31 research outputs found
Anticipated Nostalgia: Looking Forward to Looking Back
Anticipated nostalgia is a new construct that has received limited empirical attention. It concerns the anticipation of having nostalgic feelings for one’s present and future experiences. In three studies, we assessed its prevalence, content, emotional profile, and implications for self-regulation and psychological functioning. Study 1 revealed that anticipated nostalgia most typically concerns interpersonal relationships, and also concerns goals, plans, current life, and culture. Further, it is affectively laden with happiness, sadness, bittersweetness, and sociality. Studies 2 and 3 assessed the implications of anticipated nostalgia for self-regulation and psychological functioning. In both studies, positive evaluation of a personal experience was linked to stronger anticipated nostalgia, and anticipated nostalgia was linked to savouring of the experience. In Study 3, anticipated nostalgia measured prior to an important life transition predicted nostalgia a few months after the transition, and post-transition nostalgia predicted heightened self-esteem, social connectedness, and meaning in life
Is current preoperative frailty assessment adequate?
Preoperative frailty predicts adverse postoperative outcomes. Recommendations
for preoperative assessment of elderly patients include performing a frailty
assessment. Despite the advantages of incorporating frailty assessment into surgical
settings, there is limited research on surgical health care professionals’
perception and use of frailty assessment for perioperative care. We surveyed
local health care employees to assess their attitudes toward and practices for
frail patients. Nurses and allied health professionals were more likely than surgeons
to agree frailty should play a role in planning a patient’s care. Lack of
knowledge about frailty issues was a prominent barrier to the use of frailty
assessments in practice, despite clinicians understanding that frailty affects their
patients’ outcomes. Results of this survey suggest further training in frailty
issues and the use of frailty assessment instruments is necessary and could
improve the uptake of such tools for perioperative care planning
Is current preoperative frailty assessment adequate?
Preoperative frailty predicts adverse postoperative outcomes. Recommendations
for preoperative assessment of elderly patients include performing a frailty
assessment. Despite the advantages of incorporating frailty assessment into surgical
settings, there is limited research on surgical health care professionals’
perception and use of frailty assessment for perioperative care. We surveyed
local health care employees to assess their attitudes toward and practices for
frail patients. Nurses and allied health professionals were more likely than surgeons
to agree frailty should play a role in planning a patient’s care. Lack of
knowledge about frailty issues was a prominent barrier to the use of frailty
assessments in practice, despite clinicians understanding that frailty affects their
patients’ outcomes. Results of this survey suggest further training in frailty
issues and the use of frailty assessment instruments is necessary and could
improve the uptake of such tools for perioperative care planning
Both tumour cells and infiltrating T-cells in equine sarcoids express FOXP3 associated with an immune-supressed cytokine microenvironment
Genetic mechanisms of critical illness in COVID-19.
Host-mediated lung inflammation is present1, and drives mortality2, in the critical illness caused by coronavirus disease 2019 (COVID-19). Host genetic variants associated with critical illness may identify mechanistic targets for therapeutic development3. Here we report the results of the GenOMICC (Genetics Of Mortality In Critical Care) genome-wide association study in 2,244 critically ill patients with COVID-19 from 208 UK intensive care units. We have identified and replicated the following new genome-wide significant associations: on chromosome 12q24.13 (rs10735079, P = 1.65 × 10-8) in a gene cluster that encodes antiviral restriction enzyme activators (OAS1, OAS2 and OAS3); on chromosome 19p13.2 (rs74956615, P = 2.3 × 10-8) near the gene that encodes tyrosine kinase 2 (TYK2); on chromosome 19p13.3 (rs2109069, P = 3.98 × 10-12) within the gene that encodes dipeptidyl peptidase 9 (DPP9); and on chromosome 21q22.1 (rs2236757, P = 4.99 × 10-8) in the interferon receptor gene IFNAR2. We identified potential targets for repurposing of licensed medications: using Mendelian randomization, we found evidence that low expression of IFNAR2, or high expression of TYK2, are associated with life-threatening disease; and transcriptome-wide association in lung tissue revealed that high expression of the monocyte-macrophage chemotactic receptor CCR2 is associated with severe COVID-19. Our results identify robust genetic signals relating to key host antiviral defence mechanisms and mediators of inflammatory organ damage in COVID-19. Both mechanisms may be amenable to targeted treatment with existing drugs. However, large-scale randomized clinical trials will be essential before any change to clinical practice
Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19
IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19.
Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19.
DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022).
INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days.
MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes.
RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively).
CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes.
TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570
Photoluminescence Intermittency from Single Quantum Dots to Organic Molecules: Emerging Themes
Recent experimental and theoretical studies of photoluminescence intermittency (PI) or “blinking” exhibited by single core/shell quantum dots and single organic luminophores are reviewed. For quantum dots, a discussion of early models describing the origin of PI in these materials and recent challenges to these models are presented. For organic luminophores the role of electron transfer, proton transfer and other photophysical processes in PI are discussed. Finally, new experimental and data analysis methods are outlined that promise to be instrumental in future discoveries regarding the origin(s) of PI exhibited by single emitters
Dielectric Dependence of Single-Molecule Photoluminescence Intermittency: Nile Red in Poly(vinylidene fluoride)
The
dependence of single-molecule photoluminescence intermittency
(PI) or “blinking” on the local dielectric constant
(ε) is examined for nile red (NR) in thin films of poly(vinylidene
fluoride) (PVDF). In previous studies, variation of the local dielectric
constant was accomplished by studying luminophores in chemically and
structurally different hosts. In contrast, the NR/PVDF guest–host
pair allows for the investigation of PI as a function of ε while
keeping the chemical composition of both the luminophore and host
unchanged. The solvatochromic properties of NR are used to measure
the local ε, while fluctuations in NR emission intensity over
time provide a measure of the PI. PVDF is an ideal host for this study
because it provides submicron-sized dielectric domains that vary from
nonpolar (ε ≈ 2) to very polar (ε ≈ 70).
The results presented here demonstrate that the local dielectric environment
can have a pronounced effect on PI. We find that the NR emissive events
increase 5-fold with an increase in ε from 2.2 to 74. A complex
dependence on ε is also observed for NR nonemissive event durations,
initially increasing as ε increases from 2.2 to 3.4 but decreasing
in duration with further increase in ε. The variation in emissive
event durations with ε is reproduced using a photoinduced electron-transfer
model involving electron transfer from NR to PVDF. In addition, an
increase in NR photostability with an increase in ε is observed,
suggesting that the dielectric environment plays an important role
in defining the photostability of NR in PVDF
Food-evoked nostalgia
In three studies, we examined food as an elicitor of nostalgia. Study 1 participants visualised eating either a nostalgic or regularly consumed food. Study 2 participants visualised consuming 12 foods. Study 3 participants consumed 12 flavour samples. Following their food experiences, all participants responded to questions regarding the profile of food-evoked nostalgia (i.e. autobiographical relevance, arousal, familiarity, positive and negative emotions) and several psychological functions (i.e. positive affect, self-esteem, social connectedness, meaning in life). Study 2 and 3 participants also reported their state nostalgia. Results revealed that food is a powerful elicitor of nostalgia. Food-evoked nostalgia has a similar contextual profile to previously examined elicitors, but is a predominantly positive emotional experience. Food-evoked nostalgia served multiple psychological functions and predicted greater state nostalgia.</p