secondary brain injury. Perfusion CT (PCT) on the other hand offers insight into early perfusion abnormalities. We hypothesized that adding CT perfusion and permeability data to the established outcome predictors improves the performance of the prognostic model. A prospective cohort study of consecutive 50 adult patients with head injury and Glasgow Coma Scale score of 12 or less was performed at a single Level 1 Trauma Centre. Perfusion CT was added to routine control CT 12 hours to 24 hours after admission. Region of interest analysis was performed in six major vascular territories on perfusion and permeability parametric maps. Glasgow Outcome Scale (GOS) was used 6 months later to categorize patients' functional outcomes to favorable (GOS score > 3) or unfavorable (GOS score ≤ 3). We defined core prognostic model, consisting of age, motor Glasgow Coma Scale score, pupillary reactivity, and CT Rotterdam Score. Next, we added perfusion and permeability data as predictors and compared updated models to the core model using cross-validated areas under the receiver operator curves (cv-AUC). Significant advantage over core model was shown by the model, containing both mean cerebral extravascular-extracellular volume per unit of tissue volume and cerebral blood volume of the least perfused arterial territory in addition to core predictors (cv-AUC, 0.75; 95% confidence interval, 0.51-0.84 vs. 0.6; 95% confidence interval, 0.37-0.74). The development of cerebral ischemia and traumatic cerebral edema constitutes the secondary brain injury and represents the target for therapeutic interventions. Our results suggest that adding CT perfusion and permeability data to the established outcome predictors improves the performance of the prognostic model in the setting of moderate and severe TBI. Prognostic study, level III.

Vagal Flexibility Mediates the Association Between Resting Vagal Activity and Cognitive Performance Stability Across Varying Socioemotional Demands.

Vagal flexibility describes the ability to modulate cardiac vagal responses to fit a dynamic range of challenges. Extant theory on vagal function implies that vagal flexibility is a mediating mechanism through which resting vagal activity, a putative individual difference related to self-regulation, affects adaptive behavior and cognition. Nevertheless, little research has directly tested this hypothesis, thereby leaving fundamental mechanisms of vagal function and adaptability unclear. To this end, 47 healthy subjects completed a 5 min baseline followed by Stroop tasks combined with concurrent auditory distractors. There were four different Stroop task conditions that varied the social and emotional content of the auditory distractors. Electrocardiogram was continuously recorded to assess vagal responses to each condition as heart rate variability [root mean square of successive differences (RMSSDs)] reactivity. Vagal flexibility significantly mediated the association between resting vagal activity and stability of inhibition performance (Stroop interference) scores. In particular, higher resting RMSSD was related to higher standard deviation of RMSSD reactivity scores, reflecting greater differences in RMSSD reactivity between distractor conditions (i.e., greater vagal flexibility). Greater vagal flexibility was in turn related to more stability in Stroop interference across the same conditions. The mean of RMSSD reactivity scores across conditions was not significantly related to resting RMSSD or stability in Stroop performance, and mean RMSSD reactivity did not mediate relations between resting RMSSD and stability in Stroop performance. Overall, findings suggest that vagal flexibility may promote the effects of resting vagal activity on stabilizing cognitive inhibition in the face of environmental perturbations.

The patient-generated subjective global assessment is a promising screening tool for cancer cachexia

BackgroundCancer cachexia is a complex metabolic syndrome characterised by a loss of muscle with or without loss of fat mass, and is associated with high morbidity and mortality. Despite its...

Elevated levels of anti-carbamylated protein antibody in patients with rheumatoid arthritis: association with disease activity and bone destruction

To measure the serum levels of anticarbamylated protein (CarP) antibodies in patients with rheumatoid arthritis (RA) in China and to evaluate the association of anti-CarP antibodies with clinical parameters and...

Influence of educational actions on transitioning of food safety culture in a food service context: Part 1 – Triangulation and data interpretation of food safety culture elements

Foodborne diseases still occur globally, and alongside food safety systems, food safety culture has been established as a factor in ensuring food safety. This study describes the development of a mixed-methods approach to collecting quantitative and qualitative data and interpreting the triangulated data to assess the prevailing food safety culture. The mixed-methods approach was designed based on the literature and was tested in a food service establishment at an army headquarters in Brazil. Both managers (3) and food handlers (39) participated. The quantitative (questionnaires and checklists) and qualitative (participant observations) data were triangulated using a scoring system on an interpretation grid. The scoring system typified the prevailing food safety culture (FS-culture) and its elements as reactive (score 1), reactive to active (score 1–2), active (score 2), active to proactive (score 2–3), or proactive (score 3) FS-culture. The overall prevailing FS-culture in the case study, scored 1–2. This FS-culture score was mainly attributed to the score 1 for the elements of leadership, risk perception, and management systems, styles and processes, and the score 1–2 for communication, knowledge, and work environment. The mixed-methods approach revealed an overestimation of FS-culture elements in the quantitative analysis and underestimation in the qualitative analysis. This discrepancy in results emphasises the usefulness of the concurrent analysis and highlights the need to employ triangulation to enable a comprehensive assessment of the prevailing FS-culture. The assessment provides concrete input for the development of educational actions aiming for changes in the prevailing FS-culture.