Search

Systemic inflammation has been recognized as the cause and consequence of metabolic dysregulation in diabetes mellitus (DM). Presepsin has recently emerged as a promising biomarker for the detection of bacterial infections and sepsis. There is evidence that gut dysbiosis results in the increased circulating concentrations of Gram-negative bacteria lipopolysaccharide, the linkage of presepsin, which in turn promotes insulin resistance and correlates with the risk of diabetic complications. Thus, we hypothesized that presepsin could reflect the magnitude of systemic inflammation and metabolic decompensation in patients with DM even in the absence of infection. In this cross-sectional pilot study, we included 75 infection-free individuals with well-controlled (n = 19) and uncontrolled (n = 23) type 2 diabetes (T2D), well-controlled (n = 10) and uncontrolled (n = 10) type 1 diabetes (T1D), and normoglycemic controls (n = 13). Presepsin levels were compared between the groups and potential associations with demographic, clinical, and laboratory parameters were explored. We observed that the duration of DM was associated with presepsin values (p = 0.008). When the participants were classified into the type of DM groups, the presepsin levels were found to be lower in the patients with T2D compared to those with T1D (p = 0.008). However, significance in that case was driven by the difference between the well-controlled groups. After adjusting for the effects of DM duration, presepsin was significantly lower in the well-controlled T2D group compared to the well-controlled T1D group [1.34 (2.02) vs. 2.22 (4.20) ng/mL, p = 0.01]. Furthermore, we adjusted our findings for various confounders, including age, body mass index, and waist circumference, and found that the difference in the presepsin values between the adequately controlled groups remained significant (p = 0.048). In conclusion, our findings suggest that presepsin could potentially serve as a surrogate marker of inflammation and metabolic control in people with DM.

Purpose To describe the history of the Excellence Centre (EC) programme of the European Society of Hypertension (ESH) since the beginning in 2006, its achievements, and its future developments. Materials and Methods We list the number of ECs per country, the research projects performed so far, and the organisational steps needed to reshape the EC programme for the future. Results In August 2023, the ESH EC programme includes 118 registered ECs in 21 European and 7 non-European countries. Updates about the formal steps for application, re-application, transfer of EC and retirement of EC heads are given. Conclusions The EC programme of the ESH has been a success from the beginning. Further refinements will make it fit for the next decades.

The prevalence of hypertension is rising, and the majority of patients are managed by General Physicians (GPs). GPs workload influences their capacity to follow and implement hypertension guidelines adequately. The time needed to treat (TNT) each patient at the GP level should be taken into consideration in hypertension practice guidelines.

People learn by both decomposing and combining concepts; most accounts of combination are either compositional or conjunctive. We augment the DORA model of representation learning to build new predicate representation by combining (or compressing) existing predicate representations (e.g., building a predicate a_b by combining predicates a and b). The resulting model learns structured relational representations from experience and then combines these relational concepts to form more complex, compressed concepts. We show that the resulting model provides an account of a category learning experiment in which categories are defined as novel combinations of relational concepts.

Examining factors that protect against the negative repercussions of stress on everyday functioning is paramount. This experimental study investigated the effects of music listening and personality on the reduction of perceived stress and cognitive performance. Seventy adults (18-45 years, M = 22.8, SD = 6.6) completed measures of the Dark Triad traits (psychopathy, narcissism, and Machiavellianism), music preferences, and music uses, and undertook a stress-inducing procedure. Participants were randomly allocated to three groups: hip-hop/rap, classical music, control, being exposed to the respective genre or silence for 20 min after the predicted peak in stress. Results showed that classical and hip-hop/rap music equally facilitated stress reduction. Narcissism predicted lower stress when classical music preference was high. Narcissism also predicted enhanced performance but also greater stress, when paired with infrequent stress-management through music. These novel findings demonstrate how particular genres and traits, despite being predominantly negatively perceived, can enhance stress reduction or cognitive performance., Author(s): Teresa Gomes Arrulo [sup.1] , Michail Doumas [sup.1] , Kostas A. Papageorgiou [sup.1] Author Affiliations: (1) grid.4777.3, 0000 0004 0374 7521, School of Psychology, Queen's University Belfast, , David [...]

Abstract Aims The Iron Intravenous Therapy in Reducing the burden of Severe Arrhythmias in HFrEF (RESAFE‐HF) registry study aims to provide real‐word evidence on the impact of intravenous ferric carboxymaltose (FCM) on the arrhythmic burden of patients with heart failure with reduced ejection fraction (HFrEF), iron deficiency (ID), and implanted cardiac implantable electronic devices (CIEDs). Methods and results The RESAFE‐HF (NCT04974021) study was designed as a prospective, single‐centre, and open‐label registry study with baseline, 3, 6, and 12 month visits. Adult patients with HFrEF and CIEDs scheduled to receive IV FCM as treatment for ID as part of clinical practice were eligible to participate. The primary endpoint is the composite iron‐related endpoint of haemoglobin ≥ 12 g/dL, ferritin ≥ 50 ng/L, and transferrin saturation > 20%. Secondary endpoints include unplanned HF‐related hospitalizations, ventricular tachyarrhythmias detected by CIEDs and Holter monitors, echocardiographic markers, functional status (VO2 max and 6 min walk test), blood biomarkers, and quality of life. In total, 106 patients with a median age of 72 years (14.4) were included. The majority were male (84.9%), whereas 92.5% of patients were categorized to New York Heart Association II/III. Patients' arrhythmic burden prior to FCM administration was significant—19 patients (17.9%) received appropriate CIED therapy for termination of ventricular tachyarrhythmia in the preceding 12 months, and 75.5% of patients have frequent, repetitive multiform premature ventricular contractions. Conclusions The RESAFE‐HF trial is expected to provide evidence on the effect of treating ID with FCM in HFrEF based on real‐world data. Special focus will be given on the arrhythmic burden post‐FCM administration.

People often misrecognize objects that are similar to those they have previously encountered. These mnemonic discrimination errors are attributed to shared memory representations (gist) typically characterized in terms of meaning. In two experiments, we investigated multiple semantic and perceptual relations that may contribute: at the concept level, a feature-based measure of concept confusability quantified each concept's tendency to activate other similar concepts via shared features; at the item level, rated item exemplarity indexed the degree to which the specific depicted objects activated their particular concepts. We also measured visual confusability over items using a computational model of vision, and an index of color confusability. Participants studied single (Experiment 1, N = 60) or multiple (Experiment 2, N = 60) objects for each basic-level concept, followed by a recognition memory test including studied items, similar lures, and novel items. People were less likely to recognize studied items with high concept confusability, and less likely to falsely recognize their lures. This points to weaker basic-level semantic gist representations for objects with more confusable concepts because of greater emphasis on coarse processing of shared features relative to fine-grained processing of individual concepts. In contrast, people were more likely to misrecognize lures that were better exemplars of their concept, suggesting that enhanced basic-level semantic gist processing increased errors due to gist across items. False recognition was also more frequent for more visually confusable lures. The results implicate semantic similarity at multiple levels and highlight the importance of perceptual as well as semantic relations.

This mixed methods study assessed the appropriateness of an "aged-up," brief bullying bystander intervention (STAC) and explored the lived experiences of high school students trained in the program. Quantitative results included an increase in knowledge and confidence to intervene in bullying situations, awareness of bullying, and use of the STAC strategies. Utilizing the consensual qualitative research methodology, we found students spoke about (a) increased awareness of bullying situations, leading to a heightened sense of responsibility to act; (b) a sense of empowerment to take action, resulting in positive feelings; (c) fears related to intervening in bullying situations; and (d) the natural fit of the intervention strategies. Implications for counselors include the role of the school counselor in program implementation and training school staff to support student "defenders," as well as how counselors in other settings can work with clients to learn the STAC strategies through psychoeducation and skills practice.

Background: Janus kinase (JAK) inhibitors constitute a novel class of oral biologic disease-modifying antirheumatic drugs for patients with rheumatoid arthritis (RA). However, their use has been associated with increased risk of major cardiovascular events. We investigated whether treatment with JAK inhibitors exerts significant alterations in the micro- and microvasculature in RA patients. Methods: Thirteen patients with RA initiating treatment with JAK inhibitors were prospectively studied. Eventually, data from 11 patients who completed the study were analyzed. Procedures were performed at baseline and 3 months after treatment. Nailfold videocapillaroscopy was applied to detect alterations of the dermal capillary network. Participants underwent 24 h ambulatory blood pressure monitoring (Mobil-O-Graph device) for the assessment of blood pressure (both brachial and aortic) and markers of large artery stiffening [pulse wave velocity (PWV), augmentation index] throughout the whole 24 h and the respective day- and nighttime periods. Carotid intima–media thickness was assessed with ultrasound. Results: Three-month treatment with JAK inhibitors was not associated with any differences in brachial and aortic blood pressure, arterial stiffness, and carotid atherosclerosis, with the only exception of nighttime PWV, which was significantly elevated at follow-up. However, three-month treatment with JAK inhibitors induced significant microvascular alterations and increased the total number of capillaroscopic abnormalities. Conclusions: Three-month treatment with JAK inhibitors may exert significant effects on microcirculation as assessed with nailfold videocapillaroscopy, whereas macrovascular structure and function appears largely unaffected. Further research toward this direction may add substantial information to the available literature regarding cardiovascular aspects of JAK inhibitors in RA.

Humans readily generalize, applying prior knowledge to novelsituations and stimuli. Advances in machine learning have be-gun to approximate and even surpass human performance, butthese systems struggle to generalize what they have learnedto untrained situations. We present a model based on well-established neurocomputational principles that demonstrateshuman-level generalisation. This model is trained to play onevideo game (Breakout) and performs one-shot generalisationto a new game (Pong) with different characteristics. The modelgeneralizes because it learns structured representations that arefunctionally symbolic (viz., a role-filler binding calculus) fromunstructured training data. It does so without feedback, andwithout requiring that structured representations are specifieda priori. Specifically, the model uses neural co-activation todiscover which characteristics of the input are invariant and tolearn relational predicates, and oscillatory regularities in net-work firing to bind predicates to arguments. To our knowledge,this is the first demonstration of human-like generalisation ina machine system that does not assume structured representa-tions to begin with.

Participants in Goldwater et al. (2018) reported using eitherfeature- or relation-based strategy during a series of categorylearning tasks. A computational modeling study was conductedto investigate whether performance on Experiments 1 and 2 ofGoldwater et al. (2018) might be explained by the assumptionthat participants used either feature- or relation-basedrepresentational encoding during learning. Humanparticipants’ and model performance are compared andimplications are discussed

Objectives: Age-related changes in dual-task walking are well established, but research in this topic is based on evidence from laboratory rather than real-world studies. We investigated how dual-task walking on real-world surfaces affects young and older adults' gait characteristics and cognitive resource allocation. Method: Sixteen young (aged 19–35, 12 female) and fifteen older adults (aged 70–85, 7 female) with no major neurological or musculoskeletal disorders walked at a self-selected speed on forty-metre outdoor paths that had asphalt or grass surface. They walked with or without a cognitive task (counting backwards). Cognitive task difficulty was individually adjusted at 80 % accuracy. Participants performed the three tasks in Single Task (ST Asphalt, ST Grass, ST Cognitive) and Dual Task context (DT Asphalt-Cognitive, DT Grass-Cognitive). Results: The two groups showed similar dual task effects in cognition and walking speed, both of which were slower when dual-task walking. Older adults' steps were wider overall but only young adults widened their step width when dual-task walking on grass compared to asphalt. Similarly, young adults' step height increased from single to dual-task walking when on grass, where older adults' did not. Discussion: The lack of adaptation of step width and height when dual-task walking may leave older adults vulnerable to tripping or falling in common real-world conditions, such as while walking on grass, gravel, or uneven city sidewalks. Considering this, the built environment should be made more accessible to facilitate older adults' safe walking.

Cyberbullying is a significant problem among school-aged youth. Although a growing body of literature has documented the association between cyberbullying victimization and mental health risks, there is limited research examining the impact of witnessing cyberbullying, particularly among elementary school students. To address this gap, we conducted a cross-sectional study with elementary school students (N = 122). Students completed questionnaires assessing witnessing cyberbullying, witnessing school bullying, bullying victimization, depressive symptoms, and social anxiety. Regression analyses revealed that witnessing cyberbullying was positively associated with depressive symptoms ([beta] = 0.25, p < 0.04) and social anxiety ([beta] = 0.30, p < 0.01), even after controlling for frequency of witnessing school bullying and bullying victimization. Further, the moderating effect of witnessing school bullying was significant for depressive symptoms ([beta] = -0.44, p < 0.001) and social anxiety ([beta] = -0.31, p < 0.01), such that students who witnessed cyberbullying only reported the highest level of depressive symptoms and social anxiety. The moderating effect of bullying victimization was not significant. Findings suggest the importance of providing programs to support elementary school students who witness cyberbullying to reduce the mental health risks associated with being a cyberbullying bystander.

Arterial thromboembolism has been associated with cancer or its treatment. Unlike venous thromboembolism, the incidence and risk factors have not been extensively studied. Here, we investigated the incidence of arterial thromboembolic events (ATEs) in an institutional series of advanced urinary tract cancer (aUTC) treated with cytotoxic chemotherapy. The ATE definition included peripheral arterial embolism/thrombosis, ischemic stroke and coronary events. A total of 354 aUTC patients were analyzed. Most patients (95.2%) received platinum-based chemotherapy. A total of 12 patients (3.4%) suffered an ATE within a median time of 3.6 months from the start of chemotherapy. The most frequent ATE was ischemic stroke (n = 7). Two ATEs were fatal. The 6-month and 24-month incidence were 2.1% (95% confidence interval [CI]: 0.9–4.1) and 3.6% (95% CI: 1.9–6.2), respectively. Perioperative chemotherapy increased the risk for ATE by 5.55-fold. Tumors other than UTC and pure non-transitional cell carcinoma histology were also independent risk factors. No association with the type of chemotherapy was found. Overall, ATEs occur in 4.6% of aUTC patients treated with chemotherapy and represent a clinically relevant manifestation. Perioperative chemotherapy significantly increases the risk for ATE. The role of prophylaxis in high-risk groups should be prospectively studied.

A randomized controlled study evaluated a brief, bystander bullying intervention for junior high school students. Students in both groups reported an increase in knowledge and confidence to act as defenders and to utilize strategies to intervene on behalf of victims of bullying. Findings suggest possible carry-over effects from the intervention group to control group. Students in the intervention group, however, reported a significantly greater ability to identify of bullying and a decrease in anxiety (p = 0.06) relative to the control group. There were no differences in reported depression between the two groups. Implications for school counselors are discussed.

Background: Intensive rehabilitation through challenging and individualized tasks are recommended to enhance upper limb recovery after stroke. Robot-assisted therapy (RAT) and serious games could be used to enhance functional recovery by providing simultaneous motor and cognitive rehabilitation. Objective: The aim of this study is to clinically validate the dynamic difficulty adjustment (DDA) mechanism of ROBiGAME, a robot serious game designed for simultaneous rehabilitation of motor impairments and hemispatial neglect. Methods: A proof of concept, with 24 participants in subacute and chronic stroke, was conducted using a 5-day protocol (two days were dedicated to assessment and three days to consecutive training sessions). Participants performed three consecutive ROBiGAME sessions during which overall task difficulty was determined through simultaneous DDA of motor and attentional parameters. Relationships between clinical and robotic assessment scores with respective task-difficulty parameters were analyzed using a multivariate regression model and a principal component analysis. Results: Game difficulty rapidly (within approximately thirty minutes) auto-adapted to match individual impairment levels. The relationship between task-difficulty parameters with motor (Fugl Meyer Assessment: r = 0.84 p < 0.05) and with attentional impairments (Bells test total omissions: r = 0.617 p < 0.05) showed that task-difficulty during RAT adapted to each participant's degree of impairment. Principal component analysis identified two data subsets determining overall task-difficulty, one subset for motor and the other for cognitive functional evaluation scores with respective task-difficulty parameters. Conclusions: This proof of concept clinically validated a DDA mechanism and showed how task-difficulty adequately adapted to match individual degrees of impairment during RAT after stroke. ROBiGAME provided simultaneous motor and attentional exercises with parameters determining task-difficulty strongly related with respective clinical and robotic evaluation scores. Individualized levels of game difficulty and rapid adjustment of the system suggest implementation in clinical practice. Registry number This study was registered at ClinicalTrials.gov (NCT02543424). [ABSTRACT FROM AUTHOR]

Background/Objectives: Parkinson's disease (PD) is a complex neurodegenerative disorder that presents significant challenges for care home residents and staff. This scoping review aimed to synthesize evidence on PD education and training available to care home staff, examine existing programs and their effectiveness, and identify gaps in current educational approaches. Methods: A scoping review (ScR) was conducted and guided by the Preferred Reporting Items for Systematic Reviews and Meta-analysis extension for ScR (PRISMA-ScR) checklist. A comprehensive search of six electronic databases was conducted in September 2024. Studies focusing on PD education and training for care home staff were included. Data extraction and quality appraisal were performed, followed by thematic analysis to identify key patterns and themes. Results: Seven studies met the inclusion criteria. The thematic analysis revealed four main themes: improvements in PD knowledge and confidence, improvements in care practices and outcomes, the need for increased specialist education, and the incorporation of communication training. Educational interventions led to significant improvements in staff knowledge, confidence, and care practices. However, these studies also highlighted a critical need for more specialized PD training among care home staff. Conclusions: This review provides evidence of promise regarding the potential impact of PD-specific education on care home staff knowledge and practices. Future research should focus on developing and evaluating comprehensive, tailored educational programs to enhance the quality of care for people with PD in care home settings. [ABSTRACT FROM AUTHOR]