Rising global rates of pathological Internet use (PIU) and related psychological impairments have gained considerable attention in recent years. In an effort to acquire evidence-based knowledge of ...this relationship, the main objective of this study was to investigate the association between PIU, psychopathology and self-destructive behaviours among school-based adolescents in eleven European countries. This cross-sectional study was implemented within the framework of the European Union project: Saving and Empowering Young Lives in Europe. A representative sample of 11,356 school-based adolescents (M/F: 4,856/6,500; mean age: 14.9) was included in the analyses. PIU was assessed using the Young’s Diagnostic Questionnaire. Psychopathology was measured using the Beck Depression Inventory-II, Zung Self-Rating Anxiety Scale and Strengths and Difficulties Questionnaire. Self-destructive behaviours were evaluated by the Deliberate Self-Harm Inventory and Paykel Suicide Scale. Results showed that suicidal behaviours (suicidal ideation and suicide attempts), depression, anxiety, conduct problems and hyperactivity/inattention were significant and independent predictors of PIU. The correlation between PIU, conduct problems and hyperactivity/inattention was stronger among females, while the link between PIU and symptoms of depression, anxiety and peer relationship problems was stronger among males. The association between PIU, psychopathology and self-destructive behaviours was stronger in countries with a higher prevalence of PIU and suicide rates. These findings ascertain that psychopathology and suicidal behaviours are strongly related to PIU. This association is significantly influenced by gender and country suggesting socio-cultural influences. At the clinical and public health levels, targeting PIU among adolescents in the early stages could potentially lead to improvements of psychological well-being and a reduction of suicidal behaviours.
Solution-phase and solid-phase parallel synthesis and high throughput screening have enabled biologically active and selective compounds to be identified at an unprecedented rate. The challenge has ...been to convert these hits into viable development candidates. To accelerate the conversion of these hits into lead development candidates, early assessment of the physicochemical and pharmacological properties of these compounds is being made. In particular, in vitro absorption, distribution, metabolism, and elimination (ADME) assays are being conducted at earlier and earlier stages of discovery with the goal of reducing the attrition rate of these potential drug candidates as they progress through development. In this report, we present an eight-channel parallel liquid chromatography/mass spectrometry (LC/MS) system in combination with custom Visual Basic and Applescript automated data processing applications for high throughput early ADME. The parallel LC/MS system was configured with one set of gradient LC pumps and an eight-channel multiple probe autosampler. The flow was split equivalently into eight streams before the multiple probe autosampler and recombined after the eight columns and just prior to the mass spectrometer ion source. The system was tested for column-to-column variation and for reproducibility over a 17 h period (approximately 500 injections per column). The variations in retention time and peak area were determined to be less than 2 and 10%, respectively, in both tests. The parallel LC/MS system described permits time-course microsomal incubations (t
o, t
5, t
15, t
30) to be measured in triplicate and enables estimations of t
1/2 microsomal stability. The parallel LC/MS system is capable of analyzing up to 240 samples per hour and permits the complete profiling up to two microtiter plates of compounds per day (i.e., 176 test substrate compounds + sixteen controls).
Chronic renal impairment is often associated with complex bone disorders. Improvement of secondary hyperparathyroidism (HPT) is expected after kidney transplant (KT) if the glomerular filtration rate ...is normalized.
There were 888 KTs performed between 1996 and 2017 at our department. A total of 558 general patients have been operated on for HPT during the same period. The 2 populations had a common part: out of the 558, a total of 69 (12.4%) were in end-stage renal failure when operated on because of secondary HPT. That also means that 7.8% of all KTs were associated with HPT. Retrospective, single-center analysis was performed using the patients' medical records. The aim of our study was to analyze the results of parathyroidectomies after KT.
Parathyroid surgery was performed on 19 patients (2.14%) because of HPT after KT. The applied surgical technique was total parathyroidectomy with autotransplant in 6 cases, subtotal parathyroidectomy in 3 cases, and selective parathyroidectomy in 10 cases. In all cases, histology revealed benign disease. Complications were observed in 10 cases (52%); there were 6 cases of postoperative hypocalcaemia (31.58%), 1 case of transient laryngeal recurrent nerve paresis (5.26%), and 6 cases of recurrent HPT (31.58%).
The first step of HPT management is calcimimetic drug treatment. It is essential to prevent possible complications with regular laboratory monitoring. If the proper conservative therapy is refractory or severe in complications, surgery should be chosen. If the patient is already waiting for a KT, it is worth performing the parathyroid surgery before KT. Close collaboration with endocrinologists and nephrologists is needed to achieve successful therapy.
Abstract
Introduction
Carotid artery stenting (CAS) is an established alternative option to surgical treatment for carotid artery stenosis, 3 main contemporary types of stent design being used for ...this purpose (open-, closed-cell, mesh-covered stents). So far, no definite conclusions have been reached on the superiority of any of those devices for CAS. With its new double-mesh design, the Roadsaver stent has emerged as an attractive option for use in CAS, aiming to further reduce neurological events. However, its efficacy as compared to other stents, such as Wallstent, has not been thoroughly explored. We thus aimed to compare the clinical outcomes of Roadsaver and Wallstent for use in CAS.
Methods
This retrospective cohort study included patients who underwent CAS and received either Wallstent or Roadsaver stent at a tertiary centre (centre A) in a Central European country during 2009–2021, and another tertiary centre (centre B) in the same country during 2016–2019. Patients with incomplete baseline clinical records were excluded. Patients were followed up for one year at centre A, and for 30 days at centre B. The primary outcomes were 30-day and 1-year major adverse cardiac or cerebrovascular events (MACCE), defined as a composite of myocardial infarction, stroke, and cardiovascular mortality. The secondary outcome was 30-day bradycardia. Baseline covariates were balanced between groups using inverse probability treatment weighting. Thirty-day outcomes were compared using logistic regression with odds ratio (OR) as the summary statistic, and 1-year MACCE was compared using Cox regression with hazard ratio (HR) as the summary statistic.
Results
In total, 982 patients were identified. After applying the exclusion criterion, 770 patients were included in the analysis (482 patients from centre A and 288 patients from centre B; 287 (37.3%) females, mean age 68±8 years old), of which 589 (76.5%) received Wallstent and 181 (23.5%) received Roadsaver. There was no loss to follow-up. Twenty-three (3%) patients had MACCE by 30 days, and 16 (3.3%) of those who completed one-year follow-up had MACCE by one year. No significant differences in MACCE were observed between the two stents at 30 days (OR 0.697 0.374, 1.300, p=0.256) and one year (HR 0.512 0.126, 2.073, p=0.348). Roadsaver was associated with significantly higher odds of 30-day bradycardia (OR 5.391 4.089, 7.108, p<0.0001), which remained significant after adjusting for the number of post-dilatations performed (p<0.0001). Additionally, Roadsaver was associated with significantly lower risk of one-year MACCE among symptomatic patients (N=184; HR 0.131 0.024, 0.723, p=0.020; Figure 1), but not among asymptomatic patients (N=298; HR 1.774 0.332, 9.490, p=0.503).
Conclusion
There was no short- and long-term hazard difference between the 2 types of stent designs, however Roadsaver may be superior to Wallstent among symptomatic patients.
Funding Acknowledgement
Type of funding sources: None.
There have been only a few reports illustrating the moderate effectiveness of suicide-preventive interventions in reducing suicidal behavior, and, in most of those studies, the target populations ...were primarily adults, whereas few focused on adolescents. Essentially, there have been no randomized controlled studies comparing the efficacy, cost-effectiveness and cultural adaptability of suicide-prevention strategies in schools. There is also a lack of information on whether suicide-preventive interventions can, in addition to preventing suicide, reduce risk behaviors and promote healthier ones as well as improve young people's mental health.The aim of the SEYLE project, which is funded by the European Union under the Seventh Framework Health Program, is to address these issues by collecting baseline and follow-up data on health and well-being among European adolescents and compiling an epidemiological database; testing, in a randomized controlled trial, three different suicide-preventive interventions; evaluating the outcome of each intervention in comparison with a control group from a multidisciplinary perspective; as well as recommending culturally adjusted models for promoting mental health and preventing suicidal behaviors.
The study comprises 11,000 adolescents emitted from randomized schools in 11 European countries: Austria, Estonia, France, Germany, Hungary, Ireland, Israel, Italy, Romania, Slovenia and Spain, with Sweden serving as the scientific coordinating center. Each country performs three active interventions and one minimal intervention as a control group. The active interventions include gatekeeper training (QPR), awareness training on mental health promotion for adolescents, and screening for at-risk adolescents by health professionals. Structured questionnaires are utilized at baseline, 3- and 12-month follow-ups in order to assess changes.
Although it has been reported that suicide-preventive interventions can be effective in decreasing suicidal behavior, well-documented and randomized studies are lacking. The effects of such interventions in terms of combating unhealthy lifestyles in young people, which often characterize suicidal individuals, have never been reported. We know that unhealthy and risk-taking behaviors are detrimental to individuals' current and future health. It is, therefore, crucial to test well-designed, longitudinal mental health-promoting and suicide-preventive interventions by evaluating the implications of such activities for reducing unhealthy and risk behaviors while concurrently promoting healthy ones.
The German Clinical Trials Register, DRKS00000214.
The set of guidelines for good clinical research practice in pharmacodynamic studies of neuromuscular blocking agents was developed following an international consensus conference in Copenhagen in ...1996 (Viby‐Mogensen et al., Acta Anaesthesiol Scand 1996, 40, 59–74); the guidelines were later revised and updated following the second consensus conference in Stockholm in 2005 (Fuchs‐Buder et al., Acta Anaesthesiol Scand 2007, 51, 789–808). In view of new devices and further development of monitoring technologies that emerged since then, (e.g., electromyography, three‐dimensional acceleromyography, kinemyography) as well as novel compounds (e.g., sugammadex) a review and update of these recommendations became necessary. The intent of these revised guidelines is to continue to help clinical researchers to conduct high‐quality work and advance the field by enhancing the standards, consistency, and comparability of clinical studies.
There is growing awareness of the importance of consensus‐based reporting standards in clinical trials and observational studies. Such global initiatives are necessary in order to minimize heterogeneous and inadequate data reporting and to improve clarity and comparability between different studies and study cohorts. Variations in definitions of endpoints or outcome variables can introduce confusion and difficulties in interpretation of data, but more importantly, it may preclude building of an adequate body of evidence to achieve reliable conclusions and recommendations. Clinical research in neuromuscular pharmacology and physiology is no exception.
Soils form the skin of the Earth’s surface, regulating water and biogeochemical cycles and generating production of food, timber, and textiles around the world. Changes in soil and its ability to ...perform a range of processes have important implications for Earth system function, especially in the critical zone (CZ)—the area that extends from the top of the canopy to the bottom of groundwater and that harbors most of Earth’s biosphere. A key aspect of the way soil functions results from its structure, defined as the size, shape, and arrangement of soil particles and pores. The network of pores provides storage space for at least a quarter of Earth’s biodiversity, while the abundance, size and connectivity of the pore space regulates fluxes of heat, water, nutrients and gases that define the physical and chemical environment. Here we review the nature of soil structure, focusing on its co-evolution with the plants and microbes that live within the soil, and the degree to which these processes have been incorporated into flow and transport models. Though it is well known that soil structure can change with wetting and drying events, often oscillating seasonally, the dynamic nature of soil structure that we discuss is a systematic shift that results in changes in its hydro-bio-geochemical function over decades to centuries, timescales over which major changes in carbon and nutrient cycles have been observed in the Anthropocene. We argue that the variable nature of soil structure, and its dynamics, need to be better understood and captured by land surface and ecosystem models, which currently describe soil structure as static. We further argue that modelers and empiricists both are well-poised to quantify and incorporate these dynamics into their studies. From these efforts, four fundamental questions emerge: 1) How do rates of soil aggregate formation and collapse, and their overall arrangements, interact in the Anthropocene to regulate CZ functioning from soil particle to continental scales? 2) How do alterations in rooting-depth distributions in the Anthropocene influence pore structure to control hydrological partitioning, biogeochemical transformations and fluxes, exchanges of energy and carbon with the atmosphere and climate, regolith weathering, and thus regulation of CZ functioning? 3) How does changing microbial functioning in a high CO2, warmer world with shifting precipitation patterns influence soil organic carbon dynamics and void-aggregate profile dynamics? 4) How deeply does human influence in the Anthropocene propagate into the subsurface, how does this depth relate to profile structure, and how does this alter the rate at which the CZ develops? The United Nations has recently recognized that 33% of the Earth's soils are already degraded and over 90% could become degraded by 2050. This recognition highlights the importance of addressing these proposed questions, which will promote a predictive understanding of soil structure.
•Systematic shifts in soil structure are occurring over timescales relevant to humans and the Anthropocene•Shifts in soil structure at decadal scales can have meaningful effects on critical zone functioning and feedbacks•Analytical methods, imaging tools, and models can be integrated to quantify soil structural responses to climate and land use changes.
The acceptance of brain death and the legitimation of organ transplantation is very much dependent on the general knowledge of the society. In Hungary, the legislation of brain death is based on ...presumed consent. There is no structural education about the topic so far.
The role of the Gerundium program is to educate high school students about the importance of transplantation and the meaning of brain death. The goal of this study was to evaluate the effectiveness of the Gerundium contemporary educational program in a pilot study.
The education was held by medical students who successfully completed a preparatory elective course consisting of relevant information in the topic. Medical students used simple language during the 45-minute presentations. Two tests with simple but representative questions created by experts were completed by high school students: one directly before contemporary education and another 5 to 6 weeks after the lecture.
A total of 147 tests were completed: 78 before and 69 after the presentation in the city of Debrecen and 294 before the lecture in the city of Győr. In Debrecen, the overall correct answers increased by 6.05% (P < .05; before vs after). The results show that the knowledge transfer is highly effective in this manner and the students know significantly more weeks after the lectures.
There is much to do to broadly inform society about transplantation and brain death, but we will continue to increase the number of students and measure the dynamic change of the students' knowledge.
We report first measurements of e^{+}e^{-} pair production in the mass region 0.4<M_{ee}<2.6 GeV/c^{2} at low transverse momentum (p_{T}<0.15 GeV/c) in noncentral Au+Au collisions at sqrts_{NN}=200 ... GeV and U+U collisions at sqrts_{NN}=193 GeV. Significant enhancement factors, expressed as ratios of data over known hadronic contributions, are observed in the 40%-80% centrality of these collisions. The excess yields peak distinctly at low p_{T} with a width (sqrt⟨p_{T}^{2}⟩) between 40 and 60 MeV/c. The absolute cross section of the excess depends weakly on centrality, while those from a theoretical model calculation incorporating an in-medium broadened ρ spectral function and radiation from a quark gluon plasma or hadronic cocktail contributions increase dramatically with an increasing number of participant nucleons. Model calculations of photon-photon interactions generated by the initial projectile and target nuclei describe the observed excess yields but fail to reproduce the p_{T}^{2} distributions.
Vaccine development against tuberculosis (TB) is based on the induction of adaptive immune responses endowed with long-term memory against mycobacterial antigens. Memory B and T cells initiate a ...rapid and robust immune response upon encounter with Mycobacterium tuberculosis, thus achieving long-lasting protection against infection. Recent studies have shown, however, that innate immune cell populations such as myeloid cells and NK cells also undergo functional adaptation after infection or vaccination, a de facto innate immune memory that is also termed trained immunity. Experimental and epidemiological data have shown that induction of trained immunity contributes to the beneficial heterologous effects of vaccines such as bacille Calmette-Guérin (BCG), the licensed TB vaccine. Moreover, increasing evidence argues that trained immunity also contributes to the anti-TB effects of BCG vaccination. An interaction among immunological signals, metabolic rewiring, and epigenetic reprogramming underlies the molecular mechanisms mediating trained immunity in myeloid cells and their bone marrow progenitors. Future studies are warranted to explore the untapped potential of trained immunity to develop a future generation of TB vaccines that would combine innate and adaptive immune memory induction.
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