Noninvasive Analyses of Kidney Injury Molecule-1 Messenger RNA in Kidney Transplant Recipients With Graft Dysfunction

AbstractBackgroundKidney graft fibrosis is a major factor related to chronic loss of kidney function. At present, the finding of fibrosis depends on the analysis of tissue in the renal biopsy, which has important limitations. In this study, we evaluated the messenger mRNA transcription and gene expression of kidney injury molecule-1 (KIM-1) in kidney tissue and in urinary sediment cells of kidney transplant patients with graft dysfunction aiming at the development of techniques that may allow the noninvasive diagnosis of interstitral fibrosis/tubular atrophy (IF/TA).Patients and methodsRNA extracted from cells in tissue and urine of 77 renal transplant patients whose biopsies were classified according to the Banff scheme-2007. Four diagnostic groups were established: (1) acute tubular necrosis (n = 9); (2) acute rejection (n = 49); (3) acute calcineurin inhibitors nephrotoxicity (n = 10); and (4) interstitial fibrosis and tubular atrophy (IFTA, n = 29). Tissue and urine cell RNA was amplified and quantification were made by real-time polymerase chain reactron. Data from the quantification of gene expression are presented as median and 25th to 75th percentiles.ResultsMessenger RNA levels of the KIM-1 gene were higher in the biopsies (26.17; 3.38–294.53) and urinary sediment cells (0.09; 0–5.81) of the patients classified as having IF/TA as compared with all others groups. A significant correlation between gene expression in samples of urine and tissue cells was found (P < .01).ConclusionThese initial data suggests that KIM-1 gene mRNA quantification can be used as a noninvasive biomarker of IF/TA

Association between the multidimensional prognostic index and mortality during 15 Years of Follow-up in the InCHIANTI Study

Background: Multidimensional Prognostic Index (MPI) is recognized as a prognostic tool in hospitalized patients, but data on the value of MPI in community-dwelling older persons are limited. Using data from a representative cohort of community-dwelling persons, we tested the hypothesis that MPI explains mortality during 15 years of follow-up. Methods: A standardized comprehensive geriatric assessment was used to calculate the MPI and to categorize participants in low-, moderate-, and high-risk classes. The results were reported as hazard ratios (HRs) and the accuracy was evaluated with the area under the curve (AUC), with 95% confidence intervals (CIs) and the C-index. We also reported the median survival time by standard age groups. Results: All 1453 participants (mean age 68.9 years, women = 55.8%) enrolled in the InCHIANTI study at baseline were included. Compared to low-risk group, participants in moderate (HR = 2.10; 95% CI: 1.73-2.55) and high-risk MPI group (HR = 4.94; 95% CI: 3.91-6.24) had significantly higher mortality risk. The C-index of the model containing age, sex, and MPI was 82.1, indicating a very good accuracy of this model in explaining mortality. Additionally, the time-dependent AUC indicated that the accuracy of the model incorporating MPI to age and sex was excellent (&gt;85.0) during the whole follow-up period. Compared to participants in the low-risk MPI group across different age groups, those in moderate- and high-risk groups survived 2.9-7.0 years less and 4.3-8.9 years less, respectively. Conclusions: In community-dwelling individuals, higher MPI values are associated with higher risk of all-cause mortality with a dose-response effect. © 2020 The Author(s) 2020

Análise espectral de dados SMMR para estudo de padrões de Inundação do Pantanal.

Inundation seasonal patterns are important in the understanding of tropical floodplain ecosystems dynamics. In this study, we have analyzed data derived from 37-GHz polarization differences observed by the Nimbus-7 Scanning Multichannel Microwave Radiometer (SMMR). The passive microwave observations, for 10 Pantanal subregioes, provide an robust signature of inundation dynamics in large wetlands such as the Pantanal. The time series was obtained taking into account the differences between vertically and horizontally polarized brightness temperatures providing a sensitive indicator of the surface water against a vegetation land surface background. Each time series was analyzed by applying the gradient pattern analysis on a multiresolution representation obtained from wavelet decomposition /reconstrution technique. The main result have shown similar variability patterns for the following groups of subregions: (i) Miranda and Piquiri; (ii) Negro and Nhecolandia; (iii) Corixo, Paraguay, Cuiabá and Taquari fan; and (iv) Taquari river and Nabileque. Some hydrological aspects are discussed in order to understand the clusterization found from our results

Correlated Electrons Step-by-Step: Itinerant-to-Localized Transition of Fe Impurities in Free-Electron Metal Hosts

High-resolution photoemission spectroscopy and realistic ab-initio calculations have been employed to analyze the onset and progression of d-sp hybridization in Fe impurities deposited on alkali metal films. The interplay between delocalization, mediated by the free-electron environment, and Coulomb interaction among d-electrons gives rise to complex electronic configurations. The multiplet structure of a single Fe atom evolves and gradually dissolves into a quasiparticle peak near the Fermi level with increasing the host electron density. The effective multi-orbital impurity problem within the exact diagonalization scheme describes the whole range of hybridizations.Comment: 10 pages, 4 figure

Use of bioelectrical impedance analysis in centenarians: a systematic review

Background: Centenarians often represent one of the best examples of aging successfully. However, the role of body composition or hydration status assessed with bioelectrical impedance analysis (BIA) is poorly explored in this population. Therefore, the aim of this systematic review was to better understand the use and the role of BIA for evaluating body composition and hydration status in centenarians. Methods: We conducted a systematic review of the literature up to the 1st of May, 2022 for published articles providing data on BIA to evaluate body composition parameters or hydration status in centenarians. Data were summarized descriptively because a meta-analysis was not possible due to the scarcity of available studies. Results: Among 2222 articles screened, four were eligible including 291 centenarians (mean age: 100.5&nbsp;years) who were mainly women (88%). In one study, BIA overestimated fat-free mass and underestimated fat mass when compared to deuterium oxide dilution. Another study carried out in Italy including 14 centenarians found a significant correlation between BIA and fat-free mass evaluated using anthropometric tools. In one study, BIA showed a significant agreement with anthropometric measures of fat mass. In the same sample, sarcopenia and dehydration, evaluated with BIA, had a high prevalence. Conclusion: BIA may be used for assessing body composition in centenarians, but research is limited to a few studies suggesting the need of future research in this area

Patient safety culture in Italian out-ofhours primary care service: a national cross-sectional survey study

Background: Out-of-hours (OOH) services in Italy provide &gt;10 million consultations every year. To the authors' knowledge, no data on patient safety culture (PSC) have been reported. Aim: To assess PSC in the Italian OOH setting. Design &amp; setting: National cross-sectional survey using the Safety Attitudes Questionnaire — Ambulatory Version (SAQ-AV). Method: The SAQ-AV was translated into Italian and distributed in a convenience sample of OOH doctors in 2015. Answers were collected anonymously by Qualtrics. Stata (version 14) was used to estimate Cronbach's alpha, perform exploratory and confirmatory factor analysis, correlate items to doctors' characteristics, and to do item descriptive analysis. Results: Overall, 692 OOH doctors were contacted, with a 71% response rate. In the exploratory factor analysis (EFA), four factors were identified: Communication and Safety Climate (14 items); Perceptions of Management (eight items); Workload and Clinical Risk (six items); and Burnout Risk (four items). These four factors accounted for 68% of the total variance (Kaiser-Meyer-Olkin [KMO] statistic = 0.843). Cronbach's alpha ranged from 0.710-0.917. OOH doctors were often dissatisfied with their job; there is insufficient staff to provide optimal care and there is no training or supervision for new personnel and family medicine trainees. Service managers are perceived as distant, with particular issues concerning the communication between managers and OOH doctors. A large proportion of OOH doctors (56.8%) state that they do not receive adequate support. Conclusion: These findings could be useful for informing policies on how to improve PSC in Italian OOH service

The relationship between chronic diseases and number of sexual partners: an exploratory analysis

Background: We investigated sex-specific associations between lifetime number of sexual partners and several health outcomes in a large sample of older adults in England. Methods: We used cross-sectional data from 2,537 men and 3,185 women aged ≥50 years participating in the English Longitudinal Study of Ageing. Participants reported the number of sexual partners they had had in their lifetime. Outcomes were self-rated health and self-reported limiting long-standing illness, cancer, coronary heart disease (CHD), and stroke. We used logistic regression to analyse associations between lifetime number of sexual partners and health outcomes, adjusted for relevant sociodemographic and health-related covariates. Results: Having had 10 or more lifetime sexual partners was associated with higher odds of reporting a diagnosis of cancer than having had 0-1 sexual partners in men (OR=1.69, 95% CI 1.01-2.83) and women (OR=1.91, 95% CI 1.04-3.51), respectively. Women who had 10 or more lifetime sexual partners also had higher odds of reporting a limiting long-standing illness (OR=1.64, 95% CI 1.15 2.35). No other statistically significant associations were observed. Conclusions: A higher lifetime number of sexual partners is associated with increased odds of reported cancer. Longitudinal research is required to establish causality. Understanding the predictive value of lifetime number of sexual partner as a behavioural risk factor may improve clinical assessment of cancer risk in older adults

The Impact of the COVID-19 Pandemic on the Psychological Well-Being of Caregivers of People with Dementia or Mild Cognitive Impairment: A Systematic Review and Meta-Analysis

The aim of this systematic review was to investigate the effects of the COVID-19 lockdown on the psychological well-being of caregivers of people with dementia or mild cognitive impairment (PwD/MCI). Electronic databases were searched from inception to August 2022 for observational studies investigating the COVID-19 lockdown and psychological well-being of caregivers of PwD/MCI. Summary estimates of standardized mean differences (SMD) in psychological well-being scores pre- versus during COVID-19 were calculated using a random-effects model. Fifteen studies including 1702 caregivers (65.7% female, mean age 60.40 ± 12.9 years) with PwD/MCI were evaluated. Five studies found no change in psychological well-being parameters, including depression, anxiety, distress, caregiver burden, and quality of life. Ten studies found a worsening in at least one parameter: depression (six studies, n = 1368; SMD = 0.40; 95%CI: 0.09–0.71; p = 0.01, I2 = 86.8%), anxiety (seven studies, n = 1569; SMD = 1.35; 95%CI: 0.05–2.65; I2 = 99.2%), caregiver distress (six studies, n = 1320, SMD = 3.190; 95%CI: 1.42–4.95; p &lt; 0.0001; I2 = 99.4%), and caregiver burden (four studies, n = 852, SMD = 0.34; 95%CI: 0.13–0.56; p = 0.001; I2 = 54.1%) (p &lt; 0.05). There was an increase in depression, anxiety, caregiver burden, and distress in caregivers of PwD/MCI during the lockdown in the COVID pandemic. This could have longer term consequences, and it is essential that caregivers’ psychological well-being is assessed and supported, to benefit both themselves and those for whom they care

The association of pain with suicidal ideation and suicide attempts with depressive symptoms among adults aged ≥50 years from low- and middle-income countries

Objectives: We aimed to examine the relationship of pain with suicidal ideation and suicide attempts with depressive symptoms among adults aged ≥50&nbsp;years from six low- and middle-income countries (LMICs) (China, Ghana, India, Mexico, Russia, and South Africa). Methods: Cross-sectional, community-based, nationally representative data from the WHO Study on global AGEing and adult health were analyzed. Self-reported information on past 12-month suicidal ideation and suicide attempts among people with depressive symptoms was collected. Pain was assessed with the question “Overall in the last 30&nbsp;days, how much of bodily aches or pain did you have?” With answer options: “none”, “mild”, “moderate”, “severe/extreme”. Multivariable logistic regression was done to assess associations. Results: Data on 34,129 adults aged ≥50&nbsp;years (mean [SD] age 62.4 [16.0] years; males 47.9%) were analyzed. Compared to no pain, mild, moderate, and severe/extreme pain were associated with 2.83 (95% CI&nbsp;=&nbsp;1.51–5.28), 4.01 (95% CI&nbsp;=&nbsp;2.38–6.76), and 12.26 (95% CI&nbsp;=&nbsp;6.44–23.36) times higher odds for suicidal ideation. For suicide attempt, only severe/extreme pain was associated with significantly increased odds (OR&nbsp;=&nbsp;4.68; 95% CI&nbsp;=&nbsp;1.67–13.08). Conclusions: In this large sample of older adults from multiple LMICs, pain was strongly associated with suicidal thoughts and suicide attempts with depressive symptoms. Future studies should assess whether addressing pain among older people in LMICs may lead to reduction in suicidal thoughts and behaviors