Purpose
To determine whether the psychological state of patients with head and neck cancer (HCN) is associated with their nutritional status.
Methods
In 40 patients with locally advanced HNC treated ...with definitive or adjuvant (chemo)radiotherapy, psychological and nutritional status were assessed before treatment, at its completion and 3 months’ post-therapy. Psychosocial distress was measured using the Hospital Anxiety and Depression Scale questionnaire (HADS-A, HADS-D), whereas the nutritional status was evaluated using standard methods (Nutritional Risk Screening Tool 2002, anthropometric data, dynamometry and laboratory tests) and with a bioelectrical impedance analysis parameter phase angle (PA).
Results
Before treatment, more patients were screened positive for anxiety than at treatment completion (
p
= 0.037) or 3 months’ post-therapy (
p
= 0.083). Depression prevalence was non-significantly higher at the end and after therapy. Compared to the baseline, more cachectic patients and a reduction of PA values were found at successive assessments. Anxiety was more often recorded among malnourished/cachectic patients (assessment 1,
p
= 0.017; assessment 2,
p
= 0.020) who were also found more frequently depressed (assessment 2,
p
= 0.045; assessment 3,
p
= 0.023). Significantly higher PA values were measured in patients without distress determined at 3 months’ post-therapy by the HADS-A (
p
= 0.027).
Conclusion
The association between the psychological and nutritional status found in this pilot study and the options for intervention warrants further clarification in a larger prospective trial.
Izhodišče: Kakovost življenja (KŽ) slovenskih bolnikov z rakom glave in vratu (RGV), zdravljenih z radioterapijo (RT), še ni bila sistematično ovrednotena z mednarodno uveljavljenimi orodji, kar bi ...omogočilo primerjavo z rezultati tujih raziskav.
Metode: 40 bolnikov z RGV, zdravljenih s primarno (N=23) RT ali RT po operaciji (N=17), je pred pričetkom RT, ob koncu RT in 10–12 tednov po zaključku zdravljenja izpolnilo dva validirana in v slovenščino prevedena vprašalnika Evropske organizacije za raziskovanje in zdravljenje raka (EORTC): splošen vprašalnik QLQ-C30, namenjen bolnikom z različnimi vrstami raka, in vprašalnik QLQ-H&N35, namenjen bolnikom z RGV. Kot klinično pomembne smo opredelili statistično pomembne razlike med dvema meritvama, ki so znašale 10 točk ali več.
Rezultati: Pred RT so imeli slabšo KŽ bolniki s traheostomo ali hranilno sondo, kadilci, bolniki s pridruženimi boleznimi in s človeškim virusom papiloma nepovezanimi raki. Intenzivnost zdravljenja (višji odmerek RT, dodatek kemoterapije k RT) je pomembno vplivala na KŽ ob koncu RT, ne pa tudi 10–12 tednov po zdravljenju. Analiza dinamike spreminjanja kazalcev KŽ je potrdila, da se v večini primerov stanje vrne na raven pred začetkom RT. Izjema so bili kazalci, povezani z okvarami bolnikovega sistema okušanja in slinjenja, ki so specifične za RT: njihova končna ocena je bila pomembno slabša kot ocena pred RT.
Zaključek: Ocene različnih kazalcev KŽ pri slovenskih bolnikih z RGV pred, med in po RT so primerljive z rezultati podobnih analiz v tujini. KŽ po zdravljenju z RT je odvisna predvsem od stopnje okvar okušanja in slinjenja, kar vpliva tudi na požiranje.
Izhodišče: Kakovost življenja (KŽ) slovenskih bolnikov z rakom glave in vratu (RGV), zdravljenih z radioterapijo (RT), še ni bila sistematično ovrednotena z mednarodno uveljavljenimi orodji, kar bi ...omogočilo primerjavo z rezultati tujih raziskav. Metode: 40 bolnikov z RGV, zdravljenih s primarno (N=23) RT ali RT po operaciji (N=17), je pred pričetkom RT, ob koncu RT in 10–12 tednov po zaključku zdravljenja izpolnilo dva validirana in v slovenščino prevedena vprašalnika Evropske organizacije za raziskovanje in zdravljenje raka (EORTC): splošen vprašalnik QLQ-C30, namenjen bolnikom z različnimi vrstami raka, in vprašalnik QLQ-H&N35, namenjen bolnikom z RGV. Kot klinično pomembne smo opredelili statistično pomembne razlike med dvema meritvama, ki so znašale 10 točk ali več. Rezultati: Pred RT so imeli slabšo KŽ bolniki s traheostomo ali hranilno sondo, kadilci, bolniki s pridruženimi boleznimi in s človeškim virusom papiloma nepovezanimi raki. Intenzivnost zdravljenja (višji odmerek RT, dodatek kemoterapije k RT) je pomembno vplivala na KŽ ob koncu RT, ne pa tudi 10–12 tednov po zdravljenju. Analiza dinamike spreminjanja kazalcev KŽ je potrdila, da se v večini primerov stanje vrne na raven pred začetkom RT. Izjema so bili kazalci, povezani z okvarami bolnikovega sistema okušanja in slinjenja, ki so specifične za RT: njihova končna ocena je bila pomembno slabša kot ocena pred RT. Zaključek: Ocene različnih kazalcev KŽ pri slovenskih bolnikih z RGV pred, med in po RT so primerljive z rezultati podobnih analiz v tujini. KŽ po zdravljenju z RT je odvisna predvsem od stopnje okvar okušanja in slinjenja, kar vpliva tudi na požiranje.
Abstract
Community lockdowns and travel restrictions are commonly employed to decelerate epidemic spreading. We here use a stochastic susceptible-infectious-recovered model on different social ...networks to determine when and to what degree such lockdowns are likely to be effective. Our research shows that community lockdowns are effective only if the links outside of the communities are virtually completely sealed off. The benefits of targeting specifically these links, as opposed to links uniformly at random across the whole network, are inferable only beyond 90% lockdown effectiveness. And even then the peak of the infected curve decreases by only 20% and its onset is delayed by a factor of 1.5. This holds for static and temporal social networks, regardless of their size and structural particularities. Networks derived from cell phone location data and online location-based social platforms yield the same results as a large family of hyperbolic geometric network models where characteristic path lengths, clustering, and community structure can be arbitrarily adjusted. The complex connectedness of modern human societies, which enables the ease of global communication and the lightning speeds at which news and information spread, thus makes it very difficult to halt epidemic spreading with top-down measures. We therefore emphasize the outstanding importance of endogenous self-isolation and social distancing for successfully arresting epidemic spreading.
•We study the public goods games on random hyperbolic graphs.•We consider assortative and disassortative mixing with different frequencies.•We show that heterogeneous networks in hyperbolic spaces ...promote public cooperation.•We show that mixing impairs the evolutionary success of cooperators.•The negative impact of mixing depends most significantly on the mixing frequency.
Understanding the evolution of cooperation in structured populations remains one of the fundamental challenges of the 21st century, with far-reaching implications for the wellbeing of modern human societies. Studies over the past two decades showed that the structure of the network of contacts plays a crucial role in determining whether cooperation prevails or not. An important step to more realistic networks was made with the shift from regular grids and lattices to complex social networks at the turn of the century. Real networks exhibit a high mean local clustering coefficient, short average path lengths, and community structure. Recent studies have revealed that random geometric graphs in hyperbolic spaces exhibit properties that are frequently found in real networks. We here study the public goods game on random geometric graphs in hyperbolic spaces, and we consider assortative and disassortative mixing with different frequencies. We show that in hyperbolic spaces heterogeneous networks promote the evolution of public cooperation in comparison to the more homogeneous networks. We also confirm that assortative and disassortative mixing on random hyperbolic networks both impair the evolutionary success of cooperators, regardless of the network architecture. The differences between the two mixing protocols are most expressed at low mixing frequencies, whilst at high mixing frequencies the two almost converge.
•Network science provides a toolset to study the structural design of living systems.•Interactions between cells and organs can be described with the network formalism.•Advances in imaging techniques ...enable us to assess morphology of biological systems.•Progress in tissue engineering advances the need for structural connectivity analysis.
Technological advances in imaging techniques and biometric data acquisition have enabled us to apply methods of network science to study the morphology and structural design of organelles, organs, and tissues, as well as the coordinated interactions among them that yield a healthy physiology at the level of whole organisms. We here review research dedicated to these advances, in particular focusing on networks between cells, the topology of multicellular structures, neural interactions, fluid transportation networks, and anatomical networks. The percolation of blood vessels, structural connectivity within the brain, the porous structure of bones, and relations between different anatomical parts of the human body are just some of the examples that we explore in detail. We argue and show that the models, methods, and algorithms developed in the realm of network science are ushering in a new era of network-based inquiry into the morphology and structural design of living systems in the broadest possible terms. We also emphasize that the need and applicability of this research is likely to increase significantly in the years to come due to the rapid progress made in the development of bioartificial substitutes and tissue engineering.
The emergence of spatiotemporal patterns in the distribution of species is one of the most striking phenomena in ecology and nonlinear science. Since it is known that spatial inhomogeneities can ...significantly affect the dynamics of ecological populations, in the present paper we investigate the impact of environmental variability on the formation of patterns in a spatially extended predator–prey model. In particular, we utilize a predator–prey system with a Holling III functional response and introduce random spatial variations of the kinetic parameter signifying the intrinsic growth rate of the prey, reflecting the impact of a heterogeneous environment. Our results reveal that in the proximity of the Hopf bifurcation environmental variability is able to provoke pattern formation, whereby the coherence of the patterns exhibits a resonance-like dependence on the variability strength. Furthermore, we show that the phenomenon can only be observed if the spatial heterogeneities exhibit large enough regions with high growth rates of the prey. Our findings thus indicate that variability could be an essential pattern formation mechanism of the populations.
Our core body temperature is held around
37
∘
C by an effective internal thermoregulatory system. However, various clinical scenarios have a more favorable outcome under external temperature ...regulation. Therapeutic hypothermia, for example, was found beneficial for the outcome of resuscitated cardiac arrest patients due to its protection against cerebral ischemia. Nonetheless, practice shows that outcomes of targeted temperature management vary considerably in dependence on individual tissue damage levels and differences in therapeutic strategies and protocols. Here, we address these differences in detail by means of computational modeling. We develop a multi-segment and multi-node thermoregulatory model that takes into account details related to specific post-cardiac arrest-related conditions, such as thermal imbalances due to sedation and anesthesia, increased metabolic rates induced by inflammatory processes, and various external cooling techniques. In our simulations, we track the evolution of the body temperature in patients subjected to post-resuscitation care, with particular emphasis on temperature regulation via an esophageal heat transfer device, on the examination of the alternative gastric cooling with ice slurry, and on how anesthesia and the level of inflammatory response influence thermal behavior. Our research provides a better understanding of the heat transfer processes and therapies used in post-cardiac arrest patients.
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