138 research outputs found
Factor Structure and Psychometric Characteristics of the Beck Depression Inventory-Fast Screen in a Sample of Patients with Pain
The purpose of this study was to extend previous literature of the BDI-FastScreen and demonstrate a more empirical clinical utility within a sample of patients with pain. This study utilized existing data found in a large, multiphysician, multilocation pain management practice. The sample consisted of 328 male and female patients with pain. Various psychometric analyses were performed. Results pertaining to the internal consistency of the BDI-FastScreen determined the items most highly correlated were pessimism and loss of pleasure. A factor analysis revealed 49.18 % of the variance of the factor structure of the BDI-FastScreen was comprised of one factor. Gender was investigated as a moderator of depression and pain and although gender was not demonstrated to moderate the pain / depression relationship, there was a clear relationship between pain and depression. There was a significant correlation between the physicians’ rated depression score and patients’ corresponding, self-reported depression scores on the BDI-FastScreen. Researchers compared patients’ self-rated depression scores and depression descriptors embedded within another measure. A significant correlation between the BDI-FastScreen scores and the items on a derivative of the SFMPQ was found. All the correlations were significant, confirming the supposition that breaking down the seven items into descriptors and embedding the descriptors into a different measure adequately assesses for depression. Results of this project demonstrate the BDI-FastScreen can be condensed to one word descriptors and adequately assess for depression in a population with chronic pain. Instead of utilizing the data from two distinct measures, the adapted patient encounter form, a derivative of the SF-MPQ and BDI-FastScreen, both clinical disorders can be expeditiously and adequately assessed. This study will provide physicians and clinical health psychologists with diverse insights and the ability to utilize multiple depression measures to provide insightful treatments for their patients
Global tectonic studies: Hotspots and anomalous topography
Volcanic activity on Earth and its secular variations are compared with that on other terrestrial planets. Activity at divergent, transform, and convergent plate margins is described with particular emphasis on hot spots and flood basalts. The timing and causing of uplifting above 500 meters, which in not associated with either plate boundaries or the normal nonplate margin edges of continents is considered with particular focus on the Guyana Highlands in southern Venezuela and western British Guiana, and the Brazilian Highlands in the central, eastern, and southern parts of the country. The mode and mechanism of plateau uplifting and the re-elevation of old mountain belts and subsidence of intra-continental basins are also discussed
Rheology, dispersion, and cure kinetics of epoxy filled with amine‐ and non‐functionalized reduced graphene oxide for composite manufacturing
This study evaluates the effect of plasma surface functionalization of reduced graphene oxide particles on the processing characteristics and homogeneity of dispersion of a bisphenol A‐(epichlorhydrin) epoxy matrix and amine‐based hardener with varying weight fractions from 0.00 to 1.50 wt%. It was observed that amine‐functionalized reduced graphene oxide leads to a more drastic viscosity increase of up to 18‐fold of the uncured suspensions and that its presence influences the conversion rates of the curing reaction. Optical microscopy of thin sections and transmission electron microscopy analysis showed that a more homogeneous dispersion of the particles could be achieved especially at higher weight fractions by using an appropriate surface functionalization. This knowledge can be used to define suitable processing conditions for epoxies with amine‐based hardeners depending on the loading and functionalization of graphene‐related particles
Health status in older hospitalized patients with cancer or non-neoplastic chronic diseases
BACKGROUND: Whether cancer is more disabling than other highly prevalent chronic diseases in the elderly is not well understood, and represents the objective of the present study. METHODS: We used data from the Gruppo Italiano di Farmacovigilanza nell'Anziano (GIFA) study, a large collaborative observational study based in community and university hospitals located throughout Italy. Our series consisted of three groups of patients with non-neoplastic chronic disease (congestive heart failure, CHF, N = 832; diabetes mellitus, N = 939; chronic obstructive pulmonary disease, COPD, N = 399), and three groups of patients with cancer (solid tumors without metastasis, N = 813; solid tumors with metastasis, N = 259; leukemia/lymphoma, N = 326). Functional capabilities were ascertained using the activities of daily living (ADL) scale, and categorical variables for dependency in at least 1 ADL or dependency in 3 or more ADLs were considered in the analysis. Cognitive status was evaluated by the 10-items Hodgkinson Abbreviated Mental Test (AMT). RESULTS: Cognitive impairment was more prevalent in patients with CHF (28.0%) or COPD (25.8%) than in those with cancer (solid tumors = 22.9%; leukemia/lymphoma = 19.6%; metastatic cancer = 22.8%). Dependency in at least 1 ADL was highly prevalent in patients with metastatic cancer (31.3% vs. 24% for patients with CHF and 22.4% for those with non-metastatic solid tumors, p < 0.001). In people aged 80 years or more, metastatic cancer was not associated with increased prevalence of physical disability. In multivariable analysis, metastatic cancer was associated with a greater prevalence of physical (OR 2.09, 95%CI 1.51–2.90) but not cognitive impairment (OR 1.34, 95%CI 0.94–1.91) with respect to CHF patients. Finally, diabetes was significantly associated with cognitive impairment (OR 1.40, 95%CI 1.11–1.78). CONCLUSION: Cancer should not be considered as an ineluctable cause of severe cognitive and physical impairment, at least not more than other chronic conditions highly prevalent in older people, such as CHF and diabetes mellitus
The Self Model and the Conception of Biological Identity in Immunology
The self/non-self model, first proposed by F.M. Burnet, has dominated immunology for sixty years now. According to this model, any foreign element will trigger an immune reaction in an organism, whereas endogenous elements will not, in normal circumstances, induce an immune reaction. In this paper we show that the self/non-self model is no longer an appropriate explanation of experimental data in immunology, and that this inadequacy may be rooted in an excessively strong metaphysical conception of biological identity. We suggest that another hypothesis, one based on the notion of continuity, gives a better account of immune phenomena. Finally, we underscore the mapping between this metaphysical deflation from self to continuity in immunology and the philosophical debate between substantialism and empiricism about identity
Testing the theory of immune selection in cancers that break the rules of transplantation
Modification of cancer cells likely to reduce their immunogenicity, including loss or down-regulation of MHC molecules, is now well documented and has become the main support for the concept of immune surveillance. The evidence that these modifications, in fact, result from selection by the immune system is less clear, since the possibility that they may result from reorganized metabolism associated with proliferation or from cell de-differentiation remains. Here, we (a) survey old and new transplantation experiments that test the possibility of selection and (b) survey how transmissible tumours of dogs and Tasmanian devils provide naturally evolved tests of immune surveillance
Consecuencias Neurológicas y Psiquiátricas a largo plazo (6 meses) en pacientes con COVID leve de la comunidad.: Long-term (6 months) neurological and psychiatric consequences in mild COVID community patients
Long-term neurological complications of coronavirus infection have been described in the acute episode in hospitalized patients. 63% had fatigue and muscle weakness, 26% sleep disorders; 24% gait disorders and 23% anxiety and depression. The greater the severity of the acute episode, the greater the probability of long-term neurological symptoms. The objective of this work was to study the prevalence at 6 months in a cohort of mostly mild outpatients. 96 subjects with a mean age of 48 years, 54% women, and 86% mild outpatients were evaluated by means of a telephone interview. Of these, at 6 months, 32% of the population presented neurological or psychiatric symptoms. Anxiety (31%), Fatigue (26%), Mental fog (24%), Insomnia (22%), Depression (21%), Headache (19%) among others. Conclusions: In this work with subjects who suffered from mild COVID, neurological and psychiatric symptoms were still prominent as reported in acute severs ones.Las complicaciones neurológicas a largo plazo de la infección por coronavirus han sido descriptas en los pacientes hospitalizados en el episodio agudo. De ellos el 63% presentaron fatiga y debilidad muscular, el 26% trastornos del sueño; 24% trastornos en la marcha y 23% ansiedad y depresión. A mayor severidad del episodio agudo mayor probabilidad de sintomatología neurológica a largo plazo. El objetivo de este trabajo fue estudiar la prevalencia de síntomas neurológicos y psiquiátricos a los 6 meses en una cohorte de pacientes adultos, principalmente ambulatorios. Fueron evaluados mediante una entrevista telefónica 96 sujetos con una media de edad de 48 años, 54% mujeres, y el 86 % ambulatorios leves. De ellos a los 6 meses el 32% de la población presentaba aun síntomas neurológicos o psiquiátricos. Ansiedad (31%), fatiga (26%), niebla mental (24%), insomnio (22%), depresión (21%), y cefalea (19%) entre otros. Conclusiones: en el presente trabajo con sujetos que sufrieron COVID leve los síntomas neurológicos y psiquiátricos post COVID continuaron prominentes como lo reportado en otros trabajos en las formas agudas más graves
Tolerogenic Function of Dimeric Forms of HLA-G Recombinant Proteins: A Comparative Study In Vivo
HLA-G is a natural tolerogenic molecule involved in the best example of tolerance to foreign tissues there is: the maternal-fetal tolerance. The further involvement of HLA-G in the tolerance of allogeneic transplants has also been demonstrated and some of its mechanisms of action have been elucidated. For these reasons, therapeutic HLA-G molecules for tolerance induction in transplantation are actively investigated. In the present study, we studied the tolerogenic functions of three different HLA-G recombinant proteins: HLA-G heavy chain fused to β2-microglobulin (B2M), HLA-G heavy chain fused to B2M and to the Fc portion of an immunoglobulin, and HLA-G alpha-1 domain either fused to the Fc part of an immunoglobulin or as a synthetic peptide. Our results demonstrate the tolerogenic function of B2M-HLA-G fusion proteins, and especially of B2M-HLA-G5, which were capable of significantly delaying allogeneic skin graft rejection in a murine in vivo transplantation model. The results from our studies suggest that HLA-G recombinant proteins are relevant candidates for tolerance induction in human transplantation
The HCMV membrane glycoprotein US10 selectively targets HLA-G for degradation
Human cytomegalovirus (HCMV) encodes an endoplasmic reticulum (ER)-resident transmembrane glycoprotein, US10, expressed early in the replicative cycle of HCMV as part of the same cluster that encodes the known immunoevasins US2, US3, US6, and US11. We show that US10 down-regulates cell surface expression of HLA-G, but not that of classical class I MHC molecules. The unique and short cytoplasmic tail of HLA-G (RKKSSD) is essential in its role as a US10 substrate, and a tri-leucine motif in the cytoplasmic tail of US10 is responsible for down-regulation of HLA-G. Both the kinetics of HLA-G degradation and the mechanisms responsible appear to be distinct from those used by the US2 and US11 pathways, suggesting the existence of a third route of protein dislocation from the ER. We show that US10-mediated degradation of HLA-G interferes with HLA-G–mediated NK cell inhibition. Given the role of HLA-G in protecting the fetus from attack by the maternal immune system and in directing the differentiation of human dendritic cells to promote the evolution of regulatory T cells, HCMV likely targets the HLA-G–dependent axis of immune recognition no less efficiently than it interferes with classical class I MHC–restricted antigen presentation
Characteristics of Nondisabled Older Patients Developing New Disability Associated with Medical Illnesses and Hospitalization
OBJECTIVE: To identify demographic, clinical, and biological characteristics of older nondisabled patients who develop new disability in basic activities of daily living (BADL) during medical illnesses requiring hospitalization. DESIGN: Longitudinal observational study. SETTING: Geriatric and Internal Medicine acute care units. PARTICIPANTS: Data are from 1,686 patients aged 65 and older who independent in BADL 2 weeks before hospital admission, enrolled in the 1998 survey of the Italian Group of Pharmacoepidemiology in the Elderly Study. MEASUREMENTS: Study outcome was new BADL disability at time of hospital discharge. Sociodemographic, functional status, and clinical characteristics were collected at hospital admission; acute and chronic conditions were classified according to the International Classification of Disease, ninth revision; fasting blood samples were obtained and processed with standard methods. RESULTS: At the time of hospital discharge 113 patients (6.7%) presented new BADL disability. Functional decline was strongly related to patients’ age and preadmission instrumental activities of daily living status. In a multivariate analysis, older age, nursing home residency, low body mass index, elevated erythrocyte sedimentation rate, acute stroke, high level of comorbidity expressed as Cumulative Illness Rating Scale score, polypharmacotherapy, cognitive decline, and history of fall in the previous year were independent and significant predictors of BADL disability. CONCLUSION: Several factors might contribute to loss of physical independence in hospitalized older persons. Preexisting conditions associated with the frailty syndrome, including physical and cognitive function, comorbidity, body composition, and inflammatory markers, characterize patients at high risk of functional decline
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