Pictorial Representation of Illness and Self Measure Revised II (PRISM-RII) – a novel method to assess perceived burden of illness in diabetes patients

<p>Abstract</p> <p>Background</p> <p>The Pictorial Representation of Illness and Self Measure (PRISM) has been introduced as a visual measure of suffering. We explored the validity of a revised version, the PRISM-RII, in diabetes patients as part of the annual review.</p> <p>Methods</p> <p>Participants were 308 adult outpatients with either type 1 or type 2 diabetes. Measures: (1) the PRISM-RII, yielding Self-Illness Separation (SIS) and Illness Perception Measure (IPM); (2) the Problem Areas in Diabetes (PAID) scale, a measure of diabetes-related distress; (3) the WHO-5 Well-Being Index; (4) and a validation question on suffering (SQ). In addition, patients' complication status, comorbidity and glycemic control values(HbA1c) were recorded.</p> <p>Results</p> <p>Patients with complications did have marginally significant higher scores on IPM, compared to patients without complications. Type 2 patients had higher IPM scores than Type 1 patients. SIS and IPM showed low intercorrelation (<it>r </it>= -.25; <it>p </it>< .01). Convergent validity of PRISM-RII was demonstrated by significant correlations between IPM and PAID (<it>r </it>= 0.50; <it>p </it>< 0.01), WHO-5 (<it>r </it>= -.26; <it>p </it>< 0.01) and SQ (<it>r </it>= 0.36; <it>p </it>< 0.01). SIS showed only significant correlations with PAID (<it>r </it>= -0.28; <it>p </it>< 0.01) and SQ (<it>r </it>= -0.22; <it>p </it>< 0.01). Neither IPM nor SIS was significantly associated with HbA1c. The PRISM-RII appeared easy to use and facilitated discussion with care providers on coping with the burden of diabetes.</p> <p>Conclusion</p> <p>PRISM-RII appears a promising additional tool to assess the psychological burden of diabetes.</p

Chronic kidney disease in patients with normal eGFR at baseline: results from EuroSIDA

info:eu-repo/semantics/nonPublishe

AdS3_3 vacua and RG flows in three dimensional gauged supergravities

We study $AdS_3$ supersymmetric vacua in N=4 and N=8, three dimensional gauged supergravities, with scalar manifolds $(\frac{SO(4,4)}{SO(4)\times SO(4)})^2$ and $\frac{SO(8,8)}{SO(8)\times SO(8)}$, non-semisimple Chern-Simons gaugings $SO(4)\ltimes {\bf R}^6$ and $(SO(4)\ltimes {\bf R}^6)^2$, respectively. These are in turn equivalent to SO(4) and $SO(4)\times SO(4)$ Yang-Mills theories coupled to supergravity. For the N=4 case, we study renormalization group flows between UV and IR $AdS_3$ vacua with the same amount of supersymmetry: in one case, with (3,1) supersymmetry, we can find an analytic solution whereas in another, with (2,0) supersymmetry, we give a numerical solution. In both cases, the flows turn out to be v.e.v. flows, i.e. they are driven by the expectation value of a relevant operator in the dual $SCFT_2$. These provide examples of v.e.v. flows between two $AdS_3$ vacua within a gauged supergravity framework.Comment: 35 pages in JHEP form, 3 figures, typos corrected, references adde

Effectiveness of analgesic ear drops as add-on treatment to oral analgesics in children with acute otitis media: study protocol of the OPTIMA pragmatic randomised controlled trial

INTRODUCTION: Ear pain is the most prominent symptom of childhood acute otitis media (AOM). To control the pain and reduce reliance on antibiotics, evidence of effectiveness for alternative interventions is urgently needed. This trial aims to investigate whether analgesic ear drops added to usual care provide superior ear pain relief over usual care alone in children presenting to primary care with AOM. METHODS AND ANALYSIS: This is a pragmatic, two-arm, individually randomised, open, superiority trial with cost-effectiveness analysis and nested mixed-methods process evaluation in general practices in the Netherlands. We aim to recruit 300 children aged 1–6 years with a general practitioner (GP) diagnosis of AOM and ear pain. Children will be randomly allocated (ratio 1:1) to either (1) lidocaine hydrochloride 5 mg/g ear drops (Otalgan) one to two drops up to six times daily for a maximum of 7 days in addition to usual care (oral analgesics, with/without antibiotics); or (2) usual care. Parents will complete a symptom diary for 4 weeks as well as generic and disease-specific quality of life questionnaires at baseline and 4 weeks. The primary outcome is the parent-reported ear pain score (0–10) over the first 3 days. Secondary outcomes include proportion of children consuming antibiotics, oral analgesic use and overall symptom burden in the first 7 days; number of days with ear pain, number of GP reconsultations and subsequent antibiotic prescribing, adverse events, complications of AOM and cost-effectiveness during 4-week follow-up; generic and disease-specific quality of life at 4 weeks; parents’ and GPs’ views and experiences with treatment acceptability, usability and satisfaction. ETHICS AND DISSEMINATION: The Medical Research Ethics Committee Utrecht, the Netherlands, has approved the protocol (21-447/G-D). All parents/guardians of participants will provide written informed consent. Study results will be submitted for publication in peer-reviewed medical journals and presented at relevant (inter)national scientific meetings. TRIAL REGISTRATION: The Netherlands Trial Register: NL9500; date of registration: 28 May 2021. At the time of publication of the study protocol paper, we were unable to make any amendments to the trial registration record in the Netherlands Trial Register. The addition of a data sharing plan was required to adhere to the International Committee of Medical Journal Editors guidelines. The trial was therefore reregistered in ClinicalTrials.gov (NCT05651633; date of registration: 15 December 2022). This second registration is for modification purposes only and the Netherlands Trial Register record (NL9500) should be regarded as the primary trial registration

Microcirculatory rarefaction in South Asians - a potential mechanism for increased cardiovascular risk and diabetes

People of South Asian descent have an increased risk of cardiovascular disease (CVD) and diabetes, but little is known about the microcirculation in South Asian people despite evidence that this plays an important role in the aetiology of CVD. We compared the retinal microcirculation in a population-based sample of 287 middle-aged adults (144 European 143 South Asian) matched for age and sex. Retinal photographs were taken and analysed using a validated semi-automated program and microvascular measures were compared. Blood pressure, anthropometry and fasting bloods were also measured. South Asians had significantly fewer arteriolar and venular vessels and bifurcations. Arterioles and venules were longer and venules were also more tortuous in South Asians. These differences were not explained by adjustment for traditional risk factors including blood pressure, body mass index, diabetes or measures of insulin resistance. People of South Asian descent have rarefaction of the retinal microcirculation compared to age-sex matched individuals of European descent. Reduced microvascular density could contribute to the elevated risk of CVD and impaired glucose tolerance in South Asian people

Topical or oral antibiotics for children with acute otitis media presenting with ear discharge: study protocol of a randomised controlled non-inferiority trial

BACKGROUND: Around 15%-20% of children with acute otitis media present with ear discharge due to a spontaneous tear or perforation of the eardrum (AOMd). Current guidance recommends clinicians to consider oral antibiotics as first-line treatment in this condition. The opening in the eardrum however should allow topical antibiotics to enter the middle ear directly. Local administration of antibiotics does not expose children to systemic side effects and may put less selective resistance pressure on bacteria. Evidence on the effectiveness of this approach in children with AOMd is lacking. METHODS AND ANALYSIS: A primary care-based, open, individually randomised, controlled, non-inferiority trial. The trial aims to recruit 350 children aged 6 months to 12 years with AOMd and ear pain and/or fever. Participants will be randomised to 7 days of hydrocortisone-bacitracin-colistin eardrops five drops three times daily or amoxicillin oral suspension 50 mg/kg body weight per day, divided over three doses. Parents will keep a daily diary of AOM symptoms, adverse events and complications for 2 weeks. In addition, they will record AOM recurrences, healthcare utilisation and societal costs for 3 months. The primary outcome is the proportion of children without ear pain and fever at day 3. Secondary outcomes include ear pain and fever intensity/severity; days with ear discharge; eardrum perforation at 2 weeks; adverse events during first 2 weeks; costs; and cost effectiveness at 2 weeks and 3 months. The primary analyses will be intention-to-treat and per-protocol analyses will be conducted as well. ETHICS AND DISSEMINATION: The medical research ethics committee Utrecht, The Netherlands has given ethical approval (17-400/G-M). Parents/guardians of participants will provide written informed consent. Study results will be submitted for publication in peer-reviewed medical journals and presented at relevant (inter)national scientific meetings. TRIAL REGISTRATION NUMBER: The Netherlands National Trial Register; NTR6723. Date of registration: 27 November 2017

Background independent action for double field theory

Double field theory describes a massless subsector of closed string theory with both momentum and winding excitations. The gauge algebra is governed by the Courant bracket in certain subsectors of this double field theory. We construct the associated nonlinear background-independent action that is T-duality invariant and realizes the Courant gauge algebra. The action is the sum of a standard action for gravity, antisymmetric tensor, and dilaton fields written with ordinary derivatives, a similar action for dual fields with dual derivatives, and a mixed term that is needed for gauge invariance.Comment: 45 pages, v2: minor corrections, refs. added, to appear in JHE

Yang-Mills instantons and dyons on homogeneous G_2-manifolds

We consider Lie G-valued Yang-Mills fields on the space R x G/H, where G/H is a compact nearly K"ahler six-dimensional homogeneous space, and the manifold R x G/H carries a G_2-structure. After imposing a general G-invariance condition, Yang-Mills theory with torsion on R x G/H is reduced to Newtonian mechanics of a particle moving in R^6, R^4 or R^2 under the influence of an inverted double-well-type potential for the cases G/H = SU(3)/U(1)xU(1), Sp(2)/Sp(1)xU(1) or G_2/SU(3), respectively. We analyze all critical points and present analytical and numerical kink- and bounce-type solutions, which yield G-invariant instanton configurations on those cosets. Periodic solutions on S^1 x G/H and dyons on iR x G/H are also given.Comment: 1+26 pages, 14 figures, 6 miniplot

Left, right, left, right, eyes to the front! Müller-Lyer bias in grasping is not a function of hand used, hand preferred or visual hemifield, but foveation does matter

We investigated whether the control of movement of the left hand is more likely to involve the use of allocentric information than movements performed with the right hand. Previous studies (Gonzalez et al. in J Neurophys 95:3496–3501, 2006; De Grave et al. in Exp Br Res 193:421–427, 2009) have reported contradictory findings in this respect. In the present study, right-handed participants (N = 12) and left-handed participants (N = 12) made right- and left-handed grasps to foveated objects and peripheral, non-foveated objects that were located in the right or left visual hemifield and embedded within a Müller-Lyer illusion. They were also asked to judge the size of the object by matching their hand aperture to its length. Hand apertures did not show significant differences in illusory bias as a function of hand used, handedness or visual hemifield. However, the illusory effect was significantly larger for perception than for action, and for the non-foveated compared to foveated objects. No significant illusory biases were found for reach movement times. These findings are consistent with the two-visual system model that holds that the use of allocentric information is more prominent in perception than in movement control. We propose that the increased involvement of allocentric information in movements toward peripheral, non-foveated objects may be a consequence of more awkward, less automatized grasps of nonfoveated than foveated objects. The current study does not support the conjecture that the control of left-handed and right-handed grasps is predicated on different sources of information

Gender differences in the association between adiposity and probable major depression: a cross-sectional study of 140,564 UK Biobank participants

&lt;b&gt;Background&lt;/b&gt;&lt;p&gt;&lt;/p&gt; Previous studies on the association between adiposity and mood disorder have produced contradictory results, and few have used measurements other than body mass index (BMI). We examined the association between probable major depression and several measurements of adiposity: BMI, waist circumference (WC), waist-hip-ratio (WHR), and body fat percentage (BF%).&lt;p&gt;&lt;/p&gt; &lt;b&gt;Methods&lt;/b&gt;&lt;p&gt;&lt;/p&gt; We conducted a cross-sectional study using baseline data on the sub-group of UK Biobank participants who were assessed for mood disorder. Multivariate logistic regression models were used, adjusting for potential confounders including: demographic and life-style factors, comorbidity and psychotropic medication.&lt;p&gt;&lt;/p&gt; &lt;b&gt;Results&lt;/b&gt;&lt;p&gt;&lt;/p&gt; Of the 140,564 eligible participants, evidence of probable major depression was reported by 30,145 (21.5%). The fully adjusted odds ratios (OR) for obese participants were 1.16 (95% confidence interval (CI) 1.12, 1.20) using BMI, 1.15 (95% CI 1.11, 1.19) using WC, 1.09 (95% CI 1.05, 1.13) using WHR and 1.18 (95% CI 1.12, 1.25) using BF% (all p &#60;0.001). There was a significant interaction between adiposity and gender (p = 0.001). Overweight women were at increased risk of depression with a dose response relationship across the overweight (25.0-29.9 kg/m2), obese I (30.0-34.9 kg/m2), II (35.0-39.9 kg/m2) and III (≥40.0 kg/m2) categories; fully adjusted ORs 1.14, 1.20, 1.29 and 1.48, respectively (all p &#60; 0.001). In contrast, only obese III men had significantly increased risk of depression (OR 1.29, 95% CI 1.08, 1.54, p = 0.006).&lt;p&gt;&lt;/p&gt; &lt;b&gt;Conclusion&lt;/b&gt;&lt;p&gt;&lt;/p&gt; Adiposity was associated with probable major depression, irrespective of the measurement used. The association was stronger in women than men. Physicians managing overweight and obese women should be alert to this increased risk