Explicit and implicit values are associated with decision-making in dilemmas related to health

Background. Individuals who aim at changing their health behaviour do not always handle the issue immediately. This discrepancy is usually referred to as the intention behaviour gap. Implicit processes are one of the factors which mediate between intention and behaviour. Compared to cognitive and affective implicit processes, motivational implicit processes are given a very little account in the modern science. Currently it is not quite clear how implicit and explicit values are focused on within the health-related decision-making process. Objective. The present study shows how implicit and explicit values and their congruency are focused on health-related decision-making process in dilemmas. The dilemmas were described as situations within which the subjects report on making a choice: either to avoid losses related to health, or to avoid losses related to other values. Choosing health, the participant avoids losses related to it, whereas they acquire losses related to other values, and vice versa. Design. The participants participated in the Schwartz’s Value Survey (measuring explicit values), Implicit Association Tests (measuring implicit values) and solve three types of dilemmas (health vs benevolence, health vs self-direction, health vs achievement). Research Results The research shows that implicit and explicit values are not related to each other and are differently related to decision-making process in dilemmas. Namely, implicit values of achievement, benevolence and self-direction are related to decision-making in dilemmas with low potential losses. Many of these values turn to be significant to the participants, and some of the dilemmas are not solved in favour of health-related issues. Explicit values are related to decision-making process in dilemmas with high potential losses. Many of these values turn to be significant to the participants, and some of the dilemmas are not solved in favour of health-related issues. Finally, it was found that high correlation between explicit and implicit values is positively related to decision making in favor of health. Conclusion. The research shows that explicit and implicit values are differently associated with health-related decision-making in the participants

Scabies in dermatovenerologist practice: a clinical case of delayed diagnosis in a patient with chronic dermatosis. Case report

Despite the current approaches to diagnostics and treatment, regulatory documentation and guidelines, the diagnosis of scabies can often be delayed. The long-term scabies can mimic acute and chronic dermatoses which causes inadequate treatment. Physicians, including dermatovenerologists, misdiagnose scabies. Aim – to clarify historical aspects of scabies, present a clinical case of scabies complicated by allergic dermatitis and lymphoplasia in a patient with Darye's disease as an example of delayed diagnosis of scabies, errors in management tactics and features of treatment of scabies in a patient with chronic dermatosis

A New Method for Treating Burn Wounds Using Targeted Delivery of Medicinal Substances by Magnetic Nanocarrier (Experimental Part)

Проведено экспериментальное исследование на лабораторных животных по изучению эффективности адресной доставки мази левомеколь с помощью магнитных наночастиц и внешнего магнитного поля при термических ожогах. В исследовании принимало участие 20 крыс с двумя очагами ожога. Крысы были разделены на 4 группы: без лечения, терапия с использованием мази левомеколь, лечение с использованием наночастиц, мази левомеколь и внешнего магнитного поля и только магнитотерапии. При гистологическом исследовании на 14-е сутки во всех группах в зоне термического повреждения кожи были отмечены признаки глубокого ожога III и IV степени с распространением некроза на всю глубину дермы и на мышцы. В группе с наночастицами, мазью левомеколь и магнитным полем на фоне уменьшения воспаления отмечалось очаговое появление грануляционной ткани. Таким образом, гистологические исследования ожогового раневого процесса лабораторных животных показали, что использование инновационного биологически активного ранозаживляющего средства на основе наночастиц в сочетании с мазью левомеколь улучшает регенерацию тканей и приводит к ускорению эпителизации, что в целом повышает результаты лечения ожоговой раны. Использование внешнего магнитного поля способствует адресной доставке лечебного нанокомплекса и поддержанию оптимальной концентрации препарата в ранеExperimental studies have been carried out on laboratory animals to investigate the effectiveness of targeted delivery of levomekol ointment using magnetic nanoparticles and an external magnetic field for treatment of thermal burns. The study involved 20 rats, with two burns on each. The rats were divided into 4 groups: untreated; treated with levomekol ointment; treated with levomekol ointment associated with nanoparticles and an external magnetic field; and treated with magnetic field alone. Histological examination was conducted on Day 14, and in all groups, in the thermal burn zone of the skin there were signs of deep three- and four-degree burns with necrosis spread through the dermis, reaching the muscle. In the group with levomekol ointment associated with nanoparticles and magnetic field, inflammation was decreased, and focal granulation tissue formation was observed. Thus, histological studies of the burn wound process in laboratory animals showed that the use of an innovative biologically active wound healing agent based on nanoparticles in combination with the levomecol ointment improved tissue regeneration and accelerated epithelialization, which enhanced the effectiveness of burn wound treatment. The use of an external magnetic field facilitated targeted delivery of the therapeutic nanosystem and maintenance of the optimal concentration of the drug in the woun

Albiglutide and cardiovascular outcomes in patients with type 2 diabetes and cardiovascular disease (Harmony Outcomes): a double-blind, randomised placebo-controlled trial

Background: Glucagon-like peptide 1 receptor agonists differ in chemical structure, duration of action, and in their effects on clinical outcomes. The cardiovascular effects of once-weekly albiglutide in type 2 diabetes are unknown. We aimed to determine the safety and efficacy of albiglutide in preventing cardiovascular death, myocardial infarction, or stroke. Methods: We did a double-blind, randomised, placebo-controlled trial in 610 sites across 28 countries. We randomly assigned patients aged 40 years and older with type 2 diabetes and cardiovascular disease (at a 1:1 ratio) to groups that either received a subcutaneous injection of albiglutide (30–50 mg, based on glycaemic response and tolerability) or of a matched volume of placebo once a week, in addition to their standard care. Investigators used an interactive voice or web response system to obtain treatment assignment, and patients and all study investigators were masked to their treatment allocation. We hypothesised that albiglutide would be non-inferior to placebo for the primary outcome of the first occurrence of cardiovascular death, myocardial infarction, or stroke, which was assessed in the intention-to-treat population. If non-inferiority was confirmed by an upper limit of the 95% CI for a hazard ratio of less than 1·30, closed testing for superiority was prespecified. This study is registered with ClinicalTrials.gov, number NCT02465515. Findings: Patients were screened between July 1, 2015, and Nov 24, 2016. 10 793 patients were screened and 9463 participants were enrolled and randomly assigned to groups: 4731 patients were assigned to receive albiglutide and 4732 patients to receive placebo. On Nov 8, 2017, it was determined that 611 primary endpoints and a median follow-up of at least 1·5 years had accrued, and participants returned for a final visit and discontinuation from study treatment; the last patient visit was on March 12, 2018. These 9463 patients, the intention-to-treat population, were evaluated for a median duration of 1·6 years and were assessed for the primary outcome. The primary composite outcome occurred in 338 (7%) of 4731 patients at an incidence rate of 4·6 events per 100 person-years in the albiglutide group and in 428 (9%) of 4732 patients at an incidence rate of 5·9 events per 100 person-years in the placebo group (hazard ratio 0·78, 95% CI 0·68–0·90), which indicated that albiglutide was superior to placebo (p<0·0001 for non-inferiority; p=0·0006 for superiority). The incidence of acute pancreatitis (ten patients in the albiglutide group and seven patients in the placebo group), pancreatic cancer (six patients in the albiglutide group and five patients in the placebo group), medullary thyroid carcinoma (zero patients in both groups), and other serious adverse events did not differ between the two groups. There were three (<1%) deaths in the placebo group that were assessed by investigators, who were masked to study drug assignment, to be treatment-related and two (<1%) deaths in the albiglutide group. Interpretation: In patients with type 2 diabetes and cardiovascular disease, albiglutide was superior to placebo with respect to major adverse cardiovascular events. Evidence-based glucagon-like peptide 1 receptor agonists should therefore be considered as part of a comprehensive strategy to reduce the risk of cardiovascular events in patients with type 2 diabetes. Funding: GlaxoSmithKline

The relationship of seminal transforming growth factor-β1 and interleukin-18 with reproductive success in women exposed to seminal plasma during IVF/ICSI treatment

It has been proposed that the transforming growth factor (TGF)-β1 present in seminal plasma (SP) triggers a female immune response favorable for implantation. We hypothesize that seminal interleukin (IL)-18, a cytokine that can potentially cause implantation failure, interferes with the beneficial effect of TGF-β1. This study aims to determine whether the levels of seminal TGF-β1 and IL-18 are associated with reproductive outcomes in patients exposed to SP during in vitro fertilization (IVF) or IVF with intracytoplasmic sperm injection (ICSI). A prospective study, which included 71 couples undergoing IVF/ICSI was carried out. Female patients were exposed to their partners’ SP via timed intercourse before the day of ovum pick-up (OPU) and also subjected to intravaginal SP application just after OPU. Quantitative measurements of total TGF-β1 (active plus latent) as well as IL-18 were determined by FlowCytomix™ technology in the SP to be used for intravaginal applications. Comparison of SP cytokine profiles between pregnant and non-pregnant groups revealed that pregnancy was correlated with a lower concentration of IL-18 (P = 0.018) and lower content per ejaculate for both of IL-18 (P = 0.0003) and TGF-β1 (P = 0.047). The ratio of TGF-β1-to-IL-18 concentration was significantly higher in the pregnant than in the non-pregnant group (P = 0.026). This study supports the notion that two key cytokines TGF-β1 and IL-18, both present in SP are associated with reproductive outcomes in female patients exposed to SP during IVF/ICSI treatment

Inhibition of Cyclin-Dependent Kinases 8/19 Restricts Bacterial and Virus-Induced Inflammatory Responses in Monocytes

Hyperactivation of the immune system remains a dramatic, life-threatening complication of viral and bacterial infections, particularly during pneumonia. Therapeutic approaches to counteract local and systemic outbreaks of cytokine storm and to prevent tissue damage remain limited. Cyclin-dependent kinases 8 and 19 (CDK8/19) potentiate transcriptional responses to the altered microenvironment, but CDK8/19 potential in immunoregulation is not fully understood. In the present study, we investigated how a selective CDK8/19 inhibitor, Senexin B, impacts the immunogenic profiles of monocytic cells stimulated using influenza virus H1N1 or bacterial lipopolysaccharides. Senexin B was able to prevent the induction of gene expression of proinflammatory cytokines in THP1 and U937 cell lines and in human peripheral blood-derived mononuclear cells. Moreover, Senexin B substantially reduced functional manifestations of inflammation, including clustering and chemokine-dependent migration of THP1 monocytes and human pulmonary fibroblasts (HPF)

The effect of etiopathogenetic therapy of COVID-19 on the severity of the disease: results of a multicenter double-blind placebo-controlled randomized trial

Aim. The search for etiopathogenetic agents to prevent the development of severe and extremely severe COVID-19 remains relevant. A placebo-controlled randomized clinical trial was conducted to evaluate the efficacy and safety of the antibody-based biological drug (Raphamin). Materials and methods. 785 outpatients 18–75 y.o. with laboratory confirmed mild COVID-19 were included within 24 hours from the disease onset. 771 patients were randomized to the group Raphamin (n=382) and the Placebo group (n=389). The study drug/placebo was prescribed for 5 days. The rate of progression to a more severe degree of COVID-19 by day 28 as well as the time to sustained clinical recovery and the frequency of hospitalization were evaluated. Safety was assessed taking into account adverse events, vital signs and laboratory parameters. Results. The number of cases of progression to a more severe degree of COVID-19 in participants receiving Raphamin was 59 (15.5%) [52 (14.6%)] versus placebo – 89 (22.9%) [85 (23.7%)], ITT and [PP] analysis data are presented. The odds ratio between groups was OR=0.6157 [OR=0.5494], 95% confidence interval 0.4276–0.8866 [0.3750–0.8048], which meant a reduction in the chance of progression to a more severe degree by 38.4% [45.1%] or 1.48 [1.62] times; p=0.0088 [p=0.0019]. The time to sustained recovery in the Raphamin group was 4.5±2.4 [4.6±2.4] days, versus placebo – 5.8±4.7 [6.0±4.8] days; p=0.0025 [p=0.0036]. No adverse events with a certain relationship were registered. Conclusion. Raphamin reduces the risk of progression to a more severe degree of the COVID-19 and significantly shortens the duration of clinical symptoms

Development of DNA aptamers for visualization of glial brain tumors and detection of circulating tumor cells

Here, we present DNA aptamers capable of specific binding to glial tumor cells in vitro, ex vivo, and in vivo for visualization diagnostics of central nervous system tumors. We selected the aptamers binding specifically to the postoperative human glial primary tumors and not to the healthy brain cells and meningioma, using a modified process of systematic evolution of ligands by exponential enrichment to cells; sequenced and analyzed ssDNA pools using bioinformatic tools and identified the best aptamers by their binding abilities; determined three-dimensional structures of lead aptamers (Gli-55 and Gli-233) with small-angle X-ray scattering and molecular modeling; isolated and identified molecular target proteins of the aptamers by mass spectrometry; the potential binding sites of Gli-233 to the target protein and the role of post-translational modifications were verified by molecular dynamics simulations. The anti-glioma aptamers Gli-233 and Gli-55 were used to detect circulating tumor cells in liquid biopsies. These aptamers were used for in situ, ex vivo tissue staining, histopathological analyses, and fluorescence-guided tumor and PET/CT tumor visualization in mice with xenotransplanted human astrocytoma. The aptamers did not show in vivo toxicity in the preclinical animal study. This study demonstrates the potential applications of aptamers for precise diagnostics and fluorescence-guided surgery of brain tumors.peerReviewe