Διαταραχές της ινωδόλυσης σε ασθενείς που πάσχουν από μη αλκοολική λιπώδη νόσο του ήπατος

ΕΙΣΑΓΩΓΗ: Η μη αλκοολική λιπώδης νόσος του ήπατος (ΜΑΛΝΗ) αποτελεί τη συχνότερη αιτία χρόνιας ηπατικής νόσου στον ανεπτυγμένο κόσμο. Ο επιπολασμός της νόσου φτάνει στο 25% του ενήλικου πληθυσμού παγκοσμίως. Οι πάσχοντες από ΜΑΛΝΗ παρουσιάζουν αυξημένα ποσοστά θνητότητας, η οποία συνδέεται κυρίως με καρδιαγγειακά αίτια. Ο αυξημένος καρδιαγγειακός κίνδυνος έχει συσχετιστεί, σε ένα βαθμό τουλάχιστον, με την παρουσία ενός προθρομβωτικού φαινοτύπου, παρ’ ότι τα αποτελέσματα της ανάλυσης της αιμόστασης σε ασθενείς με ΜΑΛΝΗ είναι αντικρουόμενα. Με τα παρόντα δεδομένα δεν μπορούν να εξαχθούν ασφαλή συμπεράσματα για τη συμβολή της υπερπηκτικότητας στον αυξημένο θρομβωτικό κίνδυνο των ασθενών που πάσχουν από ΜΑΛΝΗ. ΣΚΟΠΟΣ: Σκοπός της μελέτης ήταν η διερεύνηση των διαταραχών της ινωδόλυσης σε ασθενείς με μη-κιρρωτική ΜΑΛΝΗ. ΥΛΙΚΟ ΚΑΙ ΜΕΘΟΔΟΣ: Συμπεριλήφθηκαν 50 ασθενείς με υπερηχογραφικά διαπιστωμένη ΜΑΛΝΗ (άρρενες:48%, μέση ηλικία:56+/-12,2 έτη, μέσο BMI:28.2+/-3.9, FIB4: 70%<1.45, 30% 1.45-3.25). Εξαιρέθηκαν ασθενείς με κίρρωση, ιογενή/άλλη δευτεροπαθή ηπατίτιδα, ιστορικό κατάχρησης οινοπνεύματος, ιστορικό συγγενούς ή επίκτητης θρομβοφιλίας, ενεργό λοίμωξη, νεοπλασματική νόσο καθώς και νοσηλευόμενοι ασθενείς και έγκυες γυναίκες. Καταγράφηκαν τα επιδημιολογικά και βιομετρικά στοιχεία των ασθενών, δεδομένα σχετικά με την παρουσία παραγόντων μεταβολικού κινδύνου από το ατομικό και οικογενειακό ιστορικό, εργαστηριακές εξετάσεις (ηπατική βιοχημεία, τιμές αιμοπεταλίων) και έγινε υπολογισμός του σκορ Fibrosis-4 (FIB-4). Μετρήθηκαν κλασσικές παράμετροι της αιμόστασης (PT, APTT, INR, ινωδογόνο) και παράγοντες ινωδόλυσης (fXIII, D-dimers, PAI-1) καθώς και η φερριτίνη ορού. ΑΠΟΤΕΛΕΣΜΑΤΑ: Όλοι οι ασθενείς είχαν φυσιολογικές τιμές fXIII. Δεν παρατηρήθηκαν αυξημένες τιμές PAI-1. 11/50 ασθενείς παρουσίαζαν παθολογικές τιμές D-dimers. Διαπιστώθηκε συσχέτιση του δείκτη μάζας σώματος, των αιμοπεταλίων και του καπνίσματος με τα δ-διμερή σε στατιστικά σημαντικό βαθμό (p<0.05). Με χρήση πολυπαραγοντικής γραμμικής παλινδρόμησης καταγράφηκε η επίδραση του εκάστοτε παράγοντα κινδύνου (ή/και συνδυασμού αυτών) στην τιμή των δ-διμερών, χωρίς να είναι δυνατή η ανάδειξη στατιστικά σημαντικών αποτελεσμάτων. ΣΥΜΠΕΡΑΣΜΑΤΑ: Στους ασθενείς με ΜΑΛΝΗ έχει περιγραφεί μια διαταραχή ισορροπίας ανάμεσα σε προπηκτικούς και αντιπηκτικούς παράγοντες που μπορεί να οδηγήσει σε υπερπηκτικό φαινότυπο. Τα αποτελέσματά μας δείχνουν ότι σε ασθενείς με ΜΑΛΝΗ και περιορισμένη ίνωση, το ινωδολυτικό σύστημα δεν φαίνεται να επηρεάζεται σημαντικά και συμβάλλει, αλλά σε μικρότερο βαθμό, στην εκδήλωση αυτού του φαινοτύπου.INTRODUCTION: The prevalence of non-alcoholic fatty liver disease (NAFLD) has risen and it is now the most common cause of liver disease in the developed world, reaching 25% of the global adult population. NAFLD patients exhibit high mortality rates, mainly due to cardiovascular causes. NAFLD is strongly associated with a prothrombotic tendency, which may, at least in part, contribute to the increased cardiovascular risk observed in these patients. Studies of the hemostatic profile of patients suffering from NAFLD have shown conflicting results. Taking current contemporary data into consideration, it remains unclear if hypercoagulability contributes to an increased thrombotic risk in patients suffering from NAFLD. AIM: The aim of the study was to investigate fibrinolysis disorders in patients suffering from non-cirrhotic NAFLD. MATERIALS AND METHODS: 50 patients suffering from ultrasound-diagnosed NAFLD were included in the study (male:48%, mean age:56+/-12,2 years, mean BMI:28.2+/-3.9, FIB4: 70%<1.45, 30% 1.45-3.25). Patients suffering from cirrhosis, viral/other secondary hepatitis, alcohol abuse history, history of familial/aquired thrombophilia, active infection or neoplasm, hospitalised patients and pregnant women, were excluded. Patients’ characteristics, including epidemiological and biometric data, the presence of metabolic syndrome risk factors and laboratory results (liver function tests, platelet values) were recorded. The Fibrosis-4 index (FIB-4) was calculated for all patients. Blood samples were drawn for laboratory testing, using conventional hemostasis assays (PT, APTT, INR, fibrinogen), fibrinolytic assays (fXIII, D-dimers, PAI-1) and ferritin measurement. RESULTS: Factor XIII levels were within reference range for all patients. No patient demonstrated high PAI-1 levels. D-dimers values were beyond normal values for 11/50 patients. A correlation between high D-dimers values, body mass index, platelet values and smoking was found to be statistically important (p<0.05). Using multivariate linear regression models, the effect of each risk factor (or combination of them) on the observed D-dimers value, was studied. Statistically important correlations were not observed. CONCLUSIONS: NAFLD patients suffer from a hemostatic imbalance between procoagulant and anticoagulant factors, which may be expressed as a prothrombotic phenotype. The results of the present study show that the fibrinolytic system of NAFLD patients without advanced fibrosis, does not seem to be seriously affected by the disease. In this patient category, fibrinolysis contributes in a limited way in the manifestation of the procoagulant phenotype

Validation of the GATE Monte Carlo simulation platform for modelling a CsI(Tl) scintillation camera dedicated to small animal imaging

Monte Carlo simulations are increasingly used in scintigraphic imaging to model imaging systems and to develop and assess tomographic reconstruction algorithms and correction methods for improved image quantitation. GATE (GEANT 4 Application for Tomographic Emission) is a new Monte Carlo simulation platform based on GEANT4 dedicated to nuclear imaging applications. This paper describes the GATE simulation of a prototype of scintillation camera dedicated to small animal imaging and consisting of a CsI(Tl) crystal array coupled to a position sensitive photomultiplier tube. The relevance of GATE to model the camera prototype was assessed by comparing simulated 99mTc point spread functions, energy spectra, sensitivities, scatter fractions and image of a capillary phantom with the corresponding experimental measurements. Results showed an excellent agreement between simulated and experimental data: experimental spatial resolutions were predicted with an error less than 100 mu m. The difference between experimental and simulated system sensitivities for different source-to-collimator distances was within 2%. Simulated and experimental scatter fractions in a [98-182 keV] energy window differed by less than 2% for sources located in water. Simulated and experimental energy spectra agreed very well between 40 and 180 keV. These results demonstrate the ability and flexibility of GATE for simulating original detector designs. The main weakness of GATE concerns the long computation time it requires: this issue is currently under investigation by the GEANT4 and the GATE collaboration

Combining Geostatistics and Remote Sensing Data to Improve Spatiotemporal Analysis of Precipitation

The wide availability of satellite data from many distributors in different domains of science has provided the opportunity for the development of new and improved methodologies to aid the analysis of environmental problems and to support more reliable estimations and forecasts. Moreover, the rapid development of specialized technologies in satellite instruments provides the opportunity to obtain a wide spectrum of various measurements. The purpose of this research is to use publicly available remote sensing product data computed from geostationary, polar and near-polar satellites and radar to improve space–time modeling and prediction of precipitation on Crete island in Greece. The proposed space–time kriging method carries out the fusion of remote sensing data with data from ground stations that monitor precipitation during the hydrological period 2009/10–2017/18. Precipitation observations are useful for water resources, flood and drought management studies. However, monitoring stations are usually sparse in regions with complex terrain, are clustered in valleys, and often have missing data. Satellite precipitation data are an attractive alternative to observations. The fusion of the datasets in terms of the space–time residual kriging method exploits the auxiliary satellite information and aids in the accurate and reliable estimation of precipitation rates at ungauged locations. In addition, it represents an alternative option for the improved modeling of precipitation variations in space and time. The obtained results were compared with the outcomes of similar works in the study area

Individuals’ Inner Wellbeing during the COVID-19 Pandemic: A Quantitative Comparison of Social Connections and Close Relationships between the UK and India

Copyright © 2023 The Author(s). Relationships form an integral part of our everyday wellbeing. In this study, the focus is on Inner Wellbeing which can be described as an individuals' thoughts and feelings about what they can do and be. Relationships can come in many forms and can be divided into Social Connections (thoughts and feelings about the social network people can establish and rely on), and Close Relationships (thoughts and feeling about the emotional support people can receive from significant others or their close, intimate circle). The purpose of this study is to compare the Social Connections and Close Relationship dimensions of Inner Wellbeing during the COVID-19 pandemic between the UK and India. As part of the study, 392 participants in the UK and 205 participants India completed an online questionnaire using the Inner Wellbeing scale. Factor analyses showed that the construct of Inner Wellbeing can be described as one factor for the UK sample whereas it can be described as two factors (one focusing on positive items and one focusing on negative items) for the Indian sample. Results showed that during COVID-19, Social Connections were significantly different in the UK compared to India, whereas there is no significant difference for Close Relationships. The implications on relationships and wellbeing are discussed in detail

The Association of Emotional Eating with Overweight/Obesity, Depression, Anxiety/Stress, and Dietary Patterns: A Review of the Current Clinical Evidence

(1) Background: Emotional eating is considered as the propensity to eat in response to emotions. It is considered as a critical risk factor for recurrent weight gain. Such overeating is able to affect general health due to excess energy intake and mental health. So far, there is still considerable controversy on the effect of the emotional eating concept. The objective of this study is to summarize and evaluate the interconnections among emotional eating and overweight/obesity, depression, anxiety/stress, and dietary patterns; (2) Methods: This is a thorough review of the reported associations among emotional eating and overweight/obesity, depression, anxiety/stress, and dietary patterns. We compressively searched the most precise scientific online databases, e.g., PubMed, Scopus, Web of Science and Google Scholar to obtain the most up-to-date data from clinical studies in humans from the last ten years (2013–2023) using critical and representative keywords. Several inclusion and exclusion criteria were applied for scrutinizing only longitudinal, cross-sectional, descriptive, and prospective clinical studies in Caucasian populations; (3) Results: The currently available findings suggest that overeating/obesity and unhealthy eating behaviors (e.g., fast food consumption) are associated with emotional eating. Moreover, the increase in depressive symptoms seems to be related with more emotional eating. Psychological distress is also related with a greater risk for emotional eating. However, the most common limitations are the small sample size and their lack of diversity. In addition, a cross-sectional study was performed in the majority of them; (4) Conclusions: Finding coping mechanisms for the negative emotions and nutrition education can prevent the prevalence of emotional eating. Future studies should further explain the underlying mechanisms of the interconnections among emotional eating and overweight/obesity, depression, anxiety/stress, and dietary patterns

Evaluating the Relationship between Circadian Rhythms and Sleep, Metabolic and Cardiovascular Disorders: Current Clinical Evidence in Human Studies

Circadian rhythms are generated by the circadian clock, a self-sustained internal timing system that exhibits 24-h rhythms in the body. Many metabolic, cellular, behavioral and physiological processes are regulated by the circadian clock in coordination with environmental cues. The present study is a comprehensive review of the currently existing evidence concerning the relationship between circadian rhythms and sleep, metabolic, and cardiovascular disorders. We thoroughly searched the online databases PubMed, Scopus, and Web of Science to find the existing clinical studies from the last twenty-three years (2000–2023). Circadian misalignment was found to be associated with an increase in the risk of metabolic disorders, cardiovascular diseases, and obesity, as well as inadequate sleep quality. In this review article, all the included studies had a strength protocol design and all of them were conducted on humans. However, the most common limitations of them were the small sample size and the short time of the intervention. In conclusion, managing the factors that disrupt the optimal function of central and peripheral clocks can help to reduce the risk of metabolic and cardiovascular diseases, improving also sleep quality. Future studies should further explore the underlying mechanisms of the interconnections between circadian clocks and sleep, metabolic, and cardiovascular disorders. This may provide new opportunities for advance chronotherapy approach

Photo-Detectors for Time of Flight Positron Emission Tomography (ToF-PET)

We present the most recent advances in photo-detector design employed in time of flight positron emission tomography (ToF-PET). PET is a molecular imaging modality that collects pairs of coincident (temporally correlated) annihilation photons emitted from the patient body. The annihilation photon detector typically comprises a scintillation crystal coupled to a fast photo-detector. ToF information provides better localization of the annihilation event along the line formed by each detector pair, resulting in an overall improvement in signal to noise ratio (SNR) of the reconstructed image. Apart from the demand for high luminosity and fast decay time of the scintillation crystal, proper design and selection of the photo-detector and methods for arrival time pick-off are a prerequisite for achieving excellent time resolution required for ToF-PET. We review the two types of photo-detectors used in ToF-PET: photomultiplier tubes (PMTs) and silicon photo-multipliers (SiPMs) with a special focus on SiPMs

Association of Maternal Pre-Pregnancy Overweight and Obesity with Childhood Anthropometric Factors and Perinatal and Postnatal Outcomes: A Cross-Sectional Study

Background: Pre-pregnancy overweight and obesity in reproductive-aged women becomes a growing tendency in middle- and high-income populations. This study aimed to evaluate whether maternal excess body mass index (BMI) before gestation is associated with children’s anthropometric characteristics, as well as perinatal and postnatal outcomes. Methods: This was a cross-sectional study performed on 5198 children aged 2–5 years old and their paired mothers, assigned from 9 different areas of Greece. Maternal and childhood anthropometric data, as well as perinatal and postnatal outcomes, were collected from medical history records or validated questionnaires. Results: Prevalences of 24.4% and 30.6% of overweight/obesity were recorded for the enrolled children and their mothers 2–5 years postpartum. Maternal pre-pregnancy overweight/obesity was more frequently observed in older mothers and female children, and was also associated with high childbirth weight, preterm birth, high newborn ponderal index, caesarean section delivery, diabetes type 1, and childhood overweight/obesity at pre-school age. In multivariate analysis, maternal pre-pregnancy overweight/obesity was independently associated with a higher risk of childhood overweight/obesity at pre-school age, as well as with a higher increased incidence of childbirth weight, caesarean section delivery, and diabetes type 1. Conclusions: Maternal overweight/obesity rates before gestation were related with increased childhood weight status at birth and 2–5 years postpartum, highlighting the necessity of encouraging healthy lifestyle promotion, including healthier nutritional habits, and focusing on obesity population policies and nutritional interventions among women of reproductive age