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Did the COVID-19 pandemic bring people together or push them apart? While infectious diseases tend to push people apart, crises can also bring people together through positive interdependence. We studied this question by asking an international sample (N = 1,006) about their inclinations to cooperate, perceptions of interdependence (i.e., shared fate), and perceived risk as well as local prevalence of COVID-19 infection across 14 time points from March to August, 2020. While perceived interdependence with others tended to increase during this time period, inclinations to cooperate decreased over time. At the within-person level, higher local prevalence of COVID-19 attenuated increases in perceived interdependence with others, and was associated with lower inclinations to cooperate. At the between-person level, people with high perceived interdependence with others reported more stable, or increasing, inclinations to cooperate over time than people with low perceived interdependence. Establishing a high sense of perceived interdependence with others may thus allow people to maintain cooperation during crises, even in the face of challenging circumstances such as those posed by a highly transmissible virus., Competing Interests: We have no conflicts of interest to disclose., (Copyright: © 2024 Guevara Beltran et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Digestion of collagen with clostridial collagenase (CC) produces peptides that can induce cellular responses consistent with wound healing in vivo. However, nonhealing human wounds are typically in a state of chronic inflammation. We evaluated the effects of CC on markers of inflammation in cell culture and wound fluid from diabetic patients., Methods: Lipopolysaccharide-induced release of tumor necrosis factor-α and interleukin-6 from interferon-γ-activated THP-1 monocytes was measured in the presence or absence of CC or CC collagen digests. In the clinical study, 17 individuals with mildly inflamed diabetic foot ulcers were randomized to receive CC ointment (CCO) or hydrogel. Weekly assessments included wound appearance and measurements. Wound exudate was collected at baseline and at 2 and 4 weeks of treatment. A multiplex assay was used to measure levels of analytes, including those associated with inflammation and with inflammation resolution., Results: Lower levels of tumor necrosis factor-α and interleukin-6 were found in media of cells cultured with CC or CC digests of collagen type I or III than for untreated lipopolysaccharide controls (P < .05). Clinically, CCO and hydrogel resulted in improvement in wound appearance and a decrease in mean wound area. The CCO, but not the hydrogel, was found to increase the level of analytes associated with resolution of inflammation while decreasing those associated with inflammation. There was a general correlation between resolution of inflammation and healing., Conclusions: These results support a hypothesis that debridement with CCO is associated with decreased inflammation and greater progress toward healing.

The effect of chronological age on skin characteristics is readily visible, and its underlying histological changes have been a field of study for several years. However, the effect of biological age (i.e. a person's rate of ageing compared to their chronological age) on the skin has so far only been studied in facial photographs. Skin biopsies obtained from middle-aged offspring of nonagenarian siblings that are genetically enriched for longevity were compared to their partners who represent the general Dutch population. Though of the same chronological age, the offspring were previously observed to be of a younger biological age than their partners. The biopsies were analysed on several aspects epidermal and elastic fibre morphology. We investigated whether these skin characteristics were dependent on chronological age, familial longevity (the difference between the offspring and partners) and Framingham heart risk scores, adjusted for external stressors. A decreased thickness and flattening of the epidermis as well as an increased amount of elastic fibres in the reticular dermis were observed with chronological age (P < 0.001, P < 0.001 and P = 0.03, respectively), but no effect of familial longevity was found. The Framingham heart risk score was associated with some skin characteristics. A slower rate of skin ageing does not mark offspring from nonagenarian siblings. Epidermal and elastic fibre morphometric characteristics are not a potential marker for familial longevity in middle-aged subjects enriched for familial longevity.

The magnetic resonance imaging (MRI) assessment of myocardial function and perfusion is a valuable complementary technique to coronary angiography. We describe a method of presenting and collating regional MRI data with the angiographic findings as annotated by the Green Lane reporting system. Routine clinical use of this approach is likely to increase the accuracy of MRI data interpretation and to influence both medical and interventional treatment strategies., (Copyright 2002 The Royal College of Radiologists.)

The authors developed and tested a dual stress magnetic resonance (MR) imaging protocol to evaluate myocardial perfusion, function, and hibernation. The technique was well tolerated, and high-quality images were achieved. The comprehensive information obtained can be used to guide clinical management decisions regarding coronary artery revascularization procedures. This protocol offers a one-stop assessment of patients with coronary artery disease with use of a clinical MR imager.

The symptoms of progressive dyspnea and stridor in the setting of malignant airway obstruction are severe and distressing. Conservative nebulizer and oxygen therapy offer little relief, and conventional stenting with T tubes requires a tracheostomy. In this article, we describe our experience with stenting in the treatment of malignant mediastinal disease using the Gianturco expanding metal-wire stents. The technique of placement is simple and the procedure was successful in all 21 cases. Relief of stridor was immediate and the dyspnea usually abated. These benefits continued through the mean survival period after stenting of 134 days (range, 2 to 799 days). The patients required only brief hospitalization (2.83 days) before returning home or to the referring institution. It appears that expandable wire stents may offer a simple yet effective intervention in the palliative treatment of mediastinal malignancy.

Background: Technetium-99m-methoxy-isobutyl-isonitrile (MIBI) has been shown to be a useful perfusion agent, and its improved imaging characteristics also allow evaluation of myocardial function. We evaluated the use of gated MIBI scintigraphy in patients undergoing percutaneous transluminal coronary angioplasty to show improvements in myocardial perfusion and function and to detect restenosis., Methods: Gated MIBI scintigraphy was performed in a preliminary study in 25 patients before angioplasty. Twenty-one patients who had undergone a successful procedure were re-examined 3 months later. Myocardial perfusion was evaluated and function measured using myocardial profiles along four axes., Results: Before angioplasty, 18 out of 21 patients had a reversible perfusion defect, and computer analysis of fractional shortening showed 19 out of 21 had abnormalities of left ventricular function during exercise. Only 11 out of 21 had a positive stress test. Mean global fractional shortening before angioplasty was 27.3% at rest and 26.6% during exercise (not significant). After angioplasty, left ventricular function was improved during exercise, with global fractional shortening increasing from 26.6% to 32.7% (P < 0.001). Repeat angiography was performed in 16 patients. Lesions in four patients had restenosed, in 11 they had not, and in one a different artery was occluded. Three of the four patients with restenosed lesions were identified using repeat perfusion imaging, and all four from abnormalities in left ventricular function. An abnormality in a new region was detected using both methods in the patient with the new occlusion. Normal perfusion and function were found in nine of the 11 patients without restenosed lesions. Two patients continued to have a positive stress test: one with a restenosed lesion and one with new disease., Conclusion: Dual assessment with gated MIBI scintigraphy provides useful data in patients undergoing angioplasty and may help in the selection of patients for repeat angiography.

Technetium-99m-methoxy-isobutyl-isonitrile (MIBI) is a myocardial perfusion agent which allows simultaneous assessment of left ventricular function. We evaluated left ventricular (LV) function with exercise using a new method of myocardial profiling in 43 patients with chest pain. Twenty-eight had significant coronary artery disease and 15 were normal on coronary angiography. Results were compared to equilibrium radionuclide ventriculography. MIBI fractional shortening (FS) correlated well with ejection fraction (EF) on exercise (r = 0.79, P = less than 0.001). There was also a good correlation between changes in global function from rest to exercise (r = 0.82, P = less than 0.001) with a sensitivity of diagnosing CAD of 71% and specificity of 80%. New regional wall abnormalities were detected in 25/28 with CAD with a sensitivity of 89% and specificity of 60%. There was also a close correlation between mean diameters measured with gated MIBI scans and volumes measured with RNV, end-diastolic diameter (EDD) versus end-diastolic volume (EDV) r = 0.78 (P = less than 0.001) at rest and r = 0.74 (P = less than 0.001) on exercise and end-systolic diameter (ESD) versus end-systolic volume (ESV) r = 0.72 (P = less than 0.001) at rest and r = 0.72 (P = less than 0.001) on exercise. This produced a sensitivity for detecting CAD of 79% and a specificity of 73%. These results show that gated MIBI scanning on exercise provides information comparable to RNV so enhancing the diagnostic usefulness of MIBI.

Technetium-99m methoxy-isobutylisonitrile, has been shown to be a useful perfusion agent for detecting coronary artery disease. Gated acquisition of perfusion images may remove motion artefact and improve detection. We compared the results of sensitivity and specificity for detecting coronary artery disease using perfusion images from the whole cardiac cycle (ungated) or from end-diastolic (gated) frames in 46 subjects, 31 with significant coronary disease and 15 with normal coronary arteries. There was no significant difference in detection of patients with coronary disease between the ungated and end-diastolic images: 25/31 with the ungated image and 28/31 with the end-diastolic. An improvement was made in detecting defects in the left anterior descending artery territory: 17/20 with the end-diastolic vs 11/20 with the ungated image (P less than 0.05) and in the right coronary artery region: 16/21 vs 10/21 (P less than 0.05), with an overall improvement in detecting regions supplied by stenosed coronary arteries: 45/55 end-diastolic vs 31/55 ungated (P less than 0.01). These results suggest use of the end-diastolic frame can significantly enhance the diagnostic capacity of methoxy-isobutylisonitrile perfusion imaging.

The introduction of the 99Tcm isonitrile perfusion agents has provided improved myocardial image quality with conventional imaging equipment allowing improved edge definition on gating. We evaluated left ventricular wall motion in 46 patients using gated 99Tcm-2-methoxy-2-methyl-isopropyl-1-isonitrile (MIBI) scintigraphy. Using a method of myocardial profiles in four axes, global and regional fractional shortening (FS) were assessed. A good correlation was found between FS in the left anterior oblique (LAO) 40 degrees projection and ejection fraction (EF) on gated radionuclide ventriculography (r = 0.81, P less than 0.001). This was improved by using FS in two planes, LAO 40 degrees and anterior (r = 0.88, P less than 0.001). There was also a good correlation between FS in two planes and EF on cine-angiography (r = 0.72, P less than 0.001). There was good intra- and interobserver agreement with the studies. Assessment of myocardial function using gated MIBI imaging and myocardial profiles provides useful additional information to the perfusion scan, thus enhancing the diagnostic usefulness of the agent.

Fluoroscopic detection of coronary artery calcification (C.A.C.) has no prognostic significance. Of 440 patients screened 78 were found to have C.A.C. The five year survival of this group was the same as that of a control group. Age, sex, distribution, and extent were also without significance. Improved equipment available today allows recognition of smaller areas of calcification which may have clinical significance.