Notes

COVID-19 (SARS-CoV-2) lymphocyte responses are generally linked to inflamed biomarkers in total mutual replacement medical procedures candidates pre-operatively.
Erectile dysfunction (ED) is often associated with endocrine metabolic diseases such as metabolic syndrome (MetS) and diabetes mellitus (DM), in which insulin resistance (IR) plays a decisive role in pathology. Triglyceride-glucose index (TyG), a simple, inexpensive and easily accessible IR marker, is calculated by fasting serum glucose and triglyceride values.

We aimed to reveal the relationship between TyG index and ED.

Of 152 male patients, aged between 24-80years, admitted to the urology outpatient clinic with complaining erectile insufficiency were evaluated. Liver function tests, complete blood count, fasting serum triglyceride, serum testosterone, fasting glucose, fasting insulin, and hemoglobinA1c (HbA1c) were analyzed. TyG index was calculated. All patients were requested to fill in the validated Turkish version of the 5-item International Index of Erectile Function (IIEF-5) survey.

A total of 142 patients were included the study. ED was detected in 91 (64.1%) of the patients. BMI, fasting insulin level, fasting glucose level, IR, GGT, HDL, HbA1c, Triglyceride, TyG, DM, HT, and MetS status of the patients in ED group were statistically significantly higher compared to non-ED group (all P < .05). It was found that the cutoff value of TyG index for ED was 8.88 (AUC=0.739, sensitivity 67%, specificity=68.6%). In multivariate logistic regression analysis, age (OR=1.07, 95% CI=1026-1115, P=.002) and TyG index above 8.88 (OR=3.865, 95% CI=1686-8859, P=.001) were found as independent predictors of ED after accounting for BMI, serum total T and IR.

TyG index might be useful in the diagnosis and follow-up of ED.
TyG index might be useful in the diagnosis and follow-up of ED.
The aim of this work was to explore the predictive value of changes in the level of carbohydrate antigen 19-9 (CA19-9) after neoadjuvant chemoradiotherapy (nCRT) and after surgery in patients with locally advanced rectal cancer (LARC).

Patients with LARC who underwent nCRT and radical surgery (between 2011 and 2016) were divided into three groups according to pre-nCRT and post-nCRT CA19-9 levels as follows normal pre-nCRT CA19-9 (normal CA19-9 group), elevated pre-nCRT and normal post-nCRT CA19-9 (normalized group) and elevated pre-nCRT and elevated post-nCRT CA19-9 (nonnormalized group). The pathological nCRT response criteria included ypCR and downstaging (ypStages 0-I). Recurrence-free survival (RFS) and overall survival (OS) were analysed.

A total of 721 patients were identified. The normal CA19-9 group was significantly associated with ypCR (n=159) and downstaging (n=347) (P<0.05). The normalized group (n=76) had worse RFS and OS than the normal CA19-9 group (n=622) and better RFS and OS than the nonnormalized group (n=23) (5-year RFS 47.0% vs 66.9% vs 81.5%, P<0.001; 5-year OS 47.0% vs 75.4% vs 85.0%, P<0.001). In multivariate analysis, CA19-9 group and ypTNM stage were independent predictors of RFS and OS. Moreover, for the 23 patients with elevated post-nCRT CA19-9 levels, the RFS and OS of patients with normalized postoperative CA19-9 levels were significantly better than those of patients with elevated postoperative CA19-9 levels (P<0.05).

Following nCRT, changes in the CA19-9 level are a strong prognostic marker for long-term survival, and they may be helpful in the selection of patients who prefer more conservative surgery after chemoradiotherapy.
Following nCRT, changes in the CA19-9 level are a strong prognostic marker for long-term survival, and they may be helpful in the selection of patients who prefer more conservative surgery after chemoradiotherapy.High and Intensive Care is a relatively new care model in Dutch mental health care for clinical admissions. One of the goals is to keep the admission short. For some patients, this goal is not realized, which results in a long-term admission. Often, this is experienced as a disruption. Disruptions in care processes are frequently defined in terms of patient characteristics. Yet, it may be that other factors play a role. The aim of this study is to gain better insight into the perceptions of care professionals of what is characteristic for disruptions at High and Intensive Care wards and how professionals can deal with these. Qualitative research was performed by means of semi-structured interviews and a focus group with professionals. Results show that a focus on patient characteristics is too narrow and that other factors also play an important role. These factors include challenges in the relation between professionals and the patient, a divided team, and a lack of collaboration with ambulatory care. In order to deal with these factors, professionals should invest in the relationship with the patient, identify destructive team processes early, and improve communication with ambulatory care. It is recommended to develop a monitoring tool that includes all these factors. see more Another recommendation is to organize structured reflection on dilemmas experienced in care. In conclusion, this study shows the importance of going beyond patient characteristics in order to better understand, identify, and deal with disruption at High and Intensive Care wards.Human-induced global change dramatically alters individual aspects of river biodiversity, such as taxonomic, phylogenetic or functional diversity, and is predicted to lead to losses of associated ecosystem functions. Understanding these losses and dependencies are critical to human well-being. Until now, however, most studies have only looked either at individual organismal groups or single functions, and little is known on the effect of human activities on multitrophic biodiversity and on ecosystem multifunctionality in riverine ecosystem. Here we profiled biodiversity from bacteria to invertebrates based on environmental DNA (hereafter, 'eDNA') samples across a major river catchment in China, and analysed their dependencies with multiple ecosystem functions, especially linked to C/N/P-cycling. Firstly, we found a spatial cross-taxon congruence pattern of communities' structure in the network of the Shaying river, which was related to strong environmental filtering due to human land use. Secondly, human land use explained the decline of multitrophic and multifaceted biodiversity and ecosystem functions, but increased functional redundancy in the riverine ecosystem. Thirdly, biodiversity and ecosystem function relationships at an integrative level showed a concave-up (non-saturating) shape. Finally, structural equation modeling suggested that land use affects ecosystem functions through biodiversity-mediated pathways, including biodiversity loss and altered community interdependence in multitrophic groups. Our study highlights the value of a complete and inclusive assessment of biodiversity and ecosystem functions for an integrated land-use management of riverine ecosystems.The compositional screening of K-Zn-Sb ternary system aided by machine learning, rapid exploratory synthesis using KH salt-like precursor and in situ powder X-ray diffraction yielded a novel clathrate type XI K58 Zn122 Sb207 . This clathrate consists of a 3D Zn-Sb framework hosting K+ ions inside polyhedral cages, some of which are reminiscent of known clathrate types while others are unique to this structure type. The complex non-centrosymmetric structure in the tetragonal space group I 4 ‾ 2 m was solved by means of single crystal X-ray diffraction as a 6-component twin due to pseudocubic symmetry and further confirmed by high-resolution synchrotron powder X-ray diffraction and state-of-the-art scanning transmission electron microscopy. The electron-precise composition of this clathrate yields narrow-gap p-type semiconductor with extraordinarily low thermal conductivity due to displacement or "rattling" of K cations inside oversized cages and as well as to twinning, stacking faults and antiphase boundary defects.Hyperdiploidy (HRD) and specific immunoglobulin heavy locus (IGH) translocations are primary chromosomal abnormalities (CA) in multiple myeloma (MM). In this retrospective study of 794 MM patients we aimed to investigate clinical features and common CA including gain(1q) in separate subgroups defined by primary CA. In the entire group, we confirmed that gain(1q) was associated with short time to next treatment and adverse overall survival (OS). The impact was worse for four or more copies of 1q21 as compared to three copies. However, in a subgroup of patients with clonal gain(11q) and without known primary IGH translocations (CG11q), already three copies of 1q21 were associated with a poor outcome; in the absence of gain(1q), patients in this subgroup had a remarkably long median OS of more than nine years. These cases were associated with HRD, coexpression of CD56 and CD117, male gender, and IgG subtype. In non-CG11q patients, four or more copies of 1q21 (but not three copies) had a significant adverse impact on outcome. Several associations with CA and clinical findings were observed for the defined subgroups. As an example, we found a predominance of early tetraploidy, plasma cell leukemia, and female gender in the t(14;16) subgroup. Our results underscore the importance of subgrouping in MM.Latinas are less likely to participate in genetic counseling (GC) and genetic testing (GT) than non-Hispanic Whites. A multisite, randomized pilot study tested a culturally targeted educational intervention to increase uptake of GC/GT among Latina breast cancer (BC) survivors (N = 52). Participants were recruited in Tampa, FL and Ponce, PR and randomized to (a) fact sheet about BC survivorship (control) or (b) a culturally targeted educational booklet about GC/GT (intervention). Participants in the intervention condition were also offered no-cost telephone GC followed by free GT with mail-based saliva sample collection. Participants self-reported hereditary breast and ovarian cancer (HBOC) knowledge and emotional distress at baseline and 1- and 3-month follow-ups. We used logistic regression to examine differences in GC/GT uptake by study arm (primary outcome) and repeated measures ANOVA to examine the effects of study arm and time on HBOC knowledge and emotional distress (secondary outcomes). Compared to the control arm, intervention participants were more likely to complete GC (ORIntervention = 13.92, 95% CI = 3.06-63.25, p .15). Study findings demonstrate the potential of our culturally targeted print intervention. Lessons learned from this multisite pilot study for enhancing GC/GT in Latinas include the need to attend to both access to GC/GT and individual factors such as attitudes and knowledge.Aspirin is considered a potential confound for functional magnetic resonance imaging (fMRI) studies. This is because aspirin affects the synthesis of prostaglandin, a vasoactive mediator centrally involved in neurovascular coupling, a process underlying blood oxygenated level dependent (BOLD) responses. Aspirin-induced changes in BOLD signal are a potential confound for fMRI studies of at-risk individuals or patients (e.g. with cardiovascular conditions or stroke) who receive low-dose aspirin prophylactically and are compared to healthy controls without aspirin. To examine the severity of this potential confound, we combined high field (7 Tesla) MRI during a simple hand movement task with a biophysically informed hemodynamic model. We compared elderly individuals receiving aspirin for primary or secondary prophylactic purposes versus age-matched volunteers without aspirin medication, testing for putative differences in BOLD responses. Specifically, we fitted hemodynamic models to BOLD responses from 14 regions activated by the task and examined whether model parameter estimates were significantly altered by aspirin.
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