Do personal traits moderate cognitive abilities in diabetes mellitus?

Introduction. The association between cognitive functions and personal traits is a question of interest and debate. Diabetes mellitus is associated with cognitive changes. The aim of our study was to find if any relations exist between cognitive functions and personal traits in persons with diabetes. Material and methods. We examined 115 patients (average age 62.47±10.60 years; 49 males, 66 females) with diabetes (13 with diabetes type 1 and 102 with type 2 diabetes; mean duration of disease 9.28±6.8 8years), admitted during 2016-2017 in the Neurology Clinic of the University Hospital “Sofiamed”, Sofia, Bulgaria. After having signed the informed consent, all patients underwent full somatic and neurological examination, and fulfilled specific neuropsychological tests and personal questionnaire (Minnesota Multiphasic Personality Inventory 2, MMPI). Results. We found statistically significant associations between MMPI subscales and cognitive domains. Conclusions. Our data analysis shows significant associations between cognitive functions and personal traits. We suggest that cognitive-focused therapy can improve some negative personal traits and vice versa

Structural supercapacitor composite technology demonstrator

Structural power composites, a class of multifunctional materials, have significant potential to facilitate lightweighting and accelerate widespread electrification in sustainable transportation. In civil aircraft, a bank of supercapacitors can provide power to open the doors in an emergency. Structural power composite fuselage components near the doors could provide this power and eliminate the mass and volume needed for the supercapacitors. To demonstrate this concept, we designed and manufactured a multifunctional component representative of a fuselage rib, which powered the opening and closing of a desktop scale composite aircraft door. This paper provides information about structural supercapacitor technology demonstrators, discusses the fabrication of this demonstrator and concludes by providing an insight into the future challenges that need to be addressed to realise structural power composite components

Mechanisms and Control of Self-Emulsification upon Freezing and Melting of Dispersed Alkane Drops

Emulsification requires drop breakage and creation of a large interfacial area between immiscible liquid phases. Usually, high-shear or high-pressure emulsification devices that generate heat and increase the emulsion temperature are used to obtain emulsions with micrometer and submicrometer droplets. Recently, we reported a new, efficient procedure of self-emulsification (Tcholakova et al. Nat. Commun. 2017, 8, 15012), which consists of one to several cycles of freezing and melting of predispersed alkane drops in a coarse oil-in-water emulsion. Within these freeze-thaw cycles of the dispersed drops, the latter burst spontaneously into hundreds and thousands of smaller droplets without using any mechanical agitation. Here, we clarify the main factors and mechanisms, which drive this self-emulsification process, by exploring systematically the effects of the oil and surfactant types, the cooling rate, and the initial drop size. We show that the typical size of the droplets, generated by this method, is controlled by the size of the structural domains formed in the cooling-freezing stage of the procedure. Depending on the leading mechanism, these could be the diameter of the fibers formed upon drop self-shaping or the size of the crystal domains formed at the moment of drop-freezing. Generally, surfactant tails that are 0-2 carbon atoms longer than the oil molecules are most appropriate to observe efficient self-emulsification. The specific requirements for the realization of different mechanisms are clarified and discussed. The relative efficiencies of the three different mechanisms, as a function of the droplet size and cooling procedure, are compared in controlled experiments to provide guidance for understanding and further optimization and scale-up of this self-emulsification process

A survey of UK medical schools' arrangements for early patient contact

Background: Many U.K. medical schools have patient contact in the first two years of the undergraduate course. Aim: To compare the purposes and organization of early patient contact in UK medical schools and to relate these arrangements to the schools' curricular objectives. Methods: A telephone survey of lead educators in UK medicals schools. Categories of contact were plotted against phases of the course to discern patterns of organisation. Results: The quantity of contact varies considerably (four to 65 days). There is a pattern, with learning objectives around the social context of health and illness preceding skills based work and integrated clinical knowledge for practice coming later. Schools fall into three categories: close adherence to the preclinical/clinical split, with limited early contact acting as an introduction to social aspects of health; provision of substantial patient contact to maximize the integration of knowledge and skills; and transitional, with limited clinical goals. General practice provides between one third and one half of early patient contact. Conclusions: Arrangements meet the objectives set by each school and reflect differing educational philosophies. Change is toward more early contact. There appears to be no national guidance which supports a minimum quantity of patient contact or specific educational purpose in the early years of U.K. basic medical training

Doctor-patient interaction in Finnish primary health care as perceived by first year medical students

BACKGROUND: In Finland, public health care is the responsibility of primary health care centres, which render a wide range of community level preventive, curative and rehabilitative medical care. Since 1990's, medical studies have involved early familiarization of medical students with general practice from the beginning of the studies, as this pre-clinical familiarisation helps medical students understand patients as human beings, recognise the importance of the doctor-patient relationship and identify practicing general practitioners (GPs) as role models for their professional development. Focused on doctor-patient relationship, we analysed the reports of 2002 first year medical students in the University of Kuopio. The students observed GPs' work during their 2-day visit to primary health care centres. METHODS: We analysed systematically the texts of 127 written reports of 2002, which represents 95.5% of the 133 first year pre-clinical medical students reports. The reports of 2003 (N = 118) and 2004 (N = 130) were used as reference material. RESULTS: Majority of the students reported GPs as positive role models. Some students reported GPs' poor attitudes, which they, however, regarded as a learning opportunity. Students generally observed a great variety of responsibilities in general practice, and expressed admiration for the skills and abilities required. They appreciated the GPs' interest in patients concerns. GPs' communication styles were found to vary considerably. Students reported some factors disturbing the consultation session, such as the GP staring at the computer screen and other team members entering the room. Working with marginalized groups, the chronically and terminally ill, and dying patients was seen as an area for development in the busy Finnish primary health care centres. CONCLUSION: During the analysis, we discovered that medical students' perceptions in this study are in line with the previous findings about the importance of role model (good or bad) in making good doctors. Therefore, medical students' pre-clinical primary health care centre visits may influence their attitudes towards primary health care work and the doctor-patient relationship. We welcome more European studies on the role of early pre-clinical general practice exposure on medical students' primary care specialty choice

Minimal residual disease prior to allogeneic hematopoietic cell transplantation in acute myeloid leukemia: a meta-analysis

Minimal residual disease prior to allogeneic hematopoietic cell transplantation has been associated with increased risk of relapse and death in patients with acute myeloid leukemia, but detection methodologies and results vary widely. We performed a systematic review and meta-analysis evaluating the prognostic role of minimal residual disease detected by polymerase chain reaction or multiparametric flow cytometry before transplant. We identified 19 articles published between January 2005 and June 2016 and extracted hazard ratios for leukemia-free survival, overall survival, and cumulative incidences of relapse and non-relapse mortality. Pre-transplant minimal residual disease was associated with worse leukemia-free survival (HR=2.76 [1.90-4.00]), overall survival (HR=2.36 [1.73-3.22]), and cumulative incidence of relapse (HR=3.65 [2.53-5.27]), but not non-relapse mortality (HR=1.12 [0.81-1.55]). These associations held regardless of detection method, conditioning intensity, and patient age. Adverse cytogenetics was not an independent risk factor for death or relapse. There was more heterogeneity among studies using flow cytometry-based than WT1 polymerase chain reaction-based detection (I(2)=75.1% vs. <0.1% for leukemia-free survival, 67.8% vs. <0.1% for overall survival, and 22.1% vs. <0.1% for cumulative incidence of relapse). These results demonstrate a strong relationship between pre-transplant minimal residual disease and post-transplant relapse and survival. Outcome heterogeneity among studies using flow-based methods may underscore site-specific methodological differences or differences in test performance and interpretation

Bottom-Up Synthesis of Polymeric Micro- and Nanoparticles with Regular Anisotropic Shapes

Shape-anisotropic polymeric micro- and nanoparticles are of significant interest for the development of novel composite materials, lock-and-key assemblies, and drug carriers. Currently, syntheses require external confinement in microfluidic devices or lithographic techniques associated with significant infrastructure and low productivity, so new methods are necessary to scale-up such production efficiently. Here we report bottom-up polymerization of regular shape-anisotropic particles (polygonal platelets with different numbers of edges, with and without protruding asperities, and fibrilar particles with controllable aspect ratios), with size control over 4 orders of magnitude (∼50 nm-1 mm). Polymerization also enables the study of much smaller shapes than could previously be studied in water suspensions, and we study the fundamental limits of the self-shaping transition process driving these transformations for monomer oil droplets of stearyl methacrylate (SMA) monomer oil. We show the method is compatible with a variety of polymerizing monomers and functional modifications of the particles (e.g., composites with magnetic nanoparticles, oil-soluble additives, etc.). We also describe postsynthetic surface modifications that lead to hierarchical superstructures. The synthesis procedure has great potential in efficient nanomanufacturing as it can achieve scalable production of the above shapes in a wide range of sizes, with minimum infrastructure and process requirements and little maintenance of the equipment

СОВРЕМЕННАЯ ЛУЧЕВАЯ ТЕРАПИЯ ЖЕЛУДКА

External beam radiation therapy (EBRT) is currently an important component of the treatment of gastric cancer (GC). In accordance with international and domestic recommendations, it can be used in the postoperative period, before the operation and as a sole option, with a curative and palliative purpose, usually in combination with chemotherapy. With the transition of RT to a new technological level, which involves the use of conformal, intensively modulated regimens, and image guidance the revision of indications for and doses of EBRT is required. The article discusses modern approaches to the determination of irradiated volumes in various clinical scenarios of current radiation therapy for GC and strategies aimed at reducing the dose in critical organs at risk and increasing the overall effectiveness of treatment.Дистанционная лучевая терапия (ЛТ) в настоящее время является важным компонентом лечения рака желудка (РЖ). В соответствии с международными и отечественными рекомендациями она может быть использована в послеоперационном периоде, перед операцией и самостоятельно, с лечебной и паллиативной целью, как правило, в сочетании с химиотерапией. В связи с переходом ЛТ на новый технологический уровень, предусматривающий использование конформных, интенсивно-модулированных режимов, требуется пересмотр показаний, доз и режимов дистанционного облучения. В статье рассмотрены современные подходы к определению облучаемых объемов при различных клинических сценариях современной ЛТ по поводу РЖ и обсуждены стратегии, направленные на снижение дозы в критических органах и повышение эффективности лечения

A systematic review of natural health product treatment for vitiligo

<p>Abstract</p> <p>Background</p> <p>Vitiligo is a hypopigmentation disorder affecting 1 to 4% of the world population. Fifty percent of cases appear before the age of 20 years old, and the disfigurement results in psychiatric morbidity in 16 to 35% of those affected.</p> <p>Methods</p> <p>Our objective was to complete a comprehensive, systematic review of the published scientific literature to identify natural health products (NHP) such as vitamins, herbs and other supplements that may have efficacy in the treatment of vitiligo. We searched eight databases including MEDLINE and EMBASE for vitiligo, leucoderma, and various NHP terms. Prospective controlled clinical human trials were identified and assessed for quality.</p> <p>Results</p> <p>Fifteen clinical trials were identified, and organized into four categories based on the NHP used for treatment. 1) L-phenylalanine monotherapy was assessed in one trial, and as an adjuvant to phototherapy in three trials. All reported beneficial effects. 2) Three clinical trials utilized different traditional Chinese medicine products. Although each traditional Chinese medicine trial reported benefit in the active groups, the quality of the trials was poor. 3) Six trials investigated the use of plants in the treatment of vitiligo, four using plants as photosensitizing agents. The studies provide weak evidence that photosensitizing plants can be effective in conjunction with phototherapy, and moderate evidence that <it>Ginkgo biloba </it>monotherapy can be useful for vitiligo. 4) Two clinical trials investigated the use of vitamins in the therapy of vitiligo. One tested oral cobalamin with folic acid, and found no significant improvement over control. Another trial combined vitamin E with phototherapy and reported significantly better repigmentation over phototherapy only. It was not possible to pool the data from any studies for meta-analytic purposes due to the wide difference in outcome measures and poor quality ofreporting.</p> <p>Conclusion</p> <p>Reports investigating the efficacy of NHPs for vitiligo exist, but are of poor methodological quality and contain significant reporting flaws. L-phenylalanine used with phototherapy, and oral <it>Ginkgo biloba </it>as monotherapy show promise and warrant further investigation.</p