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To test the effect of nurse-led Internet-based cognitive behavioural therapy for insomnia (I-CBTI), tailored for patients with cardiovascular disease (CVD), with a 6-month follow-up.
A two-arm parallel-group randomized controlled trial (RCT) registered at clinicaltrials.gov (NTC03938805) and reported according to the CONSORT checklist.
Forty-eight patients (mean age 72years, 65% men) diagnosed with CVD and insomnia were randomized to either 9-week nurse-led I-CBTI with support, or an Internet-based self-study programme without support (control group). Insomnia Severity Index (ISI) and Short Form Health Survey (SF-12) were used as primary and secondary outcomes.
ISI showed a significant treatment effect of I-CBTI compared to the control group at 9-week follow-up. The mean ISI score in the I-CBTI group at 9weeks post-treatment was maintained at the 6-month follow-up. Patients' adherence to I-CBTI was associated with a better effect on both the ISI and SF-12.
ISI showed a significant treatment effect of I-CBTI compared to the control group at 9-week follow-up. The mean ISI score in the I-CBTI group at 9 weeks post-treatment was maintained at the 6-month follow-up. Patients' adherence to I-CBTI was associated with a better effect on both the ISI and SF-12.In aging Caenorhabditis elegans, as in higher organisms, there is more than one cause of death. C. elegans exhibit early death with a swollen, infected pharynx (P death), and later death with pharyngeal atrophy (p death). Interventions that alter lifespan can differentially affect frequency and timing of each type of death, generating complex survival curve shapes. Here, we use mortality deconvolution analysis to investigate how reduction of insulin/IGF-1 signaling (IIS), which increases lifespan (the Age phenotype), affects different forms of death. All daf-2 insulin/IGF-1 receptor mutants exhibit increased lifespan in the p subpopulation (p Age), while pleiotropic class 2 daf-2 mutants show an additional marked reduction in P death frequency. The latter is promoted by pharyngeal expression of the IIS-regulated DAF-16 FOXO transcription factor, and at higher temperature by reduced pharyngeal pumping rate. Pharyngeal DAF-16 also promotes p Age in class 2 daf-2 mutants, revealing a previously unknown role for the pharynx in the regulation of aging. Necropsy analysis of daf-2 interactions with the daf-12 steroid receptor implies that previously described opposing effects of daf-12 on daf-2 longevity are attributable to internal hatching of larvae, rather than complex interactions between insulin/IGF-1 and steroid signaling. These findings support the view that wild-type IIS acts through multiple distinct mechanisms which promote different life-limiting pathologies, each of which contribute to late-life mortality. This study further demonstrates the utility of mortality deconvolution analysis to better understand the genetics of lifespan.
To report outcomes and follow-up of Baerveldt implant surgery in dogs with primary closed-angle glaucoma (PCAG).
Record review of client-owned dogs with PCAG that underwent Baerveldt implant surgery during a 6-year period. Postoperative intraocular pressure (IOP), vision and daily number of anti-glaucoma drops at fixed time points (3, 12, and 24months) were compared with preoperative values; complications were recorded. Success was defined as IOP <20mmHg and a positive menace response and navigation/tracking ability.
Twenty eyes (17 dogs) were included. Mean follow-up was 575days (range 30-1767days) from implant surgery to last examination. Three months postoperatively 15/20 (75%) eyes had IOP <20mmHg and 14/20 (70%) eyes had vision. Twelve months postoperatively 11/17 (65%) eyes had IOP <20mmHg and 12/19 (63%) eyes had vision. Twenty-four months postoperatively 8/14 (57%) eyes had IOP <20mmHg and 7/15 (47%) eyes had vision. Denominators differ between time points as eyes were included when duration after surgery reached the relevant postoperative time point or failure was documented earlier. Within 3months postoperatively 16/20 (80%) eyes had ≥1 complication, including transient IOP >20mmHg (14/20; 70% eyes), fibrin (12/20; 60% eyes), and hypotony (4/20; 20% eyes). After 3months, postoperatively 13/16 (81%) eyes had ≥1 complication, including cataracts (13/16; 81% eyes), bleb fibrosis (3/16; 19% eyes), and conjunctival wound breakdown (1/16; 6% eyes). One patient (1 eye) was euthanized for blindness and 5/20 (25%) eyes were enucleated.
The technique was effective in controlling IOP and maintaining vision in most dogs in this study.
The technique was effective in controlling IOP and maintaining vision in most dogs in this study.
Sepsis is a life-threatening condition caused by a dysregulated host response to infections and is a leading cause of death in hospitalized patients. The present study aimed to elucidate the possible association between sepsis and the tumor necrosis factor (TNF) gene -308G/A (rs1800629) polymorphism, as well as endothelial nitric oxide synthase (eNOS, NOS3) gene -786T/C (rs2070744), 4a/4b (27 bp-VNTR in intron 4, rs61722009) and 894G/T (Glu298Asp, rs1799983) polymorphisms.
In total, 188 septic adult cases and 188 healthy controls were enrolled. Genomic DNAs from the controls and patients were analyzed by polymerase chain reaction and restriction fragment length polymorphism methods.
There were significant associations between the G/G genotype and G allele of the TNF -308G/A (rs1800629) polymorphism in the sepsis group (p < 0.001). The presence of the T/C genotype (p = 0.002) and C allele (p = 0.001) of the -786T/C (rs2070744) was markedly associated with an increased risk of sepsis. However, no significant associations were found with 4a/4b (27 bp-VNTR in intron 4, rs61722009) and 894G/T (Glu298Asp, rs1799983) polymorphisms. Higher 4bGC and lower 4bTT haplotype frequencies were associated with sepsis.
Our results strongly suggest that TNF gene (-308G/A, rs1800629) and NOS3 gene -786T/C (rs2070744) polymorphisms may modify individual susceptibility to sepsis in the Turkish population.
Our results strongly suggest that TNF gene (-308G/A, rs1800629) and NOS3 gene -786T/C (rs2070744) polymorphisms may modify individual susceptibility to sepsis in the Turkish population.The bioethics research conducted in Ibero-American countries has been very much restricted to its own realm. The aim of this study was to perform a bibliometric evaluation of bioethics papers by authors affiliated with Ibero-American institutions, and to determine how their work influences global bioethics literature. We performed a literature search in the Web of Science Core Collection (WoS CC) and Scopus. We identified a total of 5,975 documents, of which 84.3% were articles, 11.6% reviews and 4.1% book chapters. The median number of citations per paper was higher in English-language journals. Only 10 articles published between 2010 and 2019 in peer-reviewed bioethics journals and produced exclusively by authors from Ibero-American institutions garnered more than 15 citations. Our study suggests that if researchers from Ibero-American institutions want to influence global bioethical thinking, they must make the required leap in quality to be able to publish in high-quality bioethics and mainstream journals.
Type II diabetes mellitus (DM2) is a significant risk factor for cancers, including breast cancer. However, a proper diabetic breast cancer mouse model is not well-established for treatment strategy design. Additionally, the precise diabetic signaling pathways that regulate cancer growth remain unresolved. In the present study, we established a suitable mouse model and demonstrated the pathogenic role of diabetes on breast cancer progression.
We successfully generated a transgenic mouse model of human epidermal growth factor receptor 2 positive (Her2
or ERBB2) breast cancer with DM2 by crossing leptin receptor mutant (Lepr
) mice with MMTV-ErbB2/neu) mice. The mouse models were administrated with antidiabetic drugs to assess the impacts of controlling DM2 in affecting tumor growth. Magnetic resonance spectroscopic imaging was employed to analyze the tumor metabolism.
Treatment with metformin/rosiglitazone in MMTV-ErbB2/Lepr
mouse model reduced serum insulin levels, prolonged overall survival, decrr results defined the signaling pathways deregulated in HER2+ breast cancer under diabetic condition, which can be intervened by anti-insulin resistance therapy.
To develop and evaluate psychometric property of quality nursing care scale (QNCS) from nurses' perspective in the Chinese context.
A cross-sectional survey design.
This study was conducted in two phases. In Phase I, literature review and interviews were conducted to develop the items. In Phase II, content validity was evaluated by five experts. Construct validity was tested through exploratory factor analysis (EFA) among 302 nurses and confirmatory factor analysis (CFA) among 510 nurses from October 2014 to January 2015. Additionally, internal consistency reliability was tested.
The EFA extracted six factors including staff characteristics, task-oriented activities, human-oriented activities, physical environment, patient outcomes and precondition. All six factors accounted for 74.78% of the total variance to explain quality nursing care. The modified measurement model of the final version of QNCS was supported by the CFA with 48 items in six dimensions. The internal consistency reliability of final QNCS was acceptable.
The EFA extracted six factors including staff characteristics, task-oriented activities, human-oriented activities, physical environment, patient outcomes and precondition. All six factors accounted for 74.78% of the total variance to explain quality nursing care. The modified measurement model of the final version of QNCS was supported by the CFA with 48 items in six dimensions. The internal consistency reliability of final QNCS was acceptable.Vertical positioning of the maxillary incisors is critical in smile design, and orthodontists also have the capability of working in the anterior-posterior plane of space. As a result, the anterior posterior positioning of the maxillary incisors becomes equally important for smile aesthetics. This manuscript presents the concept of smile projection for incorporation into the current concepts of smile design.Hidradenitis suppurativa (HS), also known as acne inversa, is a chronic inflammatory skin disease mainly affecting apocrine gland-rich areas of the body with painful nodules, persisted abscess, sinus tracts, and scarring. The etiopathology of HS remains unclearly understood, but the disease is considered as a polygenic autoinflammation condition originating from follicular hyperkeratosis and occlusion. Recent advances concerning the substantial roles of tumor necrosis factor (TNF)-α, interleukin (IL)-1β, IL-17, and IL-23 have accelerated in developing a repertoire of therapeutic biologics in HS. Currently five biologics antagonistic for these different cytokines, adalimumab, anakinra, etanercept, infliximab, and ustekinumab, have been explored in the treatment setting of HS; however, only limited evidence is available for the therapeutic advantage of IL-17 pathway blockade. We present a 47-year-old Japanese man who had a long-standing, debilitating HS complicated with psoriasis, both of which were refractory to a series of the standard treatment.
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