Determinants of vascular complications in type 2 diabetic South Asians

South Asians have a high incidence of diabetes and subsequent cardiovascular and renal complications. Increasing evidence points towards the involvement of the complement system. We found higher levels of both complement C3( the central molecule in the complement cascade) and SC5b-9 (the effector phase of complement activation) in type 2 diabetic South Asians compared to Caucasians. However, neither C3 nor Sc5b-9 predicted cardiovascular events, though higher SC5b-9 levels were associated with renal damage. Mannose binding lectin (MBL, the recognition molecule of the lectin pathway) was studies. A low MBL genotype was associated with cardiovascular events, whiel a high serem MBL level was associated with progressive renal failure.Shire, Roche, Fresenius Medical CareUBL - phd migration 201

A future orientation intervention delivered through a smartphone application and virtual reality: study protocol for a randomized controlled trial

Background: Short-term mindsets are associated with self-defeating behaviors, such as delinquency and alcohol use. In contrast, people who consider the longer-term consequences of their decisions tend to report positive outcomes, like feeling more competent and enhanced goal achievement. We evaluate an intervention, FutureU, that aims to stimulate future-oriented thinking, increase goal achievement, and reduce self-defeating behavior, by strengthening people’s identification with their future self. The intervention will be delivered through a smartphone application (app) or immersive Virtual Reality (VR). We test the effectiveness of FutureU for both delivery methods, examine working mechanisms, and identify potential moderators of intervention effects.Methods: In this Randomized Controlled Trial, a total of 240 first-year university students (n = 80 per condition) will be randomized into one of three conditions: (1) a smartphone condition, (2) a VR condition, and (3) an active control condition. We will assess proximal (i.e., future self-identification) and distal intervention outcomes (e.g., future orientation, self-defeating behaviors, goal achievement), user engagement, and examine usage data and goal content. Assessments will take place at baseline, during the intervention, immediately after the intervention, and at 3- and 6-months follow-up.Discussion: This study will provide information on the effectiveness of the intervention and allows for comparisons between delivery methods using novel technologies, a smartphone app versus immersive VR. Knowledge gained through this study can be used for further intervention development as well as theory building

Low Mannose-Binding Lectin (MBL) genotype is associated with future cardiovascular events in type 2 diabetic South Asians. A prospective cohort study

Background: South Asians have a high burden of type 2 diabetes and vascular complications. Vascular inflammation is considered central in the pathophysiology of atherosclerosis, and the complement system is thought to play an important role. Mannose-Binding Lectin (MBL), which activates the lectin pathway of complement activation, has been introduced as a risk marker of vascular damage. The present study explores the association of MBL levels, genotype and cardiovascular events in type 2 diabetic South Asians.Methods: We conducted a prospective observational study. A cohort consisting of 168 type 2 diabetic South Asians was followed for a median duration of 7.66 years. At baseline, MBL levels and genotype were determined. The association with future cardiovascular events was assessed by Cox proportional hazard regression.Results: During follow-up, 31 cardiovascular events occurred in 22 subjects (11 men, 11 women). The O/O genotype was significantly associated with the occurrence of cardiovascular events (hazard ratio 3.42, 95%CI 1.24-9.49, P = 0.018). However, log MBL levels were not associated with the occurrence of cardiovascular events (hazard ratio 0.93, 95% CI 0.50-1.73).Conclusions: In type 2 diabetic South Asians, the O/O MBL genotype is associated with cardiovascular events, although single serum MBL levels are not

Stimulating a future-oriented mindset and goal attainment through a smartphone-based intervention: study protocol for a randomized controlled trial

Background: Short-term mindsets interfere with the consideration of future consequences and therefore predict negative behaviors. We developed a smartphone-based intervention aiming to increase a future-oriented mindset and personal goal attainment by strengthening future self-identification and stimulating episodic future thinking. The aims of the study are 1) to examine users' experiences with the application and their treatment adherence, 2) to examine the effectiveness of the intervention, and 3) to explore which intervention modules generate the strongest changes in key outcomes. Methods: First-year university students (N = 166) will be randomly assigned to two conditions: 1) the smartphone-based intervention, or 2) a goal-setting control group. The intervention consists of three week-long modules. Data will be collected at the start of the intervention, at weekly intervals during the intervention, immediately after the intervention, and at 3-month follow-up (and at parallel time points for the control group). We will assess users' experiences, application usage data, primary intervention outcomes (e.g., self-defeating behavior, future orientation, future self-identification), and secondary intervention outcomes (e.g., psychosocial wellbeing, self-efficacy). Discussion: The study will provide information about users' experiences with the application, the intervention's general effectiveness, and which intervention modules show most promise. This information will be used to further develop the application and optimize this novel intervention. Trial registration: The trial is registered in the Netherlands Trial Register (number: NL9671) on 16 August 2021.Education and Child StudiesDevelopment Psychopathology in context: schoo

Neighborhood crime reduction interventions and perceived livability: A virtual reality study on fear of crime

High levels of Fear of Crime (FOC) are associated with people engaging with their community less, lower use of public spaces, and a general sense of overall anxiety. In short, such fear may reduce the livability of an area. The primary goal of this research was to examine the potential consequences of environmental interventions intended to reduce crime on FOC and perceived livability of the area. Using immersive Virtual Reality (VR) technology, in two studies we examined how environmental interventions in residential neighborhoods influence FOC. In Study 1, we examined how motion-activated, dynamic street lighting and sound may decrease FOC. In Study 2, we applied an adapted ‘watching eyes’ intervention and examined how it may inadvertently increase FOC in a neighborhood. In Study 1 the intervention did not affect feelings of safety. In Study 2, the ‘watching eyes’ intervention indirectly increased FOC via feelings of being watched. In the Discussion, we highlight the importance of better understanding the boundary conditions of such environmental interventions

Association of low ficolin-lectin pathway parameters with Cardiac Syndrome X

In patients with typical angina pectoris, inducable myocardial ischaemia and macroscopically normal coronaries (Cardiac Syndrome X, CSX) significantly elevated plasma level of terminal complement complex (TCC), the common end-product of complement activation, has been observed without subsequent activation of the classical or the alternative pathways. Therefore, our aim was to clarify the role of the ficolin-lectin pathway in CSX. Eighteen CSX patients, 37 stable angina patients with significant coronary stenosis (CHD) and 54 healthy volunteers (HC) were enrolled. Serum levels of ficolin-2, ficolin-3, ficolin-3/MASP-2 complex and ficolin-3 mediated TCC deposition (FCN3-TCC) were determined. Plasma level of TCC was significantly higher in CSX than in HC or in CHD groups (5.45 vs. 1.30 vs. 2.04AU/ml, p<0.001). Serum levels of ficolin-2 and ficolin-3 were significantly lower in CSX compared to HC or to CHD groups (3.60 vs. 5.80 or 5.20mug/ml, p<0.05; 17.80 vs. 24.10 or 26.80mug/ml, p<0.05). The ficolin-3/MASP-2 complex was significantly lower in CSX group compared to HC (92.90 vs. 144.90AU/ml, p=0.006). FCN3-TCC deposition was significantly lower in the CSX group compared to HC and to CHD (67.8% vs.143.3% or 159.7%, p<0.05). In the CSX group, significant correlation was found between TCC and FCN3-TCC level (r=0.507, p=0.032) and ficolin-3/MASP-2 complex level and FCN3-TCC deposition (r=0.651, p=0.003). In conclusion, in patients with typical angina and myocardial ischemia despite macroscopically normal coronary arteries, low levels of several lectin-pathway parameters were observed, indicating complement activation and consumption. Complement activation through the ficolin-lectin pathway might play a role in the complex pathomechanism of CSX. This article is protected by copyright. All rights reserved

Recovery of dialysis patients with COVID-19 : health outcomes 3 months after diagnosis in ERACODA

Background. Coronavirus disease 2019 (COVID-19)-related short-term mortality is high in dialysis patients, but longer-term outcomes are largely unknown. We therefore assessed patient recovery in a large cohort of dialysis patients 3 months after their COVID-19 diagnosis. Methods. We analyzed data on dialysis patients diagnosed with COVID-19 from 1 February 2020 to 31 March 2021 from the European Renal Association COVID-19 Database (ERACODA). The outcomes studied were patient survival, residence and functional and mental health status (estimated by their treating physician) 3 months after COVID-19 diagnosis. Complete follow-up data were available for 854 surviving patients. Patient characteristics associated with recovery were analyzed using logistic regression. Results. In 2449 hemodialysis patients (mean ± SD age 67.5 ± 14.4 years, 62% male), survival probabilities at 3 months after COVID-19 diagnosis were 90% for nonhospitalized patients (n = 1087), 73% for patients admitted to the hospital but not to an intensive care unit (ICU) (n = 1165) and 40% for those admitted to an ICU (n = 197). Patient survival hardly decreased between 28 days and 3 months after COVID-19 diagnosis. At 3 months, 87% functioned at their pre-existent functional and 94% at their pre-existent mental level. Only few of the surviving patients were still admitted to the hospital (0.8-6.3%) or a nursing home (∼5%). A higher age and frailty score at presentation and ICU admission were associated with worse functional outcome. Conclusions. Mortality between 28 days and 3 months after COVID-19 diagnosis was low and the majority of patients who survived COVID-19 recovered to their pre-existent functional and mental health level at 3 months after diagnosis