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Balanced, secure and dependable: the modern female traveler.
One of the great challenges related to multiple sclerosis (MS) research is the identification of markers of prognosis and treatment response. In the last couple of decades, an association between intrathecally produced immunoglobulin M (IgM) and a more severe course of the disease has been suggested. Therefore, the objective of this literature review was to gather and review evidence from studies on intrathecally produced IgM as a prognostic marker of clinically isolated syndrome (CIS) converting to clinically definite MS (CDMS), the prognosis of MS and treatment response in patients with MS. This was accomplished through a systematic literature search of the PubMed database, which resulted in 719 hits that were then systematically assessed with well-defined inclusion and exclusion criteria. This process resulted in 29 relevant research articles. The combined evidence from the current literature suggests that intrathecal IgM is a negative prognostic marker that identifies patients with CIS who have a higher risk of converting to CDMS and patients with relapsing-remitting MS (RRMS) with a higher risk of a more aggressive disease course. However, a few studies, some with large studied populations, have reported conflicting results regarding MS prognosis. Further research is needed to establish a more accurate estimate of the effect of intrathecal IgM on the disease course of MS. Further research is also necessary to evaluate the potential prognostic value of intrathecal IgM in treatment response.People usually become faster at finding a visual target after repeated exposure to the same search display. This effect, known as contextual cueing, is often thought to rely on a highly efficient learning mechanism, relatively unconstrained by the availability of attentional resources. Consistent with this view, experimental evidence suggests that contextual cueing can be found even when participants are instructed to ignore the repeated visual context, although this learning remains latent until the context receives full attention. The present study explores the contribution of selective attention to contextual cueing in four high-powered preregistered experiments. None of them supported the hypothesis that latent learning can occur without selective attention. In general, our results suggest that selective attention to visual context plays an essential role in both the acquisition and the expression of contextual cueing.BACKGROUND Currently, no specific treatment exists for heart failure with preserved ejection fraction (HFpEF). Left ventricular (LV) relaxation during diastole is a highly energy-demanding process, while energy homeostasis is known to be compromised in HFpEF. We hypothesise that trimetazidine - a fatty acid β‑oxidation inhibitor - improves LV diastolic function in HFpEF, by altering myocardial substrate use and improving the myocardial energy status. OBJECTIVES To assess whether trimetazidine improves LV diastolic function by improving myocardial energy metabolism in HFpEF. METHODS The DoPING-HFpEF trial is a randomised, double-blind, placebo-controlled cross-over intervention trial comparing the efficacy of trimetazidine and placebo in 25 patients with stable HFpEF. The main inclusion criteria are New York Heart Association functional class II to IV, LV ejection fraction ≥50%, and evidence of LV diastolic dysfunction. Patients are treated with one 20-mg trimetazidine tablet or placebo thrice daily (twice daily in the case of moderate renal dysfunction) for two periods of 3 months separated by a 2-week washout period. The primary endpoint is the change in pulmonary capillary wedge pressure during different intensities of exercise measured by right heart catheterisation. Our key secondary endpoint is the myocardial phosphocreatine (PCr)/ATP ratio measured by phosphorus-31 magnetic resonance spectroscopy and its relation to the primary endpoint. Exploratory endpoints are 6‑min walk distance, N-terminal pro-brain natriuretic peptide levels, and quality of life. CONCLUSION The DoPING-HFpEF is a phase-II trial that evaluates the effect of trimetazidine, a metabolic modulator, on diastolic function and myocardial energy status in HFpEF. [EU Clinical Trial Register 2018-002170-52; NTR registration NL7830].BACKGROUND Patient activation is associated with better outcomes in chronic conditions. OBJECTIVE We evaluated the psychometric properties of the 12-item Altarum Consumer Engagement™ Measure (ACE-12) in patients with prediabetes. PARTICIPANTS ACE-12 was administered to patients in the Prediabetes Informed Decisions and Education Study. MAIN MEASURES We conducted an exploratory factor analysis followed by confirmatory factor analytic models. read more We evaluated item response categories using item characteristic curves. Construct validity was assessed by examining correlations of the ACE-12 scales with education, depressive symptoms, self-rated health, hemoglobin A1c, body mass index, and weight loss. KEY RESULTS Participants (n = 515) had a median age of 58; 56% were female; 17% Hispanic; 54% were non-White. The scree plot and Tucker and Lewis reliability coefficient (0.95) suggested three factors similar to the original scales. One item loaded on the navigation rather than the informed choice scale. Ordinal alpha coe navigation scale. Additional items may be needed to yield acceptable reliability for the navigation scale.The present work aimed to investigate the anatomical structures of the Saanen goat head and its volumetric properties using computed tomography (CT) and stereological methods. Eight adult Saanen goat heads were included in this study. The different cavities and structures of the head, including nasal cavity, paranasal sinuses, oral cavity, orbital cavity, and cranial cavity were evaluated using CT scans, cross, sagittal, and coronal sections. The volume of head cavities and structures were estimated using the Cavalieri method. The results showed that the dorsal, middle and nasal ventral concha contained the dorsal, middle and ventral conchal sinuses, respectively. The paranasal sinuses constituted maxillary, frontal, lacrimal, and ethmoidal that were recognized and named in the CT scan images and their corresponding anatomical cross sections. The palatine and sphenoidal sinuses were not seen in the Saanen goat. Total volume of the head, nasal cavity and cranial cavity was estimated to be 1958 ± 205, 825.4 ± 62.
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