Hip fracture. Preliminary results supporting significative correlations between the psychological wellbeing of patients and their relative caregivers

Background and aim. Hip fracture is one of the major causes of loss of self-sufficiency in older patients. The associated caregiving rehabilitation task often falls to the lot of a member of the patient’s family. Our study aims at assessing the relationship between the psychological well-being of patients with hip fracture and their caregivers. Methods. The study was carried-out on 53 elderly patients with hip fracture and their primary caregivers. The Mini Mental State Examination (patient), Activities of Daily Living (patient), Instrumental Activities of Daily Living (patient), Geriatric Depression Scale (patient), Psychological General Well-Being Index (patient/caregiver) and the Caregiver Burden Inventory (caregiver) were administered to each participant. Results. The results revealed significant correlations between stress levels and the psychological well-being of hip-fracture patients and relative caregivers. In particular, the Caregiver Burden Inventory’s total score was negatively related to the patient’s Psychological General Well-Being Index score (p < 0.05) and with Anxiety (p < 0.05), Depressed Mood (p < 0.01), Positive Well-being (p < 0.05) and General Health (p < 0.05) subscale scores, as well as with the patient’s Activities of Daily Living (p < 0.05) score. Patients’ Psychological General Well-Being Index scores were related to the caregivers’ General Health subscale (p < 0.01), and negatively related to Caregiver Burden Inventory Time Dependence (p < 0.05) and Social Burden (p < 0.05) subscales, as well as with the Geriatric Depression Scale score (p < 0.05). Conclusion. A mutual relationship seems to exist between a patient’s psychological well-being and his/her caregiver’s burden. These findings highlight the importance of a bio-psychosocial approach to both patients and caregivers

A Computational Model of the Secondary Hemostasis Pathway in Reaction Systems

Reaction Systems (RSs) are a computational framework inspired by biochemical mechanisms. An RS defines a finite set of reactions over a finite set of entities (molecules, proteins, etc). Starting from an initial set of entities (the initial state), a computation is performed by applying all reactions to a state in order to produce the following state, giving rise to a sequence of sets of entities. RSs have shown to be a general computational framework whose application ranges from the modeling of biological phenomena to molecular chemistry and computer science. In this paper, we contribute to research on the application of RSs for modeling biological systems. We consider the problem of modeling hemostasis, for which several models have been defined, starting from the 1960s. Previous models are based on sets of ordinary differential equations, while we develop a discrete model in RSs for pathways of the secondary hemostasis. Then, we implement our model in BioReSolve, a computational framework for RSs that we have previously defined which provides tools for the specification and verification of properties. By using the tools in BioReSolve we derive important observations on the model behaviour for hemostasis, and in particular, we study the role of three important inhibitors, verifying that their presence or absence leads to phenomena such as thrombophilia, or thromboembolism, or excessive coagulation, etc. We can also study computationally the causality relations between the molecules involved in the reactions showing which entities play a fundamental role, thus contributing to the design of more effective and specialized drugs. Our work can hence help to show how to model complex biological systems in RSs and derive computationally and biologically relevant properties of the systems

Quantitative extensions of reaction systems based on SOS semantics

Reaction systems (RSs) are a successful natural computing framework inspired by chemical reaction networks. A RS consists of a set of entities and a set of reactions. Entities can enable or inhibit each reaction and are produced by reactions or provided by the environment. In this paper, we define two quantitative variants of RSs: the first one is along the time dimension, to specify delays for making available reactions products and durations to protract their permanency, while the second deals with the possibility to specify different concentration levels of a substance in order to enable or inhibit a reaction. Technically, both extensions are obtained by modifying in a modular way the Structural Operational Semantics (SOS) for RSs that was already defined in the literature. Our approach maintains several advantages of the original semantics definition that were: (1) providing a formal specification of the RS dynamics that enables the reuse of many formal analysis techniques and favours the implementation of tools, and (2) making the RS framework extensible, by adding or changing some of the SOS rules in a compositional way. We provide a prototype logic programming implementation and apply our tool to three different case studies: the tumour growth, the Th cell differentiation in the immune system and neural communication

Causal analysis of positive Reaction Systems

Cause/effect analysis of complex systems is instrumental in better understanding many natural phenomena. Moreover, formal analysis requires the availability of suitable abstract computational models that somehow preserve the features of interest. Our contribution focuses on the analysis of Reaction Systems (RSs), a qualitative computational formalism inspired by biochemical reactions in living cells. The primary challenge lies in dealing with inhibition mechanisms. On the one hand, inhibitors enhance the expressiveness of the computational abstraction; on the other hand, they can introduce nonmonotonic behaviors that can be computationally hard to deal with in the analysis. We propose an encoding of RSs into an equivalent formulation without inhibitors (called Positive RSs, PRSs for short) that is easier to handle, because PRSs exhibit monotonic behaviors. The effectiveness of our transformation is witnessed by its impact on two different techniques for cause/effect analysis. The first, called slicing, allows detecting the causes of some unforeseen phenomenon by reasoning backward along a given computation. Here, PRSs can be exploited to improve the quality of the analysis. The second technique, predictor analysis, is addressed by introducing a novel tool called MuMa, which is based on must/maybe sets, whence the tool name, an original abstraction for approximating ancestor formulas. MuMa exploits PRSs to improve the performance of the analysis

The use of chest magnetic resonance imaging in interstitial lung disease: A systematic review

Thin-slices multi-detector computed tomography (MDCT) plays a key role in the differential diagnosis of interstitial lung disease (ILD). However, thin-slices MDCT has a limited ability to detect active inflammation, which is an important target of newly developed ILD drug therapy. Magnetic resonance imaging (MRI), thanks to its multi-parameter capability, provides better tissue characterisation than thin-slices MDCT. Our aim was to summarise the current status of MRI applications in ILD and to propose an ILD-MRI protocol. A systematic literature search was conducted for relevant studies on chest MRI in patients with ILD. We retrieved 1246 papers of which 55 original papers were selected for the review. We identified 24 studies comparing image quality of thin-slices MDCT and MRI using several MRI sequences. These studies described new MRI sequences to assess ILD parenchymal abnormalities, such as honeycombing, reticulation and ground-glass opacity. Thin-slices MDCT remains superior to MRI for morphological imaging. However, recent studies with ultra-short echo-time MRI showed image quality comparable to thin-slices MDCT. Several studies demonstrated the added value of chest MRI by using functional imaging, especially to detect and quantify inflammatory changes. We concluded that chest MRI could play a role in ILD patients to differentiate inflammatory and fibrotic changes and to assess efficacy of new ILD drugs

Annual to seasonal glacier mass balance in High Mountain Asia derived from Pl\ue9iades stereo images: examples from the Pamir and the Tibetan Plateau

\ua9 Copyright: Glaciers are crucial sources of freshwater in particular for the arid lowlands surrounding High Mountain Asia. To better constrain glacio-hydrological models, annual, or even better, seasonal information about glacier mass changes is highly beneficial. In this study, we evaluate the suitability of very-high-resolution Pl\ue9iades digital elevation models (DEMs) to measure glacier mass balance at annual and seasonal scales in two regions of High Mountain Asia (Muztagh Ata in Eastern Pamirs and parts of western Nyainq\ueantanglha, south-central Tibetan Plateau), where recent estimates have shown contrasting glacier behaviour. The average annual mass balance in Muztagh Ata between 2019 and 2022 was -0.07ĝ€\uaf\ub1ĝ€\uaf0.20ĝ€\uafmĝ€\uafw.e.ĝ€\uafa-1, suggesting the continuation of a recent phase of slight mass loss following a prolonged period of balanced mass budgets previously observed. The mean annual mass balance in western Nyainq\ueantanglha was highly negative for the same period (-0.60ĝ€\uaf\ub1ĝ€\uaf0.15ĝ€\uafmĝ€\uafw.e.ĝ€\uafa-1), suggesting increased mass loss rates compared to the approximately previous 5 decades. The 2022 winter (+0.13ĝ€\uaf\ub1ĝ€\uaf0.24ĝ€\uafmĝ€\uafw.e.) and summer (-0.35ĝ€\uaf\ub1ĝ€\uaf0.15ĝ€\uafmĝ€\uafw.e.) mass budgets in Muztagh Ata and western Nyainq\ueantanglha (-0.03ĝ€\uaf\ub1ĝ€\uaf0.27ĝ€\uafmĝ€\uafw.e. in winter; -0.63ĝ€\uaf\ub1ĝ€\uaf0.07ĝ€\uafmĝ€\uafw.e. in summer) suggest winter- and summer-accumulation-type regimes, respectively. We support our findings by implementing the Sentinel-1-based Glacier Index to identify the firn and wet-snow areas on glaciers and characterize the accumulation type. The good match between the geodetic and Glacier Index results supports the potential of very-high-resolution Pl\ue9iades data to monitor mass balance at short timescales and improves our understanding of glacier accumulation regimes across High Mountain Asia

Prevalence of Vertebral Fractures in Osteoporotic HIP Fractured Patients: The Focus Study

Osteoporosis is a multifactorial systemic skeletal disease, characterized by low bone mass and microarchitectural modifications of bone tissue, with a consequent increase in fragility fractures. Vertebral fractures are the most prevalent osteoporotic fractures and osteoporotic hip fractures are the most serious complication of osteoporosis resulting in increased mortality and high socio-economic cost. The coexistence of these two pathological conditions in elderly patients has been previously described, leading to even worse functional outcomes than each one alone. To determine the prevalence of vertebral fractures in osteoporotic hip fractured women and to evaluate the relationship between prevalence of vertebral fractures and pre-existing factors such us autonomy in daily life activity, quality of walking, numbers of falls, cognitive aspects and comorbidities. 946 osteoporotic hip fractured women aged more than 60 years and with an X-ray evaluation of spine were consecutively enrolled in 25 Orthopaedic, Physical Medicine and geriatric centers in Italy. After spine X-ray morphometry patients were divided in two groups: previous vertebral fracture (F) and no previous fracture (NF). Moreover anamnestic, demographical and outcome related data (ADL, IADL, CIRS, SPMSQ, FAC and RANKIN scale) were collected. Prevalent vertebral fractures were present in 502 (54%) patients. 119 (13.7%) patients had at least one severe fracture. The F compared to NF group showed statistically significant worse scores regarding the pre hip fracture values of RANKIN, CIRS, SPMSQ, IADL and the overall number of falls (p<0.001). Moreover the F group showed statistically significant lower values of serif 25(OH)D than NF group (p<.0.001). Previous Vertebral fractures in hip fractured patients are a common issue and negatively influence several functional and cognitive outcome measures in these patients