In this study we tested the psychometric properties of a
German version of the Balanced Measure of Psychological Needs scale (BMNP; Sheldon & Hilpert, 2012), a
questionnaire to assess the degree of ...fulfillment of the three basic
psychological needs for autonomy, competence, and relatedness. In Study 1, 251
participants completed this questionnaire, as well as measures of life
satisfaction, self-esteem, depression, loneliness, and personality traits via
online assessment. Results indicate that a six-dimensional structure fit the
data adequately well. Furthermore, all three needs independently predicted life
satisfaction and depression over and above personality traits. Self-esteem was
only predicted by relatedness satisfaction and competence dissatisfaction, and
loneliness was only predicted by relatedness. In Study 2, we revised the BMPN by
replacing one item and largely replicated the results obtained in Study 1. Study
3 showed that the subscales of the BMPN are only moderately stable over 1 week
supporting the assumption of the BMPN being a state measure. Together, these
results suggest that the revised German version of the BMPN is a reliable and
valid measure to assess satisfaction and dissatisfaction of the psychological
needs for autonomy, competence, and relatedness.
High sleep quality has been associated with beneficial outcomes across the life span. Intensive longitudinal studies suggest that these beneficial effects can also be observed on a day-to-day level. ...However, the dynamic interplay between subjective sleep quality and affective well-being in children's daily life has only rarely been investigated. The aims of the present work were (a) to replicate findings from a prior ambulatory assessment study in this area (Könen et al., 2016), (b) to explore the effect of subjective sleep quality on well-being throughout the day, and (c) to examine the reciprocal relation between subjective sleep quality and well-being in more detail. Data from two ambulatory assessment studies with children between 8 and 11 years (N = 108/84, with assessments over 28/21 consecutive days) consistently showed that positive affect was higher and negative affect was lower after nights with better sleep quality, and that the effects of subjective sleep quality were stronger on well-being assessed in the morning compared with later in the day. Results from dynamic structural equation models revealed reciprocal effects of subjective sleep quality and positive affect. Negative affect was not consistently related to worse subsequent sleep quality after controlling for positive affect and prior night's sleep quality. Results suggest a close relation of sleep quality and positive affect, which strengthens the idea behind interventions targeting both, children's sleep and well-being. Differences between children in the dynamic interplay between sleep and affect may be important predictors of long-term outcomes.
Deep molecular response (MR(4.5)) defines a subgroup of patients with chronic myeloid leukemia (CML) who may stay in unmaintained remission after treatment discontinuation. It is unclear how many ...patients achieve MR(4.5) under different treatment modalities and whether MR(4.5) predicts survival.
Patients from the randomized CML-Study IV were analyzed for confirmed MR(4.5) which was defined as ≥ 4.5 log reduction of BCR-ABL on the international scale (IS) and determined by reverse transcriptase polymerase chain reaction in two consecutive analyses. Landmark analyses were performed to assess the impact of MR(4.5) on survival.
Of 1,551 randomly assigned patients, 1,524 were assessable. After a median observation time of 67.5 months, 5-year overall survival (OS) was 90%, 5-year progression-free-survival was 87.5%, and 8-year OS was 86%. The cumulative incidence of MR(4.5) after 9 years was 70% (median, 4.9 years); confirmed MR(4.5) was 54%. MR(4.5) was reached more quickly with optimized high-dose imatinib than with imatinib 400 mg/day (P = .016). Independent of treatment approach, confirmed MR(4.5) at 4 years predicted significantly higher survival probabilities than 0.1% to 1% IS, which corresponds to complete cytogenetic remission (8-year OS, 92% v 83%; P = .047). High-dose imatinib and early major molecular remission predicted MR(4.5). No patient with confirmed MR(4.5) has experienced progression.
MR(4.5) is a new molecular predictor of long-term outcome, is reached by a majority of patients treated with imatinib, and is achieved more quickly with optimized high-dose imatinib, which may provide an improved therapeutic basis for treatment discontinuation in CML.
The prognosis of elderly patients with acute myeloid leukemia (AML) is still dismal even with intensive chemotherapy. In this trial, we compared the antileukemic activity of standard induction and ...consolidation therapy with or without the addition of the kinase inhibitor sorafenib in elderly patients with AML.
All patients received standard cytarabine and daunorubicin induction (7+3 regimen) and up to two cycles of intermediate-dose cytarabine consolidation. Two hundred one patients were equally randomly assigned to receive either sorafenib or placebo between the chemotherapy cycles and subsequently for up to 1 year after the beginning of therapy. The primary objective was to test for an improvement in event-free survival (EFS). Overall survival (OS), complete remission (CR) rate, tolerability, and several predefined subgroup analyses were among the secondary objectives.
Age, sex, CR and early death (ED) probability, and prognostic factors were balanced between both study arms. Treatment in the sorafenib arm did not result in significant improvement in EFS or OS. This was also true for subgroup analyses, including the subgroup positive for FLT3 internal tandem duplications. Results of induction therapy were worse in the sorafenib arm, with higher treatment-related mortality and lower CR rates. More adverse effects occurred during induction therapy in the sorafenib arm, and patients in this arm received less consolidation chemotherapy as a result of higher induction toxicity.
In conclusion, combination of standard induction and consolidation therapy with sorafenib in the schedule investigated in our trial is not beneficial for elderly patients with AML.
Affectionate touch, which is vital for mental and physical health, was restricted during the Covid-19 pandemic. This study investigated the association between momentary affectionate touch and ...subjective well-being, as well as salivary oxytocin and cortisol in everyday life during the pandemic.
In the first step, we measured anxiety and depression symptoms, loneliness and attitudes toward social touch in a large cross-sectional online survey (N = 1050). From this sample, N = 247 participants completed ecological momentary assessments over 2 days with six daily assessments by answering smartphone-based questions on affectionate touch and momentary mental state, and providing concomitant saliva samples for cortisol and oxytocin assessment.
Multilevel models showed that on a within-person level, affectionate touch was associated with decreased self-reported anxiety, general burden, stress, and increased oxytocin levels. On a between-person level, affectionate touch was associated with decreased cortisol levels and higher happiness. Moreover, individuals with a positive attitude toward social touch experiencing loneliness reported more mental health problems.
Our results suggest that affectionate touch is linked to higher endogenous oxytocin in times of pandemic and lockdown and might buffer stress on a subjective and hormonal level. These findings might have implications for preventing mental burden during social contact restrictions.
The study was funded by the German Research Foundation, the German Psychological Society, and German Academic Exchange Service.
Anticipatory stress can prospectively and negatively influence diverse outcomes, including cognitive performance and emotional well-being. It has been suggested that perseverative cognitions (e.g., ...worry, rumination) during the anticipation period constitute a key mechanism driving these effects. The present study investigated the temporal dynamics among stressor anticipation, perseverative cognitions, and affective well-being. To accurately test the suggested mechanism, we focused on how these dynamics unfold within individuals over time. To that end, we analyzed data from an ecological momentary assessment study in an ethnically diverse sample (N = 243, 25-65 year olds, 68.7% Hispanic or non-Hispanic Black; 14 days, 5 measurement occasions per day) using dynamic structural equation modeling. Anticipating an upcoming stressor was linked to higher levels of perseverative cognitions approximately 3 hours later. At times when individuals reported higher levels of recent perseverative cognitions than typical for them, they also reported higher levels of negative affect and lower levels of positive affect. Mediational modeling indicated that perseverative cognitions accounted for the persistent effects of previous stressor anticipation on negative as well as positive affect several hours later. These findings suggest that perseverative cognitions may play an important role in explaining the detrimental effects of anticipatory stress on subsequent emotional well-being.
► Mesenchymal stem cells were grown in a novel hollow-fiber based bioreactor system. ► We show preclinical large-scale animal-free expansion of MSC in a GMP-compliant manner. ► We show ...immunosuppressive and biologic properties of novel bioreactor-expanded MSC.
Mesenchymal stroma cells (MSC) are increasingly recognized for various applications of cell-based therapies such as regenerative medicine or immunomodulatory treatment strategies. Standardized large-scale expansions of MSC under good manufacturing practice (GMP)-compliant conditions avoiding animal derived components are mandatory for further evaluation of these novel therapeutic approaches in clinical trials.
We applied a novel automated hollow fiber cell expansion system (CES) for in vitro expansion of human bone marrow derived MSC employing a GMP-compliant culture medium with human platelet lysate (HPL). Between 8 and 32ml primary bone marrow aspirate were loaded into the hollow fiber CES and cultured for 15–27days. 2–58million MSC were harvested after primary culture. Further GMP-compliant cultivation of second passage MSC for 13days led to further 10–20-fold enrichment. Viability, surface antigen expression, differentiation capacity and immunosuppressive function of MSC cultured in the hollow fiber CES were in line with standard criteria for MSC definition. We conclude that MSC can be enriched from primary bone marrow aspirate in a GMP-conform manner within a closed hollow fiber bioreactor and maintain their T lymphocyte inhibitory capacity. Standardized and reliable conditions for large scale MSC expansion pave the way for safe applications in humans in different therapeutic approaches.
Inflammatory conditions in patients have various causes and require different treatments. Bacterial infections are treated with antibiotics, while these medications are ineffective against viral ...infections. Autoimmune diseases and graft-versus-host disease (GVHD) after allogeneic stem cell transplantation, require immunosuppressive therapies such as glucocorticoids, which may be contraindicated in other inflammatory states. In this study, we employ a combination of straightforward blood tests to devise an explainable artificial intelligence (XAI) for distinguishing between bacterial infections, viral infections, and autoimmune diseases/graft-versus-host disease.
We analysed peripheral blood from 80 patients with inflammatory conditions and 38 controls. Complete blood count, CRP analysis, and a rapid flow cytometric test for myeloid activation markers CD169, CD64, and HLA-DR were utilized. A two-step XAI distinguished firstly with C5.0 rules pruned by ABC analysis between controls and inflammatory conditions and secondly between the types of inflammatory conditions with a new bivariate decision tree using the Simpson impurity function.
Inflammatory conditions were distinguished using an XAI, achieving an overall accuracy of 81.0% (95%CI 72 - 87%). Bacterial infection (N = 30), viral infection (N = 26), and autoimmune diseases/GVHD (N = 24) were differentiated with accuracies of 90.3%, 80.0%, and 79.0%, respectively. The most critical parameter for distinguishing between controls and inflammatory conditions was the expression of CD64 on neutrophils. Monocyte count and expression of CD169 were most crucial for the classification within the inflammatory conditions.
Treatment decisions for inflammatory conditions can be effectively guided by XAI rules, straightforward to implement and based on promptly acquired blood parameters.
TV series such as "House MD", "Grey´s Anatomy" or "Emergency Room" are well perceived by medical students. Seminars featuring medical TV series such as "House MD" might serve as door-opener to ...attract medical students to learn more about rare diseases. The TV series "House MD" is troublesome for the main character Dr. House is an excellent diagnostician but at the same time a rather misanthropic person. Therefore, lecturing medicine with the help of "House MD" requires constant evaluation. From 2008 to 2016 we are using the well-known TV series "House MD" continuously to attract medical students and teach them about rare diseases as well as diagnostic strategies. We collected from 213 students a detailed questionnaire assessing their learning experience. 76.6% of our students (n = 157) reported to watching medical dramas on a regular basis. The Dr. House seminar was compared to traditional seminars and our students reported an improved learning effect (69.9%), better concentration (89.7%), higher motivation to participate (88.7%), and more fun (86.7%) (all p<0.001). The students see Dr. House's behavior quite critically. Likert assessment on a 5-point scale identified strong disagreement with Dr. House´s interpersonal skills in dealing with his colleagues (median = 1) and patients (median = 1). At the same time, the students strongly agreed with his outstanding diagnostic (median = 5) and therapeutic capabilities (median = 4). Medical students visiting a Dr. House teaching seminar are highly motivated to learn more about rare diseases. They were positively influenced by TV series such as Dr. House to improve their diagnostic and clinical skills. At the same time, they are critical enough not to see Dr. House as a role model for their own personality. Well performed medical TV shows such as Dr. House can successfully be used in an educational setting to motivate medical students to come into seminars to learn more about rare diseases.
PDF
