Whilst it is well known that psychosocial determinants may contribute to cardiovascular diseases (CVD), data from specific groups are scarce. The present study aims to determine the contribution of ...psychosocial determinants in increasing the risk of cardiovascular events (myocardial infarction and stroke), and death from CVD, in a high risk adult population.
Longitudinal prospective study of 7263 patients (57.5% women), mean age 67.0 (SD 6.2) free from CVD but at high risk, with a median follow-up of 4.8 years (from October 2003 to December 2010). The Hazard Ratios (HRs) of cardiovascular events (myocardial infarction, stroke, and death from cardiovascular causes) related to educational attainment, diagnosed depression (based on medical records), and low social support (number of people living in the household) were estimated by multivariate Cox regression models.
Stroke incidence was associated with low educational level in the whole population (HR: 1.83, 95% CI: 1.09-3.09), and especially in men (HR: 2.11, 95% CI 1.09-4.06). Myocardial infarction and CVD mortality were not associated with any of the psychosocial factors considered.
Adults with low educational level had a higher risk of stroke. Depression and low social support were not associated with CVD incidence.
Clinical trial registration information unique identifier: ISRCTN35739639.
•The feasibility and performance of telehealth are poorly tested in women's health settings.•Telehealth provides an alternative that reduces the risk of infection during the COVID-19 pandemic.•Women ...were less enthusiastic about telephone use during periods of low COVID prevalence compared with high prevalence.•In-person visits were preferred by the majority of women attending a women's health clinic.
Telehealth has emerged as an alternative to conventional, face-to-face visits, and the COVID pandemic has hastened its introduction. Telephone appointments make use of an easy-to-use and accessible technology.
To investigate the usability of telephone-based telehealth in a women's health outpatient clinic and whether this may be affected by the severity of the COVID pandemic.
A telephone survey was prepared to explore two usability domains: interaction quality (4 items) and satisfaction, preference and future use (6 items). Women were selected from two periods during the COVID pandemic when the infection rates were high and low.
The survey was completed by 106 women (60 when the prevalence of COVID was high, mean age 53.58 years, and 46 when it was low, mean age 48.59 years) out of the 153 women who had a telephone appointment. The severity of the COVID pandemic showed an effect on responses. Women were less enthusiastic about using the telephone during the period of low COVID prevalence, as shown by lower scores on 3 of the 4 items of the first domain I had enough time; I would have understood better in person; I would have expressed myself better in person (p < 0.001 for comparison between groups on each of the 3 items), and on 4 of the 6 items in the second domain satisfied with quality of care (p < 0.001), or with the information received (p = 0.018); use of telephone in future (p < 0.001); preference to try other technologies in future (p < 0.001). Overall, women expressed a preference for in-person visits regardless of COVID prevalence rates.
Telephone calls were a feasible alternative to face-to-face visits in a women's health outpatient clinic, but the pandemic pressure modified usability parameters. Respondents preferred in-person visits at any pandemic stage.
Limited prospective studies have examined changes in non-alcoholic fatty-liver disease (NAFLD) related serum-metabolites and none the effects of NAFLD-reversion. We aimed to evaluate whether ...perturbations in metabolites indicate predisposition to NAFLD development and to assess the effects of NAFLD reversion on metabolite profiles.
A targeted liquid-chromatography tandem mass-spectrometry metabolic profiling (
= 453 metabolites) approach was applied, using serum from 45 subjects of the PREDIMED study, at baseline and after a median 3.8-year follow-up. NAFLD was determined using the hepatic steatosis index; with three groups classified and studied: Group 1, not characterized as NAFLD cases during the follow-up (
= 15); Group 2, characterized as NAFLD during the follow-up (
= 15); Group 3, characterized as NAFLD-reversion during the follow-up (
= 15).
At baseline, significantly lower storage and transport lipids (triacylglycerols and cholesteryl esters), several monoetherglycerophosphocholines, acylglycerophosphocholines, ceramides and ceramide to sphingomyelin ratio (
< 0.05), were found; whereas a higher L-cystine to L-glutamate ratio (
< 0.05) was observed, in group 2 as compared to group 1.P-ether acylglycerophosphocholines, ceramides and sphingolipids were significantly different betweengroup 3 and group 1 (
< 0.05). Higher 16:1n-7 to 16:0, and 18:0 to16:0 ratio (
< 0.05), while lower 18:1n-9 to 18:0, 16:0 to 18:2n-6, and 18:3n-6 to 18:2n-6 ratio (
< 0.05) were observed in the final, compared to baseline values, in groups 2 and 3.
The rearrangement of lipid biosynthesis and serum transport may indicate predisposition to NAFLD development. Despite an expected reduction of hepatic lipotoxicity and improved hepatic function in the participants of the study characterized as NAFLD-reversing, the side effects of NAFLD in serum metabolic profiles remained present.
The trial is registered at ISRCTN35739639. Registration date: 5th October 2005.
The executive functions, which depend on the adequate maturation and functioning of the prefrontal cortex and its connection to posterior zones, follow a process of development as age increases. This ...work studied changes in the absolute power (AP) of EEG activity recorded in the prefrontal and parietal areas during the performance of the Tower of Hanoi task in children, adolescents, and young adults. Three groups of healthy male subjects such as G1, 11–13; G2, 18–20; and G3, 26–30, years of age were recorded at the F3, F4, P3, and P4 derivations under two conditions: basal and performance of the Towers of Hanoi task. The majority of subjects in G1 failed to complete the task in the allotted time (7 min), while those in G2 and G3 were able to resolve the task quickly and efficiently. During the Towers of Hanoi task, G1 showed an increase of AP in the delta band only in the frontal areas, with a decrease in the alpha1 and alpha2 sub-bands only at the parietal derivations, while G2 and G3 were characterized by an increase of AP in the delta band and a decreased AP in the alpha1 and alpha2 sub-bands in all derivations. These data demonstrate that during the performance of the Towers of Hanoi task, the prefrontal and parietal areas show a characteristic EEG pattern in relation to age. It is probable that the AP patterns obtained in G2 and G3 are associated with the functional changes at cortical levels that adolescents and early adults require to achieve an adequate and fast performance of the Towers of Hanoi task.
Abstract
Background
Primary prevention trials have demonstrated that the traditional Mediterranean diet is associated with a reduction in cardiovascular mortality and morbidity. However, this benefit ...has not been proven for secondary prevention after an acute coronary syndrome (ACS). We hypothesized that a high-intensity Mediterranean diet intervention after an ACS decreases the vulnerability of atherosclerotic plaques by complex interactions between anti-inflammatory effects, microbiota changes and modulation of gene expression.
Methods
The MEDIMACS project is an academically funded, prospective, randomized, controlled and mechanistic clinical trial designed to address the effects of an active randomized intervention with the Mediterranean diet on atherosclerotic plaque vulnerability, coronary endothelial dysfunction and other mechanistic endpoints. One hundred patients with ACS are randomized 1:1 to a monitored high-intensity Mediterranean diet intervention or to a standard-of-care arm. Adherence to diet is assessed in both arms using food frequency questionnaires and biomarkers of compliance. The primary endpoint is the change (from baseline to 12 months) in the thickness of the fibrous cap of a non-significant atherosclerotic plaque in a non-culprit vessel, as assessed by repeated optical coherence tomography intracoronary imaging. Indices of coronary vascular physiology and changes in gastrointestinal microbiota, immunological status and protein and metabolite profiles will be evaluated as secondary endpoints.
Discussion
The results of this trial will address the key effects of dietary habits on atherosclerotic risk and will provide initial data on the complex interplay of immunological, microbiome-, proteome- and metabolome-related mechanisms by which non-pharmacological factors may impact the progression of coronary atherosclerosis after an ACS.
Trial registration
ClinicalTrials.gov
NCT03842319
. Registered on 13 May 2019
Peri-urban forest monitoring requires indicators of vegetation damage. An example is the sacred fir (Abies religiosa) forests surrounding Mexico City, which have been heavily exposed to tropospheric ...ozone, a harmful pollutant, for over 4 decades. We developed a participatory monitoring system with which local community members and scientists generated data on ozone tree damage. Santa Rosa Xochiac rangers (13) used the digital tool KoboToolBox to record ozone damage to trees, tree height, tree ages, tree condition, tree position, and whether the tree had been planted. Thirty-five percent of the trees (n = 1765) had ozone damage. Younger trees had a lower percentage of foliage damaged by ozone than older trees (p < 0.0001), and asymptomatic trees tended to be younger (p < 0.0001). Symptomatic trees were taller than asymptomatic trees of the same age (R
= 0.43, R
= 0.27). Involving local communities facilitated forest monitoring and using digital technology improved data quality. This participatory system can be used to monitor forest condition change over time and thus aids restoration efforts driven by government or local communities' interests, facilitating local decision-making.
To evaluate the effect of an intensive lifestyle intervention (ILI) on the structural and functional cardiac substrate of atrial fibrillation (AF) in overweight or obese people with metabolic ...syndrome (Mets).
Participants of the PREvención con DIeta MEDiterranea-Plus trial (n = 6874) were randomized 1:1 to an ILI programme based on an energy-reduced Mediterranean diet, increased physical activity, and cognitive-behavioural weight management or to a control intervention of low-intensity dietary advice. A core echocardiography lab evaluated left atrial (LA) strain, function, and volumes in 534 participants at baseline, 3-year, and 5-year follow-ups. Mixed models were used to evaluate the effect of the ILI on LA structure and function. In the subsample, the baseline mean age was 65 years standard deviation (SD) 5 years, and 40% of the participants were women. The mean weight change after 5 years was -3.9 kg (SD 5.3 kg) in the ILI group and -0.3 kg (SD 5.1 kg) in the control group. Over the 5-year period, both groups experienced a worsening of LA structure and function, with increases in LA volumes and stiffness index and decreases in LA longitudinal strain, LA function index, and LA emptying fraction over time. Changes in the ILI and control groups were not significantly different for any of the primary outcomes {LA emptying fraction: -0.95% 95% confidence interval (CI) -0.93, -0.98 in the control group, -0.97% 95% CI -0.94, -1.00 in the ILI group, Pbetween groups = 0.80; LA longitudinal strain: 0.82% 95% CI 0.79, 0.85 in the control group, 0.85% 95% CI 0.82, 0.89 in the ILI group, Pbetween groups = 0.24} or any of the secondary outcomes.
In overweight or obese people with Mets, an ILI had no impact on the underlying structural and functional LA substrate measurements associated with AF risk.
Worldwide, around 50 million people have dementia. Alzheimer’s disease (AD) is the most common type of dementia and one of the major causes of disability and dependency among older people worldwide. ...Clinically, AD is characterized by impaired memory accompanied by other deficiencies in the cognitive domain. Neuritic plaques (NPs) and neurofibrillary tangles (NFTs) are histopathological lesions that define the brains with AD. NFTs consist of abundant intracellular paired helical filaments (PHFs) whose main constituent is protein tau. Tau undergoes post-translational changes including hyperphosphorylation and truncation, both of which favor conformational changes in the protein. The sequential pathological processing of tau is illustrated with the following specific markers: pT231, TG-3, AT8, AT100, and Alz50. Two proteolysis sites for tau have been described: truncation at glutamate 391 and at aspartate 421, and which can be demonstrated by reactivity with the antibodies 423 and TauC-3, respectively. In this review, we describe the molecular changes of tau protein as pre-NFTs progress to extracellular NFTs, and during which the formation of a minimal nucleus of the filament, as the PHF-core, occurs. We also analyzed the PHF-core as the initiator of PHFs, and tau phosphorylation as a protective neuronal mechanism against the assembly of the PHF-core.
To assess whether breastfeeding during the first months of life is associated with adherence to the Mediterranean dietary (MedDiet) pattern in preschool children.
The Seguimiento del Niño para un ...Desarrollo Óptimo (SENDO) project is an ongoing pediatric cohort with open recruitment, started in 2015 in Spain. Participants, recruited when they are 4 to 5 years old at their primary local health center or school, are followed annually through online questionnaires. For this study, 941 SENDO participants with full data on study variables were included. Breastfeeding history was collected retrospectively at baseline. Adherence to the Mediterranean diet was assessed with the KIDMED index (range -3 to 12).
After accounting for multiple sociodemographic and lifestyle confounders, including parental attitudes and knowledge about dietary recommendations for children, breastfeeding was independently associated with a higher adherence to the MedDiet. Compared with children who were never breastfed, children breastfed for ≥6 months had a one-point increase on their mean KIDMED score (Mean difference +0.93, 95%confidence interval CI. 0.52-1.34,
for trend <0.001). The odds ratio of high adherence to the MedDiet (KIDMED index ≥8) was 2.94 (95%CI 1.50-5.36) in children who were breastfed for at least 6 months, as compared to their peers who were never breastfeed. Children who were breastfed for less than 6 months exhibited intermediate levels of adherence (
for trend <0.01).
Breastfeeding for 6 months or longer is associated with a higher adherence to the Mediterranean diet during the preschool years.
Socially assistive robots in healthcare have reported positive results in recent years, for example, in reducing the impact of mild cognitive impairment in older adults. The lack of a qualified ...workforce and the increase in the older adult population in developed countries have encouraged designers to develop socially assistive robots that operate autonomously by bringing in cognitive and decision-making methods to facilitate the caregivers' tasks, select the most appropriate activities, and personalize the interaction. This paper presents the development of a cognitive human-inspired decision-making system for autonomous social assistive robots managing the personalized selection of exercises in cognitive stimulation and providing affective support to their users. The decision-making system receives inputs from the robot's perceptions, user information stored in the robot's memory, events in an agenda, and information from a bio-inspired module. These inputs generate autonomous decisions that drive the robot's behavior depending on each situation. We show the system's capacity, integrated into our Mini social robot, to adapt the interaction, select tailored exercises based on the user's features, and execute exercises previously programmed by a caregiver to alleviate cognitive deterioration and accompany older people. Besides, the system generates a natural robot behavior based on biologically inspired methods to personalize activities, engage the user, and increase the number of robot services.
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