Social engagement after stroke – is it relevant to cognitive function? A cross-sectional analysis of UK Biobank data

Background: Findings from studies in older adult populations suggest that measures of social engagement may be associated with health outcomes, including cognitive function. Plausibly the magnitude and direction of this association may differ in stroke. The disabling nature of stroke increases the likelihood of social isolation and stroke survivors are at high risk of cognitive decline. We assessed the association between social engagement and cognitive function in a sample of stroke survivors. Methods: We included available data from stroke survivors in the UK Biobank (N=8776; age range: 40-72; 57.4% male). In a series of regression models, we assessed cross-sectional associations between proxies of social engagement (frequency of family/friend visits, satisfaction with relationships, loneliness, opportunities to confide in someone, participation in social activities) and performance on domain specific cognitive tasks: reaction time, verbal-numerical reasoning, visual memory and prospective memory. We adjusted for demographics, health-, lifestyle-, and stroke-related factors. Accounting for multiple testing, we set our significance threshold at p<0.003. Results: After adjusting for covariates, we found independent associations between faster reaction times and monthly family visits as compared to no visit (standardised beta=-0.32, 99.7% CI: -0.61 to -0.03, N=4,930); slower reaction times and religious group participation (standardised beta=0.25, 99.7% CI 0.07 to 0.44, N=4,938); and poorer performance on both verbal-numerical reasoning and prospective memory tasks with loneliness (standardised beta=-0.19, 99.7% CI: -0.34 to -0.03, N=2,074; odds ratio=0.66, 99.7% CI: 0.46 to 0.94, N=2,188; respectively). In models where all proxies of social engagement were combined, no associations remained significant. Conclusions: We found limited task-specific associations between cognitive performance and proxies of social engagement, with only loneliness related to two tasks. Further studies are necessary to confirm and improve our understanding of these relationships and investigate the potential to target psychosocial factors to support cognitive function in stroke survivors

Spectrofluorometric characteristics of fluorescent dissolved organic matter in a surface microlayer in the Southern Baltic coastal waters

This paper presents results of characterization of Dissolved Organic Matter (DOM) using fluorescence spectroscopy in the surface microlayers (SML) and subsurface layers (SS) in the Baltic Sea. Samples for spectroscopic measurements were collected during five research cruises in April/May and October 2013 and 2014 in a surface microlayer and a subsurface layer at a depth of 1 m along two transects from the river outlets to the open sea. The first transect was located from the Vistula River outlet to the Gdansk Deep and the second transect was located ´ from the Łeba River outlet to Słupsk Furrow. Results indicated that DOM fluorescence intensity in the SML is higher by 20% compared to the SS. The Humification Index, HIX values were lower in SML than SS by 13%. That indicates that SML is depleted in molecules with high molecular weight and higher aromaticy. The inverse relationship of fluorescence intensity of dominant peaks with salinity both in SML and SS suggests that FDOM variability is regulated mostly by terrestrial DOM input

Difficulties in diagnosis of malignant mesothelioma of the pleura - case reports

Złośliwy międzybłoniak opłucnej nadal stanowi częsty problem diagnostyczny. Niecharakterystyczny obraz kliniczny i radiologiczny oraz podobieństwo do innych nowotworów (gruczolakoraka) w badaniu mikroskopowym często powodują opóźnienie w ustaleniu ostatecznego rozpoznania. Badaniem rozstrzygającym jest histopatologiczna i immunohistochemiczna ocena wycinków pobranych za pomocą torakoskopii, a w przypadkach wątpliwych - za pomocą torakotomii. W niniejszej pracy przedstawiono przypadki 3 chorych z międzybłoniakiem opłucnej, u których rozpoznanie było utrudnione ze względu na nieswoiste objawy oraz fałszywie ujemny wynik biopsji torakoskopowej.Malignant pleural mesothelioma of the pleura is a difficult diagnostic problem. Diagnosis is often delayed due to nonspecific clinical symptoms, a variety of radiological images and similarity to other neoplasms particularly adenocarcinoma in microscopical evaluation. The mainstay of diagnosis is histopatological and immunohistochemical analysis of microscopic samples obtained during thoracoscopy or diagnostic thoracotomy in equivocal cases. In this report, presented are three cases of malignant pleural mesothelioma are presented

30 Leczenie skojarzone (brachyterapia HDR oraz teleterapia) zaawansowanego raka oskrzela

WstępW paliatywnym leczeniu raka oskrzela jedną z metod skutecznych w zwalczaniu duszności wywołanej obturacją jest brachyterapia. Ze względu na umiejscowienie zmiany, u niektórych chorych brachyterapia jest z leczeniem z wyboru. Leczenie skojarzone łączące teleterapię z brachyterapią jest stosowane jako radykalne (brachyterapia jako podwyższenie miejscowe dawki) lub paliatywne (teleterapia skierowana przeciw pakietom węzłów chłonnych uciskających oskrzele z zewnątrz). W pracy omówiono wyniki leczenia skojarzonego chorych na zaawansowanego raka oskrzeli.Materiał i metodyW okresie od maja 1999 do marca 2000 r. leczono w Wielkopolskim Centrum Onkologii 15 chorych na raka oskrzeli łącząc brachyterapię HDR z paliatywną teleterapią metodą hypofrakcjonacji. Wiek chorych sięgał od 39 do 80 lat, średnio 54,3 lata. U 3 chorych leczenie rozpoczęto od teleterapii (20–30 Gy) a u 12 – od brachyterapii HDR. Stosowano dawkę 3 × 7,5 Gy (9 chorych) lub 3 ×10 Gy (6 chorych) liczoną w odległości 1 cm od osi aplikatora. Chorych poddano obserwacji klinicznej oraz bronchoskopowej, oceniając remisję miejscową oraz ustępowanie duszności, kaszlu oraz krwioplucia w 1, 3 i 6 miesiącu obserwacji.WynikiPo zakończeniu leczenia subiektywną poprawę (ustępowanie duszności, kaszlu, krwawienia, bólu) stwierdzono u wszystkich chorych. W jednym przypadku uzyskano całkowitą remisję zmian utrzymującą się ponad 6 miesięcy, u 12 chorych – remisję częściową, u 2 chorych nie stwierdzono remisji w kolejnych badaniach.WnioskiLeczenie skojarzone (brachyterapia HDR i teleterapia) zaawansowanego raka oskrzela jest metodą skuteczna., powoduje u wielu chorych ustępowanie duszności oraz poprawę komfortu życia. Wysoka miejscowa dawka łączna nie wpłynęła na wzrost częstości powikłań

Research protocol – Assessing Post-Stroke Psychology Longitudinal Evaluation (APPLE) study : A prospective cohort study in stroke

Acknowledgements The following experts provided advice on the design and conduct of the APPLE study: Prof Jonathan Evans (University of Glasgow); Prof Gillian Mead (University of Edinburgh); Prof Sarah T Pendlebury (University of Oxford) Funding This work was supported by the Chief Scientist Office and Stroke Association (funders reference PPA 2015/01_CSO).Peer reviewedPublisher PD

Use of generic medicines in Latvia : Awareness, opinions and experiences of the population

Funding Information: Funding was provided by EEA Financial Mechanism and Latvian state (award number 2012.EEZ/DAP/MIC/183). The project is financially supported by Iceland, Liechtenstein and Norway. Publisher Copyright: © 2019 The Author(s).Background: To stimulate use of generic medicines a combination of supply and demand side mechanisms are employed in the Latvian reimbursement system. It is reported that patients have high out-of-pocket pharmaceutical spending and that they overpay by not choosing generic medicines. Patient preferences may be an important obstacle in implementing generic policy. Objective of this study was to assess awareness, opinions and experience of the Latvian population regarding use of generic medicines. Methods: Survey of representative sample of the population of Latvia (n = 1005) aged 18-74 was conducted in March 2015. The survey was distributed in Latvian and Russian languages using Computer Assisted Web Interviews. Associations between experience with generic medicines, preference for medicines, and sociodemographic variables were tested with Pearson Chi-square statistics. Associations between the previous experience and information given by different sources versus choice between medicines were tested with Spearman's correlation test. Results: 72.3% of the population were informed about generic medicines. Men (66.9%) and respondents with primary or secondary education (58.3%; 69.3%) were less informed compared to total (72.3%). From those who recalled using generic medicines (n = 441), 94.4% evaluated their experience as positive or neutral. Despite this, only 21% of the population would opt for generic medicines. The strongest preference for brand-name medicines was in the age group > 55 (40.5%). Opinion of a physician was the most important factor when choosing between generic and brand-name medicines (88.7%). The more positive the information provided by general practitioners, physician specialists, pharmacists, family members, friends and internet is perceived, the more likely respondents are to choose generic medicines (p < 0.001). Conclusion: This study demonstrates that people in Latvia are aware of generic medicines but only a minority of the population would choose them when presented with a choice. It is therefore important that health care professionals provide objective and unbiased information about generic medicines to their patients. Interventions should aim to reach groups that are less informed and to improve providers' understanding and communication with patients about generics.publishersversionPeer reviewe

Remote and local monitoring of dissolved and suspended fluorescent organic matter off the Svalbard

Distribution maps of CDOM and algal pigments, both in superficial and deep waters, have been obtained operating a portable dual laser spectrofluorometer and a lidar fluorosensor equipments for the first time during two polish AREX oceanographic campaigns in 2006 and 2007 summertime in the Svalbard area. The different hydrological regimes strongly affected the biological factors in the waters around the Svalbard Islands as monitored during the campaigns with strong regional differentiations between the two years. The occurrence of large phytoplanktonic blooms and patches have been observed in the western area of the Spitsbergen Island coastline due to the nutrient release from pack ice and/or iceberg melting with values of more than 10 µg/l in both campaigns. Different CDOM fractions have been monitored with the remote and local instruments and inverse proportionality with salinity is confirmed along the water column. Phycobilin pigments, as phycoerythrin and phycocyanin accessory algal pigments, have been monitored in the northern area as well as tyrosine and tryptophan protein-like fluorescence distribution. The double filtration, performed with the dual laser spectrofluorometer, allows to retrieve the small fluorescence contribution due to NADPH and carotenoids pigments in the blue fluorescence emission. Successively, the large spectroscopic data base has been critically analyzed with a robust statistic instrument, thus identifying different marine provinces and retrieve distinctive CDOM fractions

Fluorescence spectroscopy for wastewater monitoring: A review

© 2016. Wastewater quality is usually assessed using physical, chemical and microbiological tests, which are not suitable for online monitoring, provide unreliable results, or use hazardous chemicals. Hence, there is an urgent need to find a rapid and effective method for the evaluation of water quality in natural and engineered systems and for providing an early warning of pollution events. Fluorescence spectroscopy has been shown to be a valuable technique to characterize and monitor wastewater in surface waters for tracking sources of pollution, and in treatment works for process control and optimization. This paper reviews the current progress in applying fluorescence to assess wastewater quality. Studies have shown that, in general, wastewater presents higher fluorescence intensity compared to natural waters for the components associated with peak T (living and dead cellular material and their exudates) and peak C (microbially reprocessed organic matter). Furthermore, peak T fluorescence is significantly reduced after the biological treatment process and peak C is almost completely removed after the chlorination and reverse osmosis stages. Thus, simple fluorometers with appropriate wavelength selectivity, particularly for peaks T and C could be used for online monitoring in wastewater treatment works. This review also shows that care should be taken in any attempt to identify wastewater pollution sources due to potential overlapping fluorophores. Correlations between fluorescence intensity and water quality parameters such as biochemical oxygen demand (BOD) and total organic carbon (TOC) have been developed and dilution of samples, typically up to ×10, has been shown to be useful to limit inner filter effect. It has been concluded that the following research gaps need to be filled: lack of studies on the on-line application of fluorescence spectroscopy in wastewater treatment works and lack of data processing tools suitable for rapid correction and extraction of data contained in fluorescence excitation-emission matrices (EEMs) for real-time studies

Why Are Outcomes Different for Registry Patients Enrolled Prospectively and Retrospectively? Insights from the Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF).

Background: Retrospective and prospective observational studies are designed to reflect real-world evidence on clinical practice, but can yield conflicting results. The GARFIELD-AF Registry includes both methods of enrolment and allows analysis of differences in patient characteristics and outcomes that may result. Methods and Results: Patients with atrial fibrillation (AF) and ≥1 risk factor for stroke at diagnosis of AF were recruited either retrospectively (n = 5069) or prospectively (n = 5501) from 19 countries and then followed prospectively. The retrospectively enrolled cohort comprised patients with established AF (for a least 6, and up to 24 months before enrolment), who were identified retrospectively (and baseline and partial follow-up data were collected from the emedical records) and then followed prospectively between 0-18 months (such that the total time of follow-up was 24 months; data collection Dec-2009 and Oct-2010). In the prospectively enrolled cohort, patients with newly diagnosed AF (≤6 weeks after diagnosis) were recruited between Mar-2010 and Oct-2011 and were followed for 24 months after enrolment. Differences between the cohorts were observed in clinical characteristics, including type of AF, stroke prevention strategies, and event rates. More patients in the retrospectively identified cohort received vitamin K antagonists (62.1% vs. 53.2%) and fewer received non-vitamin K oral anticoagulants (1.8% vs . 4.2%). All-cause mortality rates per 100 person-years during the prospective follow-up (starting the first study visit up to 1 year) were significantly lower in the retrospective than prospectively identified cohort (3.04 [95% CI 2.51 to 3.67] vs . 4.05 [95% CI 3.53 to 4.63]; p = 0.016). Conclusions: Interpretations of data from registries that aim to evaluate the characteristics and outcomes of patients with AF must take account of differences in registry design and the impact of recall bias and survivorship bias that is incurred with retrospective enrolment. Clinical Trial Registration: - URL: http://www.clinicaltrials.gov . Unique identifier for GARFIELD-AF (NCT01090362)