In this research, we examined actors' and partners' perceptions of each other's attachment insecurities and the associations of these perceptions with relationship satisfaction. A sample of 148 ...heterosexual couples completed measures of self and partner attachment insecurities and relationship satisfaction. Results indicate that partners agree in their perceptions of their own and each other's attachment insecurities (anxiety and avoidance). Based on the actor–partner interdependence model (APIM), we also found that both actors' scores on avoidance and their perceptions of their partner's degree of avoidanc are associated with lower relationship satisfaction. Finally, we found that the way an actor perceives his or her partner's avoidance plays a mediational role in the association between partner's self‐reported avoidance and actor's relationship satisfaction.
To decrease readmissions at 30 and 90 days post-discharge from a hospital admission for chronic obstructive pulmonary disease exacerbation (COPDE) through the home care model of the Ambulatory ...Chronic Respiratory Care Unit (ACRCU), increase patient survival at one year, and validate our readmission risk scale (RRS).
This was an observational study, with a prospective data collection and a retrospective data analysis. A total of 491 patients with a spirometry diagnosis of chronic obstructive pulmonary disease (COPD) requiring hospitalisation for an exacerbation were included in the study. Subjects recruited within the first year (204 cases) received conventional care (CC). In the following year a home care (HC) programme was implemented and of those recruited that year (287) 104 were included in the ACRCU, administered by a specialised nurse.
In the group of patients included in the home care model of the Ambulatory Chronic Respiratory Care Unit (ACRCU) a lower number of readmissions was observed at 30 and 90 days after discharge (30.5% vs. 50%, p=0.012 and 47.7% vs. 65.2%, p=0.031, respectively) and a greater one-year survival (85.3% vs. 59.1%, p<0.001). The validation of our RRS revealed that the tool's capacity to predict readmissions at both 30 and 90 days was not high (AUC=0.69 and AUC=0.66, respectively).
The inclusion of exacerbator or fragile COPD patients in the ACRCU could achieve a decrease in readmissions and an increase in survival. The number of episodes of exacerbation within the 12 months prior to the hospital admission is the variable that best predicts the risk of readmission.
Disminuir los reingresos a los 30 y 90 días tras el alta por un ingreso hospitalario por exacerbación de enfermedad pulmonar obstructiva crónica (EPOC) a través del modelo de atención domiciliaria de la Unidad de Cuidados Crónicos Respiratorios Ambulatorios (UCCRA), aumentar la supervivencia al año y validar nuestra escala de riesgo de reingreso (ERR).
Estudio observacional con recogida prospectiva de datos. Se incluyó en el estudio a un total de 491 pacientes con diagnóstico espirométrico de enfermedad pulmonar obstructiva crónica que requirieron hospitalización por una agudización. Los sujetos reclutados dentro del primer año (204 casos) recibieron atención convencional (AC). Al año siguiente se implementó un programa de atención domiciliaria (AD) y de los pacientes reclutados ese año (287), 104 fueron incluidos en la UCCRA con seguimiento de una enfermera especializada.
En el grupo de pacientes incluidos en el modelo de atención domiciliaria de la UCCRA se observó un menor número de reingresos a los 30 y 90 días tras el alta (30,5% vs 50%, p=0,012 y 47,7% vs. 65,2%, p=0,031, respectivamente) y una mayor supervivencia al año (85,3% vs. 59,1%, p<0,001). La validación de nuestra ERR reveló que la capacidad de la misma para predecir reingresos tanto a los 30 como a los 90 días no era alta (AUC=0,69 y AUC=0,66, respectivamente).
La inclusión de pacientes con EPOC agudizadores o frágiles en la UCCRA podría conseguir una disminución de los reingresos y una aumento de la supervivencia. El número de agudizaciones en los 12 meses previos al ingreso hospitalario es la variable que mejor predice el riesgo de reingreso.
To analyze the effect of the central hole location in the V4c implantable collamer lens (ICL) on the quality of vision, including progressive headlight glare simulation and quality of life.
IOBA-Eye ...Institute, Valladolid, Spain.
Case series.
The central hole location was determined by slitlamp and dual Scheimpflug imaging for 6 months or more postoperatively. The visual acuity, mesopic contrast sensitivity, halogen glare contrast sensitivity, xenon glare contrast sensitivity, photostress recovery time after glare, de Boer scale, and Quality of Life Impact of Refractive Correction (QIRC) questionnaire results were evaluated. Multiple regression models were used to analyze the effect of the central hole location on parameters using the pupil center and visual axis as references based on Cartesian and polar coordinates.
The safety index was 1.13 and the efficacy index, 1.12. Under all testing circumstances, central hole decentration did not affect the visual acuity or contrast sensitivity. With the visual axis as a reference, worse QIRC values were associated with greater upward central hole displacement (P = .03) and a lower polar angle value (P = .008); also, halogen glare discomfort was greater with a higher radius (P = .04). Using the pupil center as a reference, greater nasal central hole decentration was associated with longer xenon glare photostress recovery time (P = .002).
Implantation of the ICL with a central hole yielded excellent visual outcomes, even under increasing glare sources, regardless of the hole's location. However, hole decentration might affect patient-perceived quality of life, bothersome halogen glare, and longer xenon glare photostress recovery time. Such complaints after the early postoperative period might be managed with discrete ICL centration if the central hole is decentered upward or nasally.
To evaluate the effect of 0.1%-fluorometholone (FML) on tear inflammatory molecule levels after 22-days treatment in dry eye disease (DED) patients exposed to an adverse controlled environment (ACE), ...identifying different biomarkers.
Analysis of a double-masked randomized clinical trial. Forty-one DED patients received 4-drops daily of topical FML (FML-group) or polyvinyl-alcohol (PA-group) for 22 days. At day 21, patients were exposed to an ACE. Tear samples were collected at V1 (baseline), V2 (pre-ACE), V3 (post-2-h-ACE) and V4 (24-h post-ACE). Concentrations of 18 molecules (EGF, IFN-γ, TNF-α, IL-1β, IL-1RA, IL-2, IL-4, IL-6, IL-8/CXCL8, IL-10, IL-12, IL-13, IL-17A, IP-10/CXCL10, MCP-1/CCL2, MIP-1α/CCL3, RANTES/CCL5 and MMP-9) were analyzed. Similarities among patients in molecule concentrations at V1 were evaluated. A linear-mixed effect model analyzed the influence of different variables on concentrations changes.
Multidimensional scaling (MDS) divided patients into two groups based on differences in EGF, IFN-γ, IL-8/CXCL8, RANTES/CCL5, and MMP-9 levels at V1. Groups had different clinical severities based on Schirmer test and conjunctival and corneal staining. IL-1RA, IL-2, and TNF-α were differentially affected by time, depending on treatment. Between V2-V3, there were significant changes in EGF, IL-1RA, IL-2, IL-8/CXCL8, IL-13, IP-10/CXCL10, TNF-α, and MMP-9. The strongest biomarker candidates were IFN-γ, RANTES/CCL5, and MMP-9 as DED severity biomarkers; IL-2 as DED therapeutic biomarker; and EGF as DED activity biomarker.
This clinical trial design using a controlled environment and the identified tear biomarkers could be useful to objectively select target patients, to define stress response, and to evaluate therapeutic endpoints in clinical trials.
Several researchers have suggested that the rs243865 (16q13-q21) polymorphism in the promoter region of the metalloproteinase-2 (MMP-2) gene could be associated with an increased risk of developing ...age-related macular degeneration (AMD). However, previous results remain inconclusive. To clarify this controversy, we conducted a meta-analysis of the relationship between rs243865 of MMP-2 and AMD.
We included 6 independent case-control studies involving 1,682 AMD patients and 2,295 healthy subjects. The association between the rs243865 polymorphism and AMD was examined by the overall odds ratio (OR) with a 95% confidence interval (CI). We used a recessive genetic model analysis, sensitivity analysis, and assessment of bias in our meta-analysis.
Our results showed that there was no significant association between the variant T allele (p-value = 0.10, OR 95%CI = 0.95 0.82-1.10) or the CT+TT genotype (p-value = 0.16, OR 95%CI = 0.92 0.76-1.12) of rs243865 MMP-2 polymorphism and the presence of AMD.
The rs243865 MMP-2 polymorphism was not associated with an increased risk of developing AMD. The MMP-2 (-1306 C>T) promoter variant is unlikely to have a major role in AMD risk susceptibility.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
People sometimes want attitudes that differ from the ones they currently possess. These desired attitudes appear to be psychologically meaningful, but little is known about the properties of these ...evaluations. Because desired attitudes are hypothetical constructs (i.e., attitudes that one does not yet possess) and are distant in time (i.e., attitudes one could have in the future), we argued, based on construal level theory, that they should be represented in a relatively abstract manner, and consequently, we examined the implications of this abstractness for the characteristics and impact of desired attitudes. Consistent with this, we demonstrate that people perceive desired attitudes as more invariant across time and context, that desired attitudes are less impacted by changes in low-level features related to the attitude object (Study 1a and 1b) and that desired attitudes have a greater impact on behavioral intentions when people are in an abstract rather than concrete mindset (Studies 2–3). Although we did not make specific predictions regarding actual attitudes, they better predicted behavioral intentions in the concrete mindset (Studies 2–3). This last result should be taken with caution, considering that the level of abstraction shown by actual attitudes in Study 1a was at or slightly above the midpoint of our abstraction index.
•Desired attitudes can differ from people's actual attitudes.•Desired attitudes are more stable across time and context than actual attitudes.•Desired attitudes predict behavioral intentions more in an abstract than a concrete mindset.
To determine if cytokine tear levels before hematopoietic stem cell transplantation (HSCT) can help anticipate the occurrence of ocular chronic graft-versus-host disease (cGVHD).
In this pilot study, ...25 patients undergoing HSCT were followed prospectively for ≤43 months. After ocular examinations, tears were collected before HSCT. Levels of 19 cytokines (epidermal growth factor EGF, eotaxin 1/CCL11, fractalkine/CX3CL1, IL-1Ra, IL-1β, IL-2, IL-4, IL-5, IL-6, IL-8/CXCL8, IL-10, IL-12p70, IL-13, IL-17A, IP-10/CXCL10, IFN-γ, VEGF, TNF-α, and RANTES/CCL5) were measured by multiplex bead assay. A multistate model (MSM) based on four states (HSCT, systemic cGVHD, ocular cGVHD, and death) was developed to identify cytokines associated with each transition probability. Molecules included in the final multivariable model were selected by a supervised principal components analysis. Bootstrap resampling internally validated the final MSM. Model discriminatory ability was determined by time-dependent receiver operating characteristic curves and the corresponding area under the curve (AUC).
The final model, based on fractalkine, IL-1Ra, and IL-6 tear levels, accurately influenced the transition between the four different states. The AUC for this model, based on a new variable built upon the combination of these three molecules, was 67% to 80% throughout follow-up and, thus, had good discriminatory ability.
In this prospective study, a model based on pre-HSCT tear levels of the inflammatory molecules fractalkine, IL-1Ra, and IL-6 had good prognostic ability for the development of ocular cGVHD after HSCT. These cytokines potentially could act as susceptibility biomarkers for the development of this disease after HSCT.
Previous research on citizens' reactions after terrorist events has shown that positive reactions can also emerge alongside pain and horror. Positive emotions have been widely associated with an ...abstract style of thinking. In the context of the Paris terrorist attacks in 2015, we explored Spanish citizens' positive reactions - empathic concern, positive emotional climate, and esteem for humanity - and examined the relationships of these responses with an abstract (vs. concrete) style of thinking.
A longitudinal study was designed involving an online questionnaire that was administered 10 days, 3 weeks, and 2 months after the attacks (
= 253).
Empathic concern and personal distress toward Parisians decreased from the weeks following the attacks to 2 months later, with empathic concern always being more intense than personal distress. Emotional climate was perceived as more hostile than positive, although positive feelings persisted. People reported moderately positive esteem for humanity. Individuals with a more abstract style of thinking reported greater empathic concern, a more positive emotional climate, and more esteem for humanity.
Our results support and extend previous research showing that abstraction enhances people's resilience, even under traumatic circumstances such as those surrounding a terrorist attack.
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