Hasil untuk "Internal medicine"

Lin Hu, Haixia Feng, Jing Han et al.

Abstract Background Frailty is a syndrome as with aging in the population of type 2 diabetes mellitus (T2DM) and exercise has become an essential non-pharmacological tool especially in the pre-frail stage. Notably, the form of supervised home-based exercise program has been strongly recommended in recent years. This study aimed to verify the potential effects of the supervised home-based elastic band exercise in pre-frail older T2DM patients in China. Methods A total of 100 participants were included and randomly divided into intervention group (IG) (n = 50) and control group (CG) (n = 50). The CG received a routine care, while the IG received an extra home-based elastic band training under online and offline supervisions sustaining 12-weeks. The glycosylated hemoglobin (HbA1c), blood lipids, body composition, physical function, scales of Diabetes specificity quality of life scale (DSQL), Pittsburgh sleep quality index (PSQI) and short form geriatric depression scale (GDS-15) of the participants were evaluated before and after intervention. Results The average age of the participants were 66.01 ± 4.76 with 55% male and average BMI 24.75 ± 3.51 kg/m2. The clinical characteristics of the two groups were comparable. After 12 weeks’ training, muscle mass of the limbs (P < 0.05), physical function indicators including grip strength, chair stands (both P < 0.05), walking time (P < 0.01), HbA1c (P < 0.05), frailty score (P < 0.05), subjective sleep quality (P < 0.05), total DSQL scores (P < 0.01) and the depressive status (P < 0.01) improved significantly in IG when compared with CG. Conclusion Supervised home-based elastic band exercise could improve limb muscle mass, physical fitness, glucose and lipid control and quality of life in pre-frail older T2DM patients. Trial registration number ChiCTR2300070726; Registration date: 21/04/2023.

Robert D Brook, Pia-Allison Roa, Phillip D Levy et al.

Background: Fine particulate matter <2.5 µm (PM2.5) air pollution increases cardio-pulmonary morbidity and mortality. To inform the public regarding local air quality and reduce short-term exposures to PM2.5, daily Air Quality Indices (AQIs) with activity guidance are issued across the United States (US). We aimed to estimate the cardio-pulmonary health benefits of the current AQI strategy. Methods: We estimated the number needed to treat (NNT) per county per day to avoid 1 atherosclerotic cardiovascular disease (ASCVD) or pulmonary event during each PM2.5 AQI action day (defined as a day with an AQI >100 for PM2.5) for 3 groups (healthy adults, ASCVD and pulmonary disease patients) in the US during 2022. The theoretical number of adverse events potentially prevented per county was estimated each day as the relevant county population divided by the corresponding NNT. These results were summed for all AQI action days among US counties to equal the potential total number of ASCVD and pulmonary events avoided nationwide. Results: There were 1081 AQI action days for PM2.5 (58.0 ± 32.4 µg/m3) across 236 counties in 2022, accounting for an estimated excess of 164 ASCVD and 3963 pulmonary events. Approximately 31 ASCVD and 796 pulmonary events could be theoretically avoided if all populations followed activity guidelines during every AQI action day. Conclusions: Daily AQI activity guidelines, as currently structured and implemented, likely prevent few cardio-pulmonary events per year in the US. Additional research is warranted to determine how to improve the overall approach to more effectively protect public health.

Rossella Rispoli, Barbara Cappelletto

Rosa Lillo, Rosa Lillo, Alessio Cianci et al.

BackgroundTo date, only limited data are available on right atrium (RA) morphofunctional remodeling in Fabry disease (FD).PurposeWe aimed to investigate RA structural and functional remodeling in patients with FD vs. healthy controls using 2D speckle tracking echocardiography (STE) and to explore whether any differences exist in FD patients with and without left ventricular hypertrophy (LVH).MethodsWe prospectively enrolled patients with FD and controls matched for age, sex, and cardiovascular risk factors. Patients with FD were divided in two groups according to the presence/absence of LVH (LVH+: left ventricular wall thickness &gt;12 mm). All patients underwent standard echocardiography and STE analysis investigating the mechanics of all cardiac chambers, including RA reservoir, contractile and conduit strain.ResultsA total of 64 patients with FD (50% males; mean age 50 ± 17 years; 51.5% LVH+) and 64 control patients were included in the study. Focusing on right chambers, RA and right ventricular (RV) dimensions were similar between FD and controls. No differences were found for tricuspid annular plane systolic excursion (p = 0.073) and RV fractional area change (p = 0.461), while RV systolic Tissue Doppler velocity was reduced in patients with FD (p = 0.041). STE analysis revealed impaired strain values for all cardiac chambers in FD vs controls, specifically: left ventricular global longitudinal strain (LV-GLS, p &lt; 0.001), left atrial (LA) reservoir strain (p = 0.001), conduit strain (p = 0.012), and contractile strain (p &lt; 0.001), RV-GLS and RV free wall strain (p &lt; 0.001). Similarly, all RA strain phases were significantly reduced in patients with FD compared with control patients (RA reservoir 27.4 ± 11.1 vs. 41.9 ± 8.3%, p &lt; 0.001; RA contractile 9.9 ± 5.1 vs. 18.0 ± 4.9%, p &lt; 0.001; RA conduit 19.1 ± 8.1 vs. 24.1 ± 8.1%, p = 0.001). When comparing FD patients without LVH to controls, it was found that RA reservoir and contractile strains were significantly reduced in the former (p &lt; 0.001). In multivariable linear regression analyses, LA reservoir strain (p = 0.010) and LV-GLS (p = 0.044) emerged as independent correlates of RA mechanics after adjustments were made for RA dimensions, RV systolic function parameters and hypertrophy, and LV maximal wall thickness.ConclusionsIn FD impaired RA strain is a common finding. RA reservoir and contractile strains are reduced in FD patients even before LVH ensues, as compared to controls. LA reservoir strain and LV-GLS show an independent correlation with RA reservoir strain.

Jinchao Pan, Jijun Liu

Consider an inverse problem of the simultaneous recovery of boundary impedance and internal conductivity in the electrical impedance tomography (EIT) model using local internal measurement data, which is governed by a boundary value problem for an elliptic equation in divergence form with Robin boundary condition. We firstly express the solution to the forward problem by volume and surface potentials in terms of the Levi function. Then, for the inverse problem, we prove the uniqueness of the solution in an admissible set by unique extension of the solution under some {a-prior} assumption. Finally we establish the regularizing reconstruction schemes for boundary impedance and internal conductivity using noisy measurement data with rigorous error estimates. The mollification method is proposed to recover the boundary impedance from the boundary condition, and the internal conductivity with known boundary value is recovered from an integral system, where the Tikhonov regularization is applied to seek the stable solution, considering that the error involved in the boundary impedance coefficient reconstruction will propagate to the recovering process for internal conductivity. Numerical implementations are presented to illustrate the validity of the proposed method.

Li He

We give an internal description of constructible objects in an $\infty$-topos. More precisely, $P$-consctructible objects are locally constant objects internal to Fun($P$,An), for any noetherian poset $P$.

Yeo-Jin Lee, Eun-Ju Lee, Soo Min Ahn et al.

Abstract Background Ankylosing spondylitis (AS) has been known to have auto-inflammatory nature; hence, the efficacy of autoantibodies is low. However, studies on autoantibodies are ongoing, with some studies showing associations. Previous studies showed that anti-protein phosphatase magnesium-dependent 1A (PPM1A) IgG was increased in patients with AS and associated with radiographic progression. However, the diagnostic usefulness was limited due to relatively low sensitivity and specificity. This pilot study evaluated the diagnostic utility of anti-PPM1A-IgM and anti-PPM1A-IgG in patients with active AS. Methods Serum samples were obtained from the registry cohort of a single tertiary center in Korea. Serum levels of anti-PPM1A-IgG/IgM were measured by direct ELISA. Receiver operating characteristic (ROC) analysis was used to predict the diagnostic sensitivity and specificity of serum anti-PPM1A-IgG/IgM. Results Samples were collected from 28 patients with active AS, 16 healthy controls (HCs), and 28 patients with rheumatoid arthritis (RA). Although total serum IgM was lower in the RA and AS groups than in the HC group, anti-PPM1A-IgM was significantly lower in the AS group than in the other groups. In evaluating the diagnostic utility of anti-PPM1A-IgG/IgM for AS patients compared with HCs, the area under the curve (AUC) of anti-PPM1A-IgM was 0.998 (sensitivity 96.4%, specificity 100.0%). When ROC analysis of anti-PPM1A-IgM for AS patients compared with RA patients was conducted, sensitivity was 78.6% and specificity was 71.4%, with an AUC of 0.839. Conclusion Decreased anti-PPM1A-IgM levels in AS patients suggests a potential role for anti-PPM1A-IgM in the diagnosis of active AS.

Isabelle Gouin-Thibault, Alexandre Mansour, Michael Hardy et al.

Yu. Ganzhula, Zh. Borykbay, V. Tkachev et al.

Introduction. The health of centenarians is a major focus in global studies. Dyslipidemia is directly linked to the risk of cardiovascular diseases, which pose a growing burden on healthcare due to the increasing elderly population. Studying the lipid profiles of centenarians is important for preventing circulatory system diseases and promoting healthy aging. This research aims to compare the prevalence of dyslipidemia in centenarians (median age 96 [95-97]) with elderly individuals (median age was 69 [64 – 74]) in the Republic of Kazakhstan and examine potential predictors of dyslipidemia in the centenarian group. Methods. The study involved 46 centenarians (study group) and 82 elderly individuals (control group). Statistical analysis was used to process the data, including blood markers and demographic variables, to identify factors contributing to dyslipidemia. Results and conclusion. The prevalence of hypercholesterolemia in centenarians was 32.6% (15 people - 3 men; 12 women), with elevated LDL levels in 4.3% (2 women). In the control group, hypercholesterolemia prevalence was 29.3% (24 people - 6 men; 18 women) and elevated triglycerides in 6.1% (3 women; 2 men). The study and control groups were compared based on their lipid profile characteristics, which showed similarities as indicated by all p-values being above 0.05: Cholesterol (p=0.348), HDL (p=0.975), LDL (p=0.161), and Triglycerides (p=0.159). Decreased physical activity was a predictor of dyslipidemia in centenarians. Excessive cholesterol levels were significantly higher among women than men in both groups. The primary factor for dyslipidemia was low physical activity, with other predictors having no significant impact on the lipid profiles of centenarians. This factor should be considered when assessing cardiovascular disease risks and all-cause mortality.

Hardik Bohra, Sumit R. Das, Gautam Mandal et al.

Realizations of the holographic correspondence in String/M theory typically involve spacetimes of the form $AdS \times Y$ where $Y$ is some internal space which geometrizes an internal symmetry of the dual field theory, hereafter referred to as an "$R$ symmetry". It has been speculated that areas of Ryu-Takayanagi surfaces anchored on the boundary of a subregion of $Y$, and smeared over the base space of the dual field theory, quantify entanglement of internal degrees of freedom. A natural candidate for the corresponding operators are linear combinations of operators with definite $R$ charge with coefficients given by the "spherical harmonics'' of the internal space: this is natural when the product spaces appear as IR geometries of higher dimensional AdS spaces. We study clustering properties of such operators both for pure $AdS \times Y$ and for flow geometries, where $AdS \times Y$ arises in the IR from a different spacetime in the UV, for example higher dimensional AdS or asymptotically flat spacetime. We show, in complete generality, that the two point functions of such operators separated along the internal space obey clustering properties at scales larger than the $AdS$ scale. For non-compact $Y$, this provides a notion of approximate locality. When $Y$ is compact, clustering happens only when the size of $Y$ is parametrically larger than the $AdS$ scale. This latter situation is realized in flow geometries where the product spaces arise in the IR from an asymptotically AdS geometry at UV, but not typically when they arise near black hole horizons in asymptotically flat spacetimes. We discuss the significance of this result for entanglement and comment on the role of color degrees of freedom.

Qin Z, Ye X, Liu H et al.

Zhuzhu Qin,1,&ast; Xinxin Ye,2,&ast; Huanju Liu,3 Yining Tao,4 Xutong Zheng,1 Yanxia Zhong,5 Danfeng Chen,1 Wan Ye,6 Chenju Zhan7 1School of Nursing, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China; 2Department of Sports and Exercise Science, College of Education, Zhejiang University, Hangzhou, Zhejiang, China; 3Women’s Hospital and Institute of Genetics, Zhejiang University School of Medicine, Hangzhou, China; 4Department of Global Public Health, Karolinska Institute, Stockholm, Sweden; 5Department of Nursing, Shijiazhuang Medical College, Shijiazhuang, China; 6Department of Nursing, Xiamen Medical College, Xiamen, Fujian, China; 7Department of Nursing, Mindong Hospital Affiliated to Fujian Medical University, Ningde, China&ast;These authors contributed equally to this workCorrespondence: Wan Ye, Department of Nursing, Xiamen Medical College, Xiamen, Fujian, China, Tel +86 13806086169, Email 200600010142@xmmc.edu.cn Chenju Zhan, Department of Nursing, Mindong Hospital Affiliated to Fujian Medical University, No. 89 HeShan Road, Fuan City, Fujian Province, 355000, China, Tel +86 13809562183, Email zhanchenju@yeah.netObjective: This study investigated factors influencing the knowledge, attitudes, practice profiles, and vaccination intentions among Chinese nursing students and nursing interns toward the coronavirus disease (COVID-19) vaccination.Materials and Methods: The multicenter cross-sectional study was based on a self-reported questionnaire collecting information among nursing students and nursing interns from three major geographic regions of China, and the sample was selected by consecutive sampling. The questionnaire was developed by knowledge, attitudes, and practice (KAP) theory. Univariate and multivariate logistic regression were used for statistical analysis.Results: A total of 3180 nursing students and interns (effective rate: 99.8%) from six Chinese provinces were polled. The vaccine hesitation rate was 9.65% (307/3180), 2230 participants (70.1%) had gotten at least one dose of the vaccine, and 643 participants (67.7%) had indicated a readiness to be vaccinated. The results showed that older age, higher academic background, perfect vaccine management, others’ recommendations, influenza vaccination history, epidemic under control, knowledge of vaccines or intervals, and vaccine knowledge training were associated with higher vaccination rates. Conversely, vaccine hesitancy was caused by a perceived lack of physical need, uncertainty about vaccination requirements, and fear of vaccination.Conclusion: This study provided population-based estimates of COVID-19 vaccine uptake intention among mainland Chinese nursing students and interns. Factors such as age, education, vaccine knowledge, and attitudes influence COVID-19 vaccine behaviour. Relevant authorities should understand the barriers to COVID-19 vaccination from knowledge, attitude and practice, which is significant for formulating effective response strategies in future global public health crises.Graphical Abstract: Keywords: COVID-19, vaccine, knowledge, attitudes, practice, nursing students and interns

Alexandre Simonin, Jean-Yves Fournier

莫名, 陈忠军, 范铁平, 赵旭生, 胡腾, 李迪

Dandan Wang, Chang Xu, Wenxiao Wang et al.

Allele 4 of the apolipoprotein E gene (APOE ε4) and hypertension are considered risk factors for Alzheimer’s Disease (AD). The detection of differences in cognitive function and brain networks between hypertensive patients who are APOE ε4 carriers and non-carriers may help in understanding how hypertension and risk genes cumulatively impair brain function, which could provide critical insights into the genetic mechanism by which hypertension serves as a potential risk factor for cognitive decline and even AD. Using behavioral data from 233 elderly hypertensive patients and neuroimaging data from 38 of them from Beijing, China; the study aimed to assess the effects of APOE ε4 on cognition and to explore related changes in functional connectivity. Cognitively, the patients with APOE ε4 showed decreased executive function, memory and language. In the MRI sub-cohort, the frontoparietal networks in the APOE ε4 carrier group exhibited an altered pattern, mainly in the left precentral regions, inferior frontal lobe and angular gyrus. More importantly, the decline of cognitive function was correlated with abnormal FC in the left precentral regions in APOE ε4 carriers. APOE ε4 aggravated the dysfunction in frontal and parietal regions in hypertensive patients. This highlights the importance of brain protection in hypertensive patients, especially those with a genetic risk of AD.

Brian Van Stratum, Jonathan E. Clark, Kourosh Shoele

The gaits of undulating animals arise from a complex interaction of their central nervous system, muscle, connective tissue, bone, and environment. As a simplifying assumption, many previous studies have often assumed that sufficient internal force is available to produce observed kinematics, thus not focusing on quantifying the interconnection between muscle effort, body shape, and external reaction forces. This interplay, however, is critical to locomotion performance in crawling animals, especially when accompanied by body viscoelasticity. Moreover, in bio-inspired robotic applications, the body's internal damping is indeed a parameter that the designer can tune. Still, the effect of internal damping is not well understood. This study explores how internal damping affects the locomotion performance of a crawler with a continuous, visco-elastic, nonlinear beam model. Crawler muscle actuation is modeled as a traveling wave of bending moment propagating posteriorly along the body. Consistent with the friction properties of the scales of snakes and limbless lizards, environmental forces are modeled using anisotropic Coulomb friction. It is found that by varying the crawler body's internal damping, the crawler's performance can be altered, and distinct gaits could be achieved, including changing the net locomotion direction from forward to back. We will discuss this forward and backward control and identify the optimal internal damping for peak crawling speed.

Ruichen Su, Tian Zhou

Parkinson’s disease (PD) is a neurodegenerative disorder closely related to immunity. An important aspect of the pathogenesis of PD is the interaction between α-synuclein and a series of immune cells. Studies have shown that accumulation of α-synuclein can induce an autoimmune response that accelerates the progression of PD. This study discusses the mechanisms underlying the interaction between α-synuclein and the immune system. During the development of PD, abnormally accumulated α-synuclein becomes an autoimmune antigen that binds to Toll-like receptors (TLRs) that activate microglia, which differentiate into the microglia type 1 (M1) subtype. The microglia activate intracellular inflammatory pathways, induce the release of proinflammatory cytokines, and promote the differentiation of cluster of differentiation 4 + (CD4 +) T cells into proinflammatory T helper type 1 (Th1) and T helper type 17 (Th17) subtypes. Given the important role of α-synuclein in the immune system of the patients with PD, identifying potential targets of immunotherapy related to α-synuclein is critical for slowing disease progression. An enhanced understanding of immune-associated mechanisms in PD can guide the development of associated therapeutic strategies in the future.

Jun Gao, Chunli Shao, Wenyao Wang et al.

Yvonne Schröder, Daniela Michelle Hohmann, Tina Meller et al.

Abstract Background Previous case–control studies of autistic spectrum disorder (ASD) have identified altered brain structure such as altered frontal and temporal cortex volumes, or decreased fractional anisotropy (FA) within the inferior fronto-occipital fasciculus in patients. It remains unclear whether subclinical autistic-like traits might also be related to variation in these brain structures. Methods In this study, we analyzed magnetic resonance imaging (MRI) data of 250 psychiatrically healthy subjects phenotyped for subclinical autistic-like traits using the Autism Spectrum Quotient (AQ). For data analysis, we used voxel-based morphometry of T1-MRIs (Computational Anatomy Toolbox) and tract-based spatial statistics for diffusion tensor imaging data. Results AQ attention switching subscale correlated negatively with FA values in the bilateral uncinate fasciculus as well as the bilateral inferior fronto-occipital fasciculus. Higher AQ attention switching subscale scores were associated with increased mean diffusivity and radial diffusivity values in the uncinate fasciculus, while axial diffusivity values within this tract show a negative correlation. AQ attention to detail subscale correlated positively with gray matter volume in the right pre- and postcentral gyrus. Conclusions We demonstrate that individuals with higher levels of autism-spectrum-like features show decreased white matter integrity in tracts associated with higher-level visual processing and increased cortical volume in areas linked to movement sequencing and working memory. Our results resemble regional brain structure alterations found in individuals with ASD. This offers opportunities to further understand the etiology and pathogenesis of the disorder and shows a subclinical continuum perspective.

Zhao Peng, Yu Lu, Yao Xu et al.

This paper describes the development and validation of a Monte Carlo (MC) dose computing module dedicated to organ dose calculations of patients undergoing nuclear medicine (NM) internal radiation exposures involving 18F-FDG PET/CT examination. This new module extends the more-than-10-years-long ARCHER project that developed a GPU-accelerated MC dose engine by adding dedicated NM source-definition features. To validate the code, we compared dose distributions from the 0.511-MeV point photon source calculated for a water phantom as well as a patient PET/CT phantom against a well-tested MC code, GATE. The water-phantom results show excellent agreement, suggesting that the radiation physics module in the new NM code is adequate. To demonstrate the clinical utility and advantage of ARCHER-NM, one set of PET/CT data for an adult male NM patient is calculated using the new code. Radiosensitive organs in the CT dataset are segmented using a CNN-based tool called DeepViewer. The PET image intensity maps are converted to radioactivity distributions to allow for MC radiation transport dose calculations at the voxel level. The dose rate maps and corresponding statistical uncertainties were calculated for the duration of PET image acquisition. The dose rate results of the 18F-FDG PET imaging patient show that ARCHER-NM's results agree very well with those of the GATE within 0.58% to 4.11%. Most impressively, ARCHER-NM obtains such results in less than 0.5 minutes while it takes GATE as much as 376 minutes. This is the first study presenting GPU-accelerated patient-specific MC internal radiation dose rate calculations for clinically realistic 18F-FDG PET/CT imaging cases involving auto-segmentation of whole-body PET/CT images. This study suggests that modern computing tools -- ARCHER-NM and DeepViewer -- are accurate and fast enough for routine internal dosimetry in NM clinics.

Christian Grussler, Thiago B. Burghi, Somayeh Sojoudi

The classes of externally Hankel $k$-positive LTI systems and autonomous $k$-positive systems have recently been defined, and their properties and applications began to be explored using the framework of total positivity and variation diminishing operators. In this work, these two system classes are subsumed under a new class of internally Hankel $k$-positive systems, which we define as state-space LTI systems with $k$-positive controllability and observability operators. We show that internal Hankel $k$-positivity is a natural extension of the celebrated property of internal positivity ($k=1$), and we derive tractable conditions for verifying the cases $k> 1$ in the form of internal positivity of the first $k$ compound systems. As these conditions define a new positive realization problem, we also discuss geometric conditions for when a minimal internally Hankel $k$-positive realization exists. Finally, we use our results to establish a new framework for bounding the number of over- and undershoots in the step response of general LTI systems.