Subclinical Group Research Articles

High serum Bhlhe40 levels are associated with subclinical atherosclerosis in patients with type 2 diabetes mellitus: A cross-sectional study.

Our previous studies have shown that the basic helix-loop-helix family member e40 (Bhlhe40) plays a critical role in regulating calcification and senescence of vascular smooth muscle cells induced by high glucose. In this study, we determined the association between serum Bhlhe40 levels and subclinical atherosclerosis in patients with type 2 diabetes mellitus (T2DM). 247 patients with T2DM were included in this cross-sectional study between June 2021 and July 2022. The presence of subclinical atherosclerosis was evaluated by carotid ultrasonography. Serum Bhlhe40 concentrations were measured with an ELISA kit. Serum Bhlhe40 levels were remarkably higher in the subclinical atherosclerosis group than in the subjects without subclinical atherosclerosis (p < 0.001). Correlation analysis showed a positive correlation between serum Bhlhe40 and carotid intima-media thickness (C-IMT) (r = 0.155, p = 0.015). The optimal threshold of serum Bhlhe40 > 5.67ng/mL had an area under the ROC curve (AUC) was 0.709 (p < 0.001). In addition, serum Bhlhe40 levels were associated with the prevalence of subclinical atherosclerosis (OR: 1.790, 95% CI: 1.414-2.266, p < 0.001). Serum Bhlhe40 levels were significantly higher in T2DM subjects with subclinical atherosclerosis and positively associated with C-IMT.

Altered Low Frequency Heart Rate Variability Associated with Agoraphobia in Panic Disorder: A Retrospective Study.

This study aimed to compare the clinical features of panic disorder (PD) with comorbid agoraphobia to those of PD alone. We focused on autonomic nervous system (ANS) alterations reflected in heart rate variability (HRV) and executive function deficits reflected in the Stroop test. We retrospectively compared psychometric features, Stroop test results, and resting-state HRV across three groups: a subclinical group with anxiety attack history, a PD group without agoraphobia, and a PD group with agoraphobia. The subclinical group included 10 male and 34 female, the PD without agoraphobia group included 17 male and 19 female, and the PD with agoraphobia group included 11 male and 18 female. The PD with agoraphobia group had higher Symptom Checklist-95 scores than the other groups. Both PD groups had longer reaction times in the Stroop test than the subclinical group. There were no significant differences in HRV parameters between the PD groups with and without agoraphobia. Compared with the subclinical group, the PD with agoraphobia group showed significantly lower values of the natural logarithm of low-frequency HRV. Our results do not support that executive function deficits and ANS alterations are more pronounced with comorbid agoraphobia among PD groups. However, PD with agoraphobia patients showed more complex and severe clinical symptoms in their self-reports. Compared with the subclinical group, PD patients with agoraphobia showed specific features in the natural logarithm of low-frequency HRV. Our findings suggest that agoraphobia comorbidity should be considered when evaluating or treating patients with PD.

Current Energy and Lipid Metabolism Biomarkers in Sheep with Subclinical And Clinical Pregnancy Toxemia

The aim of this study was to evaluate the relationship between existing metabolic biomarkers (asprosin, FABP1, PPARα and FGF21) and clinical parameters and to determine their role in the early diagnosis of sheep pregnancy toxemia. In the study, 70 Akkaraman sheep aged three to five years in the last three weeks of pregnancy were divided into three groups: healthy group (n = 20), subclinical group (n = 30), and clinical group (n = 20). Clinical examination (body temperature, respiratory rate, and heart rate), blood serum biochemistry, and ELISA analyses were performed. In sheep with clinical and subclinical pregnancy toxemia, serum PPARα, β-HBA, NEFA, HbA1c, HDL, triglyceride, creatinine, and phosphorus levels were statistically higher, whereas serum glucose and LDL levels were lower than in healthy sheep. However, serum FGF21, AST, ALT, and VLDL values were not statistically different between the three groups. In addition, serum asprosin and FABP1 levels were higher in the subclinical group than in the clinical group. Thus it was concluded that serum asprosin, FABP1, and PPARα findings could be useful in evaluating lipid and energy metabolism in subclinical and clinical forms of pregnancy toxemia. Since this study was based on blood samples from individually reared sheep herds, many environmental factors (e.g., housing, nutrition, and population density) could not be considered. For this reason, it is thought that there is a need for experimental studies in which environmental variables can be controlled.

New look at the power of zero coronary artery calcium (CAC) in Asian population: a systemic review and meta-analysis.

Numerous studies have validated a 5-year warranty period for heart health in Western populations with a coronary artery calcium (CAC) score of zero. While the calcium score is a crucial cardiovascular risk indicator, its interpretation in Asian populations remains unclear. This meta-analysis aimed to clarify the uncertainty surrounding the prevalence, warranty period, and prognostic implications of zero CAC scores in Asian populations. It also examined the impact of sex on subclinical CAC progression. While the calcium score is a crucial cardiovascular risk indicator, its interpretation in Asian populations remains unclear. The study aimed to shed light on these issues by exploring the specificities of subclinical CAC progression in the Asian context. Our systematic literature search, from the study's inception to October 2023, targeted studies on subclinical CAC progression in the Asian population with a zero CAC score. We searched the Cochrane Library, and PubMed. The search terms included "zero score", "coronary calcification", "zero CAC score", and "CAC scan". We evaluated seven published studies through a meta-analysis and assessed the risk of bias using the Newcastle-Ottawa Scale (NOS). In this meta-analysis of three observational studies addressing zero CAC prevalence (n=7,661), the pooled prevalence of zero CAC scores in the Asian population was 18.2% [95% confidence interval (CI): 12.5-25.9%]. A significant difference in follow-up warranty period was observed between the CAC zero group and subclinical CAC progression group (mean difference, 1.26 years; 95% CI: 0.94-1.58; P<0.001). Furthermore, the conversion rate of subclinical CAC progression differed significantly between males and females (risk ratio, 2.37; 95% CI: 1.98-2.84; P<0.001). Analysis of four studies revealed a notable discrepancy in the major adverse cardiovascular event (MACE) rate between the CAC (-) and CAC (+) groups (risk ratio, 4.78; 95% CI: 2.21-10.36; P<0.001). The meta-analysis of zero CAC scores in Asian populations suggested an 18.2% prevalence. A 5-year warranty period was noted, with heightened subclinical CAC progression likelihood after this duration. Additionally, sex-based differences were observed in subclinical CAC progression rates. These findings will provide clinical cardiovascular risk stratification for guiding gender-specific clinical decision-making in asymptomatic in Asian individuals.

Indicadores proteicos, enzimáticos e minerais da toxemia da prenhez clínica e subclínica durante o período de transição de cabras leiteiras

Abstract The purpose of this study was to evaluate the influence of clinical and subclinical pregnancy toxemia (PT) forms on the dynamics of blood metabolites, composing the protein, enzymatic and mineral profiles of dairy goats during the transitional period. 111 multiparous dairy goats were used in this research. The animals were raised under an intensive system. Experimental groups (n=3) were created using the βHB blood concentrations as a cut-off point. The G1 or control group (n = 40), G2 or subclinical PT group (n = 39) were established when least one of the experimental assessment times presented βHB values between 0.8 mmol/L and 1.6 mmol/L; whereas G3 or clinical PT group (n = 32), which at any of the experimental assessment times of βHB values were higher than 1.6 mmol / L when verified and also presented clinical signs of PT. The animals were evaluated on the 30th , 20th and 10th day ante-partum (dap), at parturition and on the 10th, 20th and 30th day postpartum (dpp). Total proteins (TP), albumin, globulin, urea, creatinine, aspartate aminotransferase (AST), Gamma glutamiltransferase (GGT), creatine kinase (CK), amylase, phosphorus, chloride and calcium, sodium and potassium ions were measured. The analysis of variance (F Test) was performed in order to investigate the effects and interactions between group and assessment times. Clinical and/or subclinical disease during the transitional period resulted in an increase of phosphorus and potassium concentrations (P&lt;0.05), while a decrease in total protein, albumin, globulin, and ionized calcium values was observed (P&lt;0.05). No statistical effect of PT on urea, creatinine, AST, GGT, CK, amylase and sodium was observed (P&gt;0.05). Except the ionized calcium and phosphorus, the levels of all the metabolites were influenced (P&lt;0.05) by late pregnancy, parturition and lactation. The occurrence of the subclinical form was higher than the clinical form during the transitional period. Among the all variables studied, mineral profile were those that suffered alteration resulting from PT, highlighting the ionized calcium. Attention is drawn to the magnitude of the impact of disease on these components interfering in animal health.

Proactive and reactive response inhibition of individuals with high schizotypy viewing different facial expressions: An ERP study using an emotional stop-signal task

The present study aimed to examine whether impairments in reactive (outright stopping) and proactive (preparation for stopping) response inhibition are affected by negative emotions in individuals with high schizotypy, a subclinical group at risk for schizophrenia, as well as the neural mechanisms underlying these processes. Twenty-seven participants with high schizotypy and 28 matched low-schizotypy individuals completed an emotional stop-signal task in which they responded to facial emotions (neutral or angry) or inhibited their responses (when the frame of the picture turned red). Electroencephalogram (EEG) data were also recorded during the task. At the neural level, analysis of go trials revealed that viewing angry faces impaired proactive inhibition. In addition, the high-schizotypy group exhibited a greater P3 amplitude in go trials in the neutral condition than the low-schizotypy group; however, no group difference was found in the angry condition. For stop trials (reactive inhibition), a smaller P3 amplitude was found in the angry condition than in the neutral condition. Moreover, high-schizotypy individuals showed smaller P3 amplitudes than low-schizotypy individuals. The current findings suggest that, at the neural level, viewing negative emotions impaired both proactive and reactive response inhibition. Individuals with high schizotypy exhibited impairments in proactive response inhibition in the neutral condition but not in the angry condition; they exhibited impaired reactive response inhibition in both emotion conditions. The present findings deepen our understanding of emotional response inhibition in individuals on the schizophrenia spectrum.

Fetal heart rate patterns complicated by chorioamnionitis and subsequent cerebral palsy in Japan.

This retrospective study was performed to investigate whether certain fetal heart rate patterns were associated with subsequent cerebral palsy (CP) in infants with chorioamnionitis at or near term. We used cases registered by the Japan Obstetric Compensation System for CP, which is a nationwide population-based database. Among them, 133 infants with chorioamnionitis who were born at ≥34 weeks of gestation were enrolled. All infants underwent magnetic resonance imaging (MRI), and all fetal heart rate charts had been interpreted according to the National Institute of Child Health and Human Development criteria, focusing on antepartum and immediately before delivery. The incidence of CP after chorioamnionitis at ≥34 weeks of gestation was 0.3 per 10 000 in Japan. Between the clinical (24%) and subclinical groups (76%), the incidence of abnormal fetal heart rate patterns did not differ. According to the MRI classification, 88% of the infants with CP showed hypoxic-ischemic encephalopathy. Half of the infants with CP experienced terminal bradycardia, leading to severe acidosis and exclusively to hypoxic-ischemic encephalopathy. In another half, who did not experience bradycardia, 80% had moderate acidosis (pH7.00-7.20) resulting in hypoxic-ischemic encephalopathy, and the remaining 20% showed non-acidosis resulting in brain damage other than hypoxic-ischemic encephalopathy. The fetal heart rate patterns before the terminal bradycardia showed that the incidence rates of late deceleration or decreased variability were high (>60%). Fifty percent of pregnant women with chorioamnionitis-related CP had terminal bradycardia that exclusively resulted in hypoxic-ischemic encephalopathy.

Changed cerebral function and morphology serve as neuroimaging evidence for subclinical type 2 diabetic polyneuropathy.

Central and peripheral nervous systems are all involved in type 2 diabetic polyneuropathy mechanisms, but such subclinical changes and associations remain unknown. This study aims to explore subclinical changes of the central and peripheral and unveil their association. A total of 55 type-2 diabetes patients consisting of symptomatic (n = 23), subclinical (n = 12), and no polyneuropathy (n = 20) were enrolled in this study. Cerebral morphology, function, peripheral electrophysiology, and clinical information were collected and assessed using ANOVA and post-hoc analysis. Gaussian random field correction was used for multiple comparison corrections. Pearson/Spearman correlation analysis was used to evaluate the association of the cerebral with the peripheral. When comparing the subclinical group with no polyneuropathy groups, no statistical differences were shown in peripheral evaluations except amplitudes of tibial nerves. At the same time, functional connectivity from the orbitofrontal to bilateral postcentral and middle temporal cortex increased significantly. Gray matter volume of orbitofrontal and its functional connectivity show a transient elevation in the subclinical group compared with the symptomatic group. Besides, gray matter volume in the orbitofrontal cortex negatively correlated with the Neuropathy Symptom Score (r = -0.5871, p < 0.001), Neuropathy Disability Score (r = -0.3682, p = 0.009), and Douleur Neuropathique en 4 questions (r = -0.4403, p = 0.003), and also found correlated positively with bilateral peroneal amplitude (r > 0.4, p < 0.05) and conduction velocities of the right sensory sural nerve(r = 0.3181, p = 0.03). Similarly, functional connectivity from the orbitofrontal to the postcentral cortex was positively associated with cold detection threshold (r = 0.3842, p = 0.03) and negatively associated with Neuropathy Symptom Score (r = -0.3460, p = 0.01). Function and morphology of brain changes in subclinical type 2 diabetic polyneuropathy might serve as an earlier biomarker. Novel insights from subclinical stage to investigate the mechanism of type 2 diabetic polyneuropathy are warranted.

Substance use and psychotic-like experiences in young people: a systematic review and meta-analysis.

This study aimed to systematically review and synthesise the available evidence on the prevalence and associations between psychotic-like experiences (PLEs) and substance use in children and adolescents aged ⩽17 years, prior to the typical age of development of prodromal symptoms of psychosis. As substance use has been associated with earlier age of psychosis onset and more severe illness, identifying risk processes in the premorbid phase of the illness may offer opportunities to prevent the development of prodromal symptoms and psychotic illness. MEDLINE, PsycINFO, and CINAHL databases were searched for chart review, case-control, cohort, twin, and cross-sectional studies. Study reporting was assessed using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist, and pooled evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Searches identified 55 studies that met inclusion criteria. Around two-in-five substance users reported PLEs [rate = 0.41, 95% confidence interval (CI) 0.32-0.51; low quality evidence], and one-in-five with PLEs reported using substances (rate = 0.19, 95% CI 0.12-0.28; moderate-to-high quality evidence). Substance users were nearly twice as likely to report PLEs than non-users [odds ratio (OR) 1.77, 95% CI 1.55-2.02; moderate quality evidence], and those with PLEs were twice as likely to use substances than those not reporting PLEs (OR 1.93, 95% CI 1.55-2.41; very low quality evidence). Younger age was associated with greater odds of PLEs in substance users compared to non-users. Young substance users may represent a subclinical at-risk group for psychosis. Developing early detection and intervention for both substance use and PLEs may reduce long-term adverse outcomes.

The Emotion-Regulation Benefits of Implicit Reappraisal in Clinical Depression: Behavioral and Electrophysiological Evidence.

Major depressive disorder (MDD) is characterized by emotion dysregulation. Whether implicit emotion regulation can compensate for this deficit remains unknown. In this study, we recruited 159 subjects who were healthy controls, had subclinical depression, or had MDD, and examined them under baseline, implicit, and explicit reappraisal conditions. Explicit reappraisal led to the most negative feelings and the largest parietal late positive potential (parietal LPP, an index of emotion intensity) in the MDD group compared to the other two groups; the group difference was absent under the other two conditions. MDD patients showed larger regulatory effects in the LPP during implicit than explicit reappraisal, whereas healthy controls showed a reversed pattern. Furthermore, the frontal P3, an index of voluntary cognitive control, showed larger amplitudes in explicit reappraisal compared to baseline in the healthy and subclinical groups, but not in the MDD group, while implicit reappraisal did not increase P3 across groups. These findings suggest that implicit reappraisal is beneficial for clinical depression.

Plasma metabolome of healthy and Rhodococcus equi-infected foals over time.

Foals that develop pulmonary ultrasonographic lesions on Rhodococcus equi (R. equi) endemic farms are treated with antibiotics because those at risk of developing clinical pneumonia (~20%) cannot be recognised early. Candidate biomarkers identified using metabolomics may aid targeted treatment strategies against R. equi. (1) To describe how foal ageing affects their plasma metabolome (birth to 8 weeks) and (2) to establish the effects that experimental infection with Rhodococcus equi (R. equi) has on foal metabolome. Experimental study. Nine healthy newborn foals were experimentally infected with R. equi as described in a previous study. Foals were treated with oral antibiotics if they developed clinical pneumonia (n=4, clinical group) or remained untreated if they showed no signs of disease (n=5, subclinical group). A group of unchallenged foals (n=4) was also included in the study. By the end of the study period (8 weeks), all foals were free of disease. This status was confirmed with transtracheal wash fluid evaluation and culture as well as thoracic ultrasonography. Plasma metabolomics was determined by GC-MS weekly for the study duration (8 weeks). Foals' plasma metabolome was altered by ageing (birth to 8 weeks) and experimental infection with R. equi as demonstrated using multivariate statistical analysis. The intensities of 25 and 28 metabolites were altered by ageing and infection (p < 0.05) respectively. Furthermore, 20 metabolites changed by more than 2-fold between clinical and subclinical groups. The number of foals is limited. Foals were experimentally infected with R. equi. Ageing and R. equi infection induced changes in the plasma metabolome of foals. These results provide an initial description of foal's plasma metabolome and serve as background for future identification of R. equi pneumonia biomarkers.

Impact of Fuchs Endothelial Corneal Dystrophy Severity on Scheimpflug-Derived Parameters After Descemet Membrane Endothelial Keratoplasty.

The aim of this study was to evaluate how Scheimpflug-derived parameters of eyes with Fuchs endothelial corneal dystrophy (FECD) are influenced by Descemet membrane endothelial keratoplasty (DMEK) depending on FECD severity and the presence of subclinical edema. A retrospective cohort study including 115 eyes (115 patients) that underwent DMEK for FECD and a control group of 27 eyes with nonpathological corneas was conducted. Preoperative and 6 months postoperative Scheimpflug imaging was used to analyze pachymetry, presence of tomographic features (loss of isopachs/displacement of the thinnest point/focal posterior depression), and corneal backscatter. FECD severity was based on the modified Krachmer scale and the absence/presence of subclinical edema. Scheimpflug-derived pachymetry, tomographic, and corneal backscatter parameters were correlated with FECD severity, and all changed from preoperatively to postoperatively (all P < 0.05). Postoperative central corneal thickness, anterior and posterior corneal backscatter, and presence of focal posterior depression remained different from the control group (all P < 0.05). Of eyes without preoperative clinical edema (n = 75), 18.7% showed 0 or 1 tomographic feature (no edema group) and 82.4% had 2 or 3 features (subclinical edema group). Compared with the control group, postoperative best-corrected visual acuity for the "no edema" group did not differ (0.03 ± 0.12 vs. -0.02 ± 0.08 logarithm of the minimum angle of resolution, P = 0.150) but was worse for the subclinical edema group (0.06 ± 0.08 vs. -0.02 ± 0.08 logarithm of the minimum angle of resolution, P = 0.001). For eyes without preoperative edema, more parameters reversed back to 'normal' levels than for eyes with (sub)clinical edema. Although most analyzed parameters correlated with FECD severity, corneal tomography might be best suited for objective grading of disease severity to aid in surgical decision-making.

Sensitivity and specificity of high frequency ultrasound score (DCEC) in diabetic peripheral neuropathy

ObjectivesTo summarize the ultrasonic characteristics of peripheral nerve damage in type 2 diabetes and to verify the diagnostic value of DCEC score for DPN.MethodsA total of 289 patients with type 2 diabetes evaluated peripheral neuropathy with neuroultrasound and nerve conduction at the Affiliated Hospital of Guizhou Medical University from June 2016 to June 2020. According to the diagnostic criteria from 2017 guidelines of China, 289 patients with type 2 diabetes were divided into three groups: DPN group: 203 cases; subclinical group: 48 cases; and non-DPN group: 38 cases. Kruskal Wallis test was used to identify the differences and characteristics of ultrasound scores between the all groups. The best cut-off value, sensitivity and specificity of DCEC score were obtained by receiver operator characteristic curve. Taking the diagnostic standard of diabetes peripheral neuropathy as the “gold standard”, the best diagnostic threshold, sensitivity and specificity were obtained by drawing the ROC curve of DCEC score, and then the diagnostic value of DCEC score for DPN was verifiedResultsCompared with non-DPN group, DCEC score in DPN group was significantly higher (P < 0.05). Otherwise,according to the ROC curve, the best cut-off value of DCEC score for DPN diagnosis was 12.5 (sensitivity 69.7%, specificity 71.1%).ConclusionsThe DCEC score system can effectively diagnose DPN with length-dependence,mainly including the increase of definition score.

Mindfulness-based Cognitive Therapy to Improve Sleep Quality in Older Adults with Insomnia.

There is a high prevalence of insomnia in older adults, which has negative consequences for their well-being and quality of life. The recommendation for first-line treatments is to administer non-pharmacological interventions. The objective of this research was to verify the effectiveness of Mindfulness-Based Cognitive Therapy in older adults with subclinical and moderate insomnia, studying its impact on sleep quality. One hundred and six older adults participated and were assigned to the subclinical insomnia (n = 50) or moderate insomnia (n = 56) groups; subsequently, they were randomly assigned to the control and intervention groups. Subjects were evaluated at two times with the Insomnia Severity Index and the Pittsburgh Sleep Quality Index. Significant results were obtained on both scales, with a reduction in insomnia symptoms in the subclinical and moderate intervention groups. The administration of a treatment that combines mindfulness and cognitive therapy is effective for treating insomnia in older adults.

Temperature Perception in the Blushing Region

Abstract. Background: Individuals with social phobia are characterized by a heightened sensitivity for physical symptom such as blushing. Objectives: We exploratorily examined whether blushing-fearful individuals with / without social phobia were more sensitive to perceiving facial temperature increases compared to healthy controls. Methods: 50 participants were tested using an adaptive two-alternative forced-choice task. A Peltier element was attached to the cheek and repeatedly warmed up in one of two phases. The participants’ task was to indicate in which of the two phases the temperature had increased. Results: Contrary to our hypothesis, blushing-fearful individuals with social phobia ( n = 11) were less sensitive to facial temperature increases, i. e., exhibited higher temperature perception threshold, than the subclinical group ( n = 14) and healthy controls ( n = 23). Limitations: The preliminary nature of our study should be noted, and replication in a larger sample is warranted. Conclusions: The findings may be best understood within a predictive coding framework: Individuals with social phobia may rely on priors when assessing their physical symptoms to form an impression of their public self in social situations.

Posttraumatic Stress Symptoms and Pain Sensitization After Whiplash Injury: A Longitudinal Cohort Study With Quantitative Sensory Testing.

Posttraumatic stress symptoms (PTSS) are common after whiplash injury and are associated with poor recovery. The acute stress response may lead to pain sensitization and widespread pain, thereby compromising recovery. To our knowledge, no longitudinal study has assessed the associations between early PTSS and pain sensitization over time using quantitative sensory testing (QST). The aim of this study was to compare participants with different levels of PTSS, as measured by the impact of event scale (IES; subclinical 0–8, mild 9–25, and clinical ≥ 26) at baseline (<10-day post-injury) and at a follow-up of 1, 3, 6, and 12-month post-injury on pain sensitivity, neck mobility, pain distribution, and pain intensity. In total, 740 participants were recruited from emergency units or general practitioners with acute neck pain after a whiplash injury. The clinical PTSS group showed increased pain sensitivity on all QSTs at all time points compared to the subclinical PTSS group. Also, the clinical PTSS group showed significantly lower neck mobility at all time points except for a 3-month follow-up compared to the subclinical PTSS group. Moreover, the clinical PTSS group showed more widespread pain and self-reported headache and neck pain intensity at all time points compared to the subclinical PTSS group. This study emphasizes that participants with clinical levels of PTSS constitute a high-risk group that is sensitized to pain early after the injury. Hence, screening for PTSS within the 1st week after whiplash injury for those who experience high levels of pain intensity and distress may be an important clinical procedure in the assessment and treatment of whiplash-associated disorders (WAD).

Experimental Infection of Pigs with a ST 245 Brachyspira hyodysenteriae Isolated from an Asymptomatic Pig in a Herd with No History of Swine Dysentery

Swine dysentery (SD) is characterized by a severe mucohemorrhagic colitis caused by infection with Brachyspira species. In infected herds the disease causes considerable financial loss due to mortality, slow growth rates, poor feed conversion, and costs of treatment. B. hyodysenteriae is the most common etiological agent of SD and infection is usually associated with disease. However, isolated reports have described low pathogenic strains of B. hyodysenteriae. The aim of this study was to describe an experimental infection trial using a subclinical B. hyodysenteriae isolated from an animal without clinical signs and from a disease-free herd, to evaluate the pathogenicity and clinical pathological characteristics compared to a highly clinical isolate. Forty-eight 5-week-old pigs were divided into three groups: control, clinical and the subclinical isolates. The first detection/isolation of B. hyodysenteriae in samples of the animals challenged with a known clinical B. hyodysenteriae strain (clinical group) occurred 5th day post inoculation. Considering the whole period of the study, 11/16 animals from this group were qPCR positive in fecal samples, and diarrhea was observed in 10/16 pigs. In the subclinical isolate group, one animal had diarrhea. There were SD large intestine lesions in 3 animals at necropsy and positive B. hyodysenteriae isolation in 7/15 samples of the subclinical group. In the control group, no diarrhea, gross/microscopic lesions, or qPCR positivity were observed. Clinical signs, bacterial isolation, macroscopic and histologic lesions were significantly difference among groups, demonstrating low pathogenicity of the subclinical isolate in susceptible pigs.

Performances of Corneal Topography and Tomography in the Diagnosis of Subclinical and Clinical Keratoconus.

AimThe purpose of the study was to assess the efficacy of topographical and tomographical indices given by the Pentacam (pachymetric, tomopetric, and aberometric) in clinical and subclinical keratoconus (KCN) diagnosis.Material and MethodsIn this observational analytic retrospective study, patients with abnormal findings in topography and tomography maps but with no signs on clinical examination (subclinical KCN group, sKCN), patients with clinical keratoconus (KCN group), and healthy subjects (Control group) were evaluated.ResultsThe KCN group proved significantly different (p < 0.001) values of the investigated parameters than the Control group. Eleven out of 28 investigated parameters proved significantly different in the sKCN group compared to controls (p < 0.001). Two topographic measurements, namely I-S (cut-off = 1.435, a large value indicates the presence of KCN) and CCT (cut-off = 537, a small value indicates the presence of KCN), showed AUCs equal to 1 [0.999 to 1]. Six other Pentacam measurements, including Back maximum keratometry (Back Kmax) proved to be excellent parameters for case-finding and screening. In distinguishing sKCN from normal eyes, Pentacam index of vertical asymmetry (IVA), inferior-superior difference (I-S) value, thinnest point (TP), Belin Ambrosio Enhanced Ectasia Display (BAD_D) and root mean square total (RMS total) performed best.ConclusionsIn distinguishing sKCN from normal eyes, Back Kmax, IVA, I-S, and RMS total values demonstrated higher accuracy and utility. Six indices, namely ISV, IVA, KISA, PRC, RMS-HOA, and Back Kmax demonstrate excellent utility in case-finding and screening for clinical KCN.

Incremental Value of Noncontrast Chest Computed Tomography-derived Parameters in Predicting Subclinical Carotid Atherosclerosis: From the PERSUADE Study.

To investigate the incremental value of noncontrast chest computed tomography (CT)-derived parameters, such as coronary artery calcium score (CACS) and epicardial adipose tissue volume (EATv), in predicting subclinical carotid atherosclerosis above traditional risk factors in community-based asymptomatic populations of northern China. A total of 2195 community-based asymptomatic individuals were enrolled from Jidong Oilfield in accordance with the PERSUADE study. CACS and EATv were measured on noncontrast chest CT. Demographics and ideal cardiovascular health score (ICHS) were collected through questionnaires. We recalculated the ideal cardiovascular health risk score (ICHRS) (ICHRS=14-ICHS) and standardized the parameters as log-CACS and body mass index adjusted EATv (i-EATv). Subclinical carotid atherosclerosis was assessed by Doppler sonography and defined as any prevalence of average carotid intima-media thickness ≥1.00 mm, appearance of carotid plaque, and carotid arterial stenosis in the areas of extracranial carotid arteries on both sides. A total of 451 (20.55%) individuals presented subclinical carotid atherosclerosis. CACS and EATv were significantly greater in the subclinical group, while ICHS was lower. In multivariate logistic regression, ICHRS (odds ratio [OR]=1.143, 95% confidence interval [CI]: 1.080-1.210, P <0.001), log-CACS (OR=1.701, 95% CI: 1.480-1.955, P <0.001), and i-EATv (OR=1.254, 95% CI: 1.173-1.341, P <0.001) were found to be independent risk predictors for subclinical carotid atherosclerosis. In receiver-operating characteristic curve analysis, when combined with male sex and age level, the area under the curve of the ICHRS basic model increased from 0.627 (95% CI: 0.599-0.654) to 0.757 (95% CI: 0.732-0.781) ( P <0.0001). Further adding log-CACS and i-EATv, the area under the curve demonstrated a statistically significant improvement (0.788 [95% CI: 0.765-0.812] vs. 0.757 [95% CI: 0.732-0.781], P <0.0001). Noncontrast chest CT-derived parameters, including CACS and EATv, could provide significant incremental improvement for predicting subclinical carotid atherosclerosis beyond the conventional risk assessment model based on ICHRS.

A meta-analysis of conditioned fear generalization in anxiety-related disorders.

Generalization of conditioned fear is adaptive in some situations but maladaptive when fear excessively generalizes to innocuous stimuli with incidental resemblance to a genuine threat cue. Recently, empirical interest in fear generalization as a transdiagnostic explanatory mechanism underlying anxiety-related disorders has accelerated. As there are now several studies of fear generalization across multiple types of anxiety-related disorders, the authors conducted a meta-analysis of studies reporting behavioral measures (subjective ratings and psychophysiological indices) of fear generalization in anxiety-related disorder vs. comparison groups. We conducted systematic searches of electronic databases (conducted from January-October 2020) for fear generalization studies involving anxiety-related disorder groups or subclinical analog groups. A total of 300 records were full-text screened and two unpublished datasets were obtained, yielding 16 studies reporting behavioral fear generalization measures. Random-effects meta-analytic models and meta-regressions were applied to the identified data. Fear generalization was significantly heightened in anxiety-related disorder participants (N = 439) relative to comparison participants (N = 428). We did not identify any significant clinical, sample, or methodological moderators. Heightened fear generalization is quantitatively supported as distinguishing anxiety-related disorder groups from comparison groups. Evidence suggests this effect is transdiagnostic, relatively robust to experimental or sample parameters, and that generalization paradigms are a well-supported framework for neurobehavioral investigations of learning and emotion in anxiety-related disorders. We discuss these findings in the context of prior fear conditioning meta-analyses, past neuroimaging investigations of fear generalization in anxiety-related disorders, and future directions and challenges for the field.