This study aimed to analyze published studies regarding the usefulness of Acceptance and Commitment Therapy in the treatment of oncological patients. A systematic review of the literature was ...conducted using the Web of Science, Google Scholar and Dialnet (2000-2016). Nineteen articles fulfilled the inclusion criteria. Those patients who received interventions based on Acceptance and Commitment Therapy showed a better emotional state and quality of life and greater psychological flexibility. Acceptance and Commitment Therapy proved to be useful in the psychological treatment of oncological patients. However, the heterogeneity and limitations of the studies, principally with regard to sample characteristics, study design and manner in which mechanisms responsible for changes are evaluated, make further studies necessary with a view to ascertaining what patient and/or intervention characteristics might improve results. Randomized controlled trials comparing the efficacy of Acceptance and Commitment Therapy with no treatment, with treatment with placebo and with other efficacious therapies, including a study of medium- and long-term results, would be of particular interest.
Summary
In this paper, we propose an adaptive refinement strategy for phase‐field models of brittle fracture, which is based on a novel hybridizable discontinuous Galerkin (HDG) formulation of the ...problem. The adaptive procedure considers standard elements and only one type of h‐refined elements, dynamically located along the propagating cracks. Thanks to the weak imposition of interelement continuity in HDG methods, and in contrast with other existing adaptive approaches, hanging nodes or special transition elements are not needed, which simplifies the implementation. Various numerical experiments, including one branching test, show the accuracy, robustness, and applicability of the presented approach to quasistatic phase‐field simulations.
Succinate is a signaling metabolite sensed extracellularly by succinate receptor 1 (SUNCR1). The accumulation of succinate in macrophages is known to activate a pro-inflammatory program; however, the ...contribution of SUCNR1 to macrophage phenotype and function has remained unclear. Here we found that activation of SUCNR1 had a critical role in the anti-inflammatory responses in macrophages. Myeloid-specific deficiency in SUCNR1 promoted a local pro-inflammatory phenotype, disrupted glucose homeostasis in mice fed a normal chow diet, exacerbated the metabolic consequences of diet-induced obesity and impaired adipose-tissue browning in response to cold exposure. Activation of SUCNR1 promoted an anti-inflammatory phenotype in macrophages and boosted the response of these cells to type 2 cytokines, including interleukin-4. Succinate decreased the expression of inflammatory markers in adipose tissue from lean human subjects but not that from obese subjects, who had lower expression of SUCNR1 in adipose-tissue-resident macrophages. Our findings highlight the importance of succinate-SUCNR1 signaling in determining macrophage polarization and assign a role to succinate in limiting inflammation.
Objectives
To review the evidence regarding the outcomes of laparoscopic techniques in cases of splenomegaly.
Background
Endoscopic approaches such as laparoscopic, hand-assisted laparoscopic, and ...robotic surgery are commonly used for splenectomy, but the advantages in cases of splenomegaly are controversial.
Review methods
We conducted a systematic review using PRISMA guidelines. PubMed/MEDLINE, ScienceDirect, Scopus, Cochrane Library, and Web of Science were searched up to February 2020.
Results
Nineteen studies were included for meta-analysis. In relation to laparoscopic splenectomy (LS) versus open splenectomy (OS), 12 studies revealed a significant reduction in length of hospital stay (LOS) of 3.3 days (
p
= <0.01) in the LS subgroup. Operative time was higher by 44.4 min (
p
< 0.01) in the LS group. Blood loss was higher in OS 146.2 cc (
p
= <0.01). No differences were found regarding morbimortality. The global conversion rate was 19.56%. Five studies compared LS and hand-assisted laparosocpic splenectomy (HALS), but no differences were observed in LOS, blood loss, or complications. HALS had a significantly reduced conversion rate (
p
< 0.01). In two studies that compared HALS and OS (
n
= 66), HALS showed a decrease in LOS of 4.5 days (
p
< 0.01) and increase of 44 min in operative time (
p
< 0.01), while OS had a significantly higher blood loss of 448 cc (
p
= 0.01). No differences were found in the complication rate.
Conclusion
LS is a safe approach for splenomegaly, with clear clinical benefits. HALS has a lower conversion rate. Higher-quality confirmatory trials with standardized splenomegaly grading are needed before definitive recommendations can be provided.
Prospero registration number: CRD42019125251.
This paper presents an adaptive strategy for phase-field simulations with transition to fracture. The phase-field equations are solved only in small subdomains around crack tips to determine ...propagation, while an extended finite element method (XFEM) discretization is used in the rest of the domain to represent sharp cracks, enabling to use a coarser discretization and therefore reducing the computational cost. Crack-tip subdomains move as cracks propagate in a fully automatic process. The same mesh is used during all the simulation, with an
h
-refined approximation in the elements in the crack-tip subdomains. Continuity of the displacement between the refined subdomains and the XFEM region is imposed in weak form via Nitsche’s method. The robustness of the strategy is shown for some numerical examples in 2D and 3D, including branching and coalescence tests.
Abstract
Background
Succinate is produced by both human cells and by gut bacteria and couples metabolism to inflammation as an extracellular signaling transducer. Circulating succinate is elevated in ...patients with obesity and type 2 diabetes and is linked to numerous complications, yet no studies have specifically addressed the contribution of gut microbiota to systemic succinate or explored the consequences of reducing intestinal succinate levels in this setting.
Results
Using germ-free and microbiota-depleted mouse models, we show that the gut microbiota is a significant source of circulating succinate, which is elevated in obesity. We also show in vivo that therapeutic treatments with selected bacteria diminish the levels of circulating succinate in obese mice. Specifically, we demonstrate that
Odoribacter laneus
is a promising probiotic based on its ability to deplete succinate and improve glucose tolerance and the inflammatory profile in two independent models of obesity (
db/db
mice and diet-induced obese mice). Mechanistically, this is partly mediated by the succinate receptor 1. Supporting these preclinical findings, we demonstrate an inverse correlation between plasma and fecal levels of succinate in a cohort of patients with severe obesity. We also show that plasma succinate, which is associated with several components of metabolic syndrome including waist circumference, triglycerides, and uric acid, among others, is a primary determinant of insulin sensitivity evaluated by the euglycemic-hyperinsulinemic clamp.
Conclusions
Overall, our work uncovers
O. laneus
as a promising next-generation probiotic to deplete succinate and improve glucose tolerance and obesity-related inflammation.
Background and Purpose
Glucagon‐like peptide‐2 (GLP‐2) is a gastrointestinal hormone released in response to nutritional intake that exerts a wide range of effects by activating GLP‐2 receptors. In ...addition to its intestinotrophic effects, GLP‐2 also positively influences glucose metabolism under conditions of obesity, but the mechanisms behind this remain unclear. Here, we have investigated the molecular role of the GLP‐2/GLP‐2 receptor axis in energetic metabolism, focusing on its potential modulatory effects on adipose tissue.
Experimental Approach
Physiological measurements (body weight, food intake, locomotor activity, and energy expenditure) and metabolic studies (glucose and insulin tolerance tests) were performed on lean and obese mice treated with the protease‐resistant GLP‐2 analogue teduglutide.
Key Results
Acute but not chronic centrally administered teduglutide decreased food intake and weight‐gain. By contrast, chronic activation of peripheral GLP‐2 receptors increased body weight‐independent glucose tolerance and had anti‐inflammatory effects on visceral adipose tissue. Using a gene silencing approach, we found that adipose tissue is necessary for these beneficial effects of teduglutide. Finally, teduglutide regulates the inflammatory state and acts as an anabolic signal in human adipocytes.
Conclusion and Implications
Overall, our data identify adipose tissue as a new, clinically relevant, site of action for GLP‐2 activity in obesity.
LINKED ARTICLES
This article is part of a themed issue on Cellular metabolism and diseases. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v178.10/issuetoc
From a contextual transdiagnostic approach, this study focuses on the importance of the processes of Experiential Avoidance and Activation in explaining and treating psychological problems. There ...exists widespread empirical evidence to suggest that the response pattern known as Experiential Avoidance, a general unwillingness to remain in contact with particular private experiences through the use of maladaptive avoidance strategies, acts as a functional dimension in various psychological problems. Activation, that is, maintaining contact with experiences/conditions of life and consequently with associated sources of reward, is a condition present in most therapeutic processes. Although a great deal of research has analyzed the relationship of the value of reward with the etiology and maintenance of psychological problems, Activation, as a transdiagnostic factor, has been studied less. The aim of this paper is to carry out an empirical study of the relationship between Activation, EA and emotional state and analyze the capacity of these two conditions to discriminate the intensity and symptomatology type in subjects with emotional distress.
The Hospital Anxiety and Depression Scale (HADS), Environmental Reward Observation Scale (EROS) and Behavioral Activation for Depression Scale (BADS) were completed by 240 health center users.
Of the participants, 55% showed clinically relevant emotional distress. All cases of depression showed clinical anxiety. To discriminate between subjects without (
= 109) and with emotional distress (
= 131), analyses of the ROC curves and logistic regression analysis identified the BADS-Avoidance/Rumination followed by the EROS. To discriminate between subjects with anxiety but without depression (
= 61) and with anxiety and depression (
= 70), the most efficient scales were EROS followed by BADS-Social Impairment.
It was shown that people with no emotional complaints maintained greater contact with life experiences and with environmental sources of reward than those with emotional distress. Response patterns showing Experiential Avoidance and a reduction in Activation responses were associated with clinical distress. A reduction in Activation was the condition which distinguished those people with the greatest distress and also the greatest comorbidity of symptoms of depression and anxiety. These data support the transdiagnostic nature of Activation and suggest greater attention should be paid to this concept.
Lipid overload in obesity and type 2 diabetes is associated with adipocyte dysfunction, inflammation, macrophage infiltration, and decreased fatty acid oxidation (FAO). Here, we report that the ...expression of carnitine palmitoyltransferase 1A (CPT1A), the rate-limiting enzyme in mitochondrial FAO, is higher in human adipose tissue macrophages than in adipocytes and that it is differentially expressed in visceral vs. subcutaneous adipose tissue in both an obese and a type 2 diabetes cohort. These observations led us to further investigate the potential role of CPT1A in adipocytes and macrophages. We expressed CPT1AM, a permanently active mutant form of CPT1A, in 3T3-L1 CARΔ1 adipocytes and RAW 264.7 macrophages through adenoviral infection. Enhanced FAO in palmitate-incubated adipocytes and macrophages reduced triglyceride content and inflammation, improved insulin sensitivity in adipocytes, and reduced endoplasmic reticulum stress and ROS damage in macrophages. We conclude that increasing FAO in adipocytes and macrophages improves palmitate-induced derangements. This indicates that enhancing FAO in metabolically relevant cells such as adipocytes and macrophages may be a promising strategy for the treatment of chronic inflammatory pathologies such as obesity and type 2 diabetes.
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