The different patterns of Emotional Intelligence (EI) deficits in schizophrenia and bipolar I disorder are are not yet well understood. This study compares EI levels among these groups and highlights ...the potential impact of non-social cognition on EI.
Fifty-eight schizophrenia and 60 bipolar outpatients were investigated using the Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT) and the Brief Assessment of Cognition in Schizophrenia (BACS). Analyses of covariance were performed with adjustment for the BACS composite score.
Compared to bipolar subjects, schizophrenia patients showed significantly lower levels in both EI and non-social cognition. After adjustment for the BACS composite score, the difference in EI was lost. The mediation analysis revealed that differences between schizophrenia and bipolar patients in strategic EI are almost fully attributable to the mediating effect of non-social cognition.
Our findings suggest that in both schizophrenia and bipolar patients EI is strongly influenced by non-social cognitive functioning. This has to be taken into account when interpreting MSCEIT data in comparative studies in serious mental illness and emphasizes the importance of cognitive remediation.
Aims
It remains unclear whether transitional care management outside of a clinical trial setting provides benefits for patients with acute heart failure (AHF) after hospitalization. We evaluated the ...feasibility and effectiveness of a multidimensional post-discharge disease management programme using a telemedical monitoring system incorporated in a comprehensive network of heart failure nurses, resident physicians, and secondary and tertiary referral centres (HerzMobil Tirol, HMT),
Methods and results
The non-randomized study included 508 AHF patients that were managed in HMT (
n
= 251) or contemporaneously in usual care (UC,
n
= 257) after discharge from hospital from 2016 to 2019. Groups were retrospectively matched for age and sex. The primary endpoint was time to HF readmission and all-cause mortality within 6 months. Multivariable Cox proportional hazard models were used to assess the effectiveness. The primary endpoint occurred in 48 patients (19.1%) in HMT and 89 (34.6%) in UC. Compared with UC, management by HMT was associated with a 46%-reduction in the primary endpoint (adjusted HR 0.54; 95% CI 0.37–0.77;
P
< 0.001). Subgroup analyses revealed consistent effectiveness. The composite of recurrent HF hospitalization and death within 6 months per 100 patient-years was 64.2 in HMT and 108.2 in UC (adjusted HR 0.41; 95% CI 0.29–0.55;
P
< 0.001 with death considered as a competing risk). After 1 year, 25 (10%) patients died in HMT compared with 66 (25.7%) in UC (HR 0.38; 95% CI 0.23–0.61,
P
< 0.001).
Conclusions
A multidimensional post-discharge disease management programme, comprising a telemedical monitoring system incorporated in a comprehensive network of specialized heart failure nurses and resident physicians, is feasible and effective in clinical practice.
Originally licensed in 1993 the Tritium Laboratory Karlsruhe (TLK) is a unique pilot scale isotope laboratory focused on tritium handling and processing to conduct a variety of scientific experiments ...and development tasks. In order to fulfil all requirements regarding the license, a framework of regulations is applied as a basis for the operation of TLK, as well as the setup of new experiments and the design of components. This paper will give an overview on the framework of operation in view of licensing issues, as well as administrative and technical regulations mandatory to legally and reliably operate an isotope laboratory of this scale.
Aims/hypothesis
In vitro, insulin glargine (A21Gly,B31Arg,B32Arg human insulin) has an insulin receptor (IR) profile similar to that of human insulin, but a slightly higher affinity for the IGF-1 ...receptor (IGF1R). Insulin aspart B10 (B10Asp human insulin) (AspB10), the only insulin analogue with proven carcinogenic activity, has a greater affinity for IGF1R and IR, and a prolonged IR occupancy time. The pharmacological and signalling profile of therapeutic and suprapharmacological doses of glargine were analysed in different tissues of rats, and compared with human insulin and AspB10.
Methods
Male Wistar rats were injected s.c. with human insulin or insulin analogue at doses of 1 to 200 U/kg, and the effects on blood glucose and the phosphorylation status of IR, IGF1R, Akt and extracellular signal-regulated protein kinase 1/2 in muscle, fat, liver and heart samples were investigated.
Results
Glargine, AspB10 and human insulin lowered blood glucose, with the onset of action delayed with glargine. Glargine treatment resulted in phosphorylation levels of IR and Akt that were comparable with those achieved with human insulin, although delayed in time in some tissues. AspB10 treatment resulted in at least twofold higher phosphorylation levels and significantly longer duration of IR and Akt phosphorylation in most tissues. None of the insulin treatments resulted in detectable IGF1R phosphorylation in muscle or heart tissue, whereas intravenous injection of IGF-1 increased IGF1R phosphorylation.
Conclusions/interpretation
The IR signalling pattern of AspB10 in vivo is distinctly different from that of human insulin and insulin glargine, and might challenge the notion that activation of IGF1R plays a role in the observed carcinogenic effect of AspB10.
AbstractTwo subsets of human gamma delta T cells can be identified by T cell receptor (TCR) V gene usage. V delta 2V gamma 9 T cells dominate in peripheral blood and recognize microbe- or ...tumour-derived phosphoantigens. V delta 1 T cells are abundant in mucosal tissue and recognize stress-induced MHC-related molecules. Toll-like receptors (TLRs) are known to co-stimulate interferon- gamma (IFN- gamma ) production in peripheral blood gamma delta T cells and in V delta 2V gamma 9 T cell lines. By microarray analysis, we have identified a range of genes differentially regulated in freshly isolated gamma delta T cells by TCR versus TCR plus TLR3 stimulation. Furthermore, we have investigated TLR expression in freshly isolated V delta 1 and V delta 2 subsets and cytokine-chemokine production in response to TLR1-2-6, 3 and 5 ligands. TLR1,2,6,7 RNA was abundantly expressed in both subsets, whereas TLR3 RNA was present at low levels, and TLR5 and 8 RNA only marginally in both subsets. Despite abundant RNA expression, TLR1 was rarely detectable by flow cytometry. In contrast, TLR2 and TLR6 proteins were detected in purified V delta 1 and V delta 2 T cells, and TLR3 protein was detected intracellularly in both subsets. TLR1-2-6, 3 and 5 ligands co-stimulated the IFN- gamma and chemokine secretion in TCR-activated V delta 1 and V delta 2 subsets, although the levels of IFN- gamma secreted by V delta 1 T cells were much lower than those produced by V delta 2 T cells. Our results reveal comparable expression of TLRs and functional responses to TLR ligands in freshly isolated V delta 1 and V delta 2 T cells and underscore the intrinsically different capacity for IFN- gamma secretion of V delta 1 versus V delta 2 T cells.
Two subsets of human γδ T cells can be identified by T cell receptor (TCR) V gene usage. Vδ2Vγ9 T cells dominate in peripheral blood and recognize microbe- or tumour-derived phosphoantigens. Vδ1 T ...cells are abundant in mucosal tissue and recognize stress-induced MHC-related molecules. Toll-like receptors (TLRs) are known to co-stimulate interferon-γ (IFN-γ) production in peripheral blood γδ T cells and in Vδ2Vγ9 T cell lines. By microarray analysis, we have identified a range of genes differentially regulated in freshly isolated γδ T cells by TCR versus TCR plus TLR3 stimulation. Furthermore, we have investigated TLR expression in freshly isolated Vδ1 and Vδ2 subsets and cytokine/chemokine production in response to TLR1/2/6, 3 and 5 ligands. TLR1,2,6,7 RNA was abundantly expressed in both subsets, whereas TLR3 RNA was present at low levels, and TLR5 and 8 RNA only marginally in both subsets. Despite abundant RNA expression, TLR1 was rarely detectable by flow cytometry. In contrast, TLR2 and TLR6 proteins were detected in purified Vδ1 and Vδ2 T cells, and TLR3 protein was detected intracellularly in both subsets. TLR1/2/6, 3 and 5 ligands co-stimulated the IFN-γ and chemokine secretion in TCR-activated Vδ1 and Vδ2 subsets, although the levels of IFN-γ secreted by Vδ1 T cells were much lower than those produced by Vδ2 T cells. Our results reveal comparable expression of TLRs and functional responses to TLR ligands in freshly isolated Vδ1 and Vδ2 T cells and underscore the intrinsically different capacity for IFN-γ secretion of Vδ1 versus Vδ2 T cells.
•We present a new concept to recover tritium from the helium in breeder blankets.•Zeolite membranes are fully tritium compatible and can pre-concentrate tritiated molecules.•PERMCAT catalytic ...membrane reactor recovers tritium to be reused in the fuel cycle.
While the tritium technology for the inner DT fuel cycle of fusion reactors shall be demonstrated in ITER, the tritium management in the breeder blanket remains very challenging. Most of the process options rely on ad(b)sorption/desorption cycles, using dedicated packed beds to handle separately the molecular and oxide forms of tritium. This approach seems satisfactory for ITER, but seems difficult to scale up to DEMO. The alternative use of a catalytic membrane reactor in combination with inorganic membranes would simplify and improve the overall tritium management. Zeolite membranes should enable in a single step the pre-concentration of all tritiated species. This tritium enriched stream could be afterwards processed using PERMCAT (catalytic Pd-based membrane reactor) to finally recover the tritium in its pure molecular form. This paper discusses at the conceptual level such approach. The latest experimental results on zeolite membrane and multi-tube PERMCAT reactor are presented. Next R&D activities for technical scale demonstrations and refined simulation tools are proposed to finally estimate the sizes of the components to be operated in ITER and DEMO.
Cardiovascular diseases are the most frequent cause of death in industrialized countries. Non-adherence with prescribed medication and recommended lifestyle changes significantly increases the risk ...of major cardiovascular events. The telemonitoring programme MyCor (Myokardinfarkt und Koronarstent Programm in Tirol) is a multi-modal intervention programme to improve lifestyle and medication management of patients with coronary heart disease (CHD). It includes patient education, self-monitoring with goal-setting and feedback, and regular clinical visits. We evaluated the MyCor telemonitoring programme regarding technical feasibility, user acceptance, patient adherence, change in health status, and change in quality of life.
A 4½-month study was conducted with two telemonitoring phases and one interim phase. The study comprised patient surveys, standardized assessment of quality of life using the MacNew questionnaire at study entry and after 4 and 18 weeks, analysis of adherence to medication and physical activity during the two telemonitoring phases, and analysis of reached goals regarding health conditions during the telemonitoring phases.
Twenty-five patients (mean age: 63 years) participated in the study. Patients showed a high acceptance of the MyCor telemonitoring programme. Patients reported feelings of self-control, motivation for lifestyle changes, and improved quality of life. Adherence to daily measurements was high with 86% and 77% in the two telemonitoring phases. Adherence to medication was also high with up to 87% and 80%. Pre-defined goals for physical activity were reached in up to 86% and 73% of days, respectively. Quality of life improved from 5.5 at study entry to 6.3 at the end (p< 0.01; MacNew questionnaire). Reductions in blood pressure and heart rate or an improvement in reaching defined goals could not be observed.
The MyCor telemonitoring programme Tirol for CHD patients has a high rate of acceptance among included patients. Critical evaluation revealed subjective benefits regarding quality of life and health status as well as high adherence rates to medication and lifestyle changes. Achieving long-term adherence and verifying clinical outcomes, however, remains an open issue. Our findings will promote further studies, addressing different strategies for an optimal mix of patient education, telemonitoring, feedback, and clinical follow-ups.
A
PERMCAT reactor is a catalytic membrane reactor that combines a Pd/Ag membrane and a catalyst bed. It has been developed to ensure very high tritium recovery from the unspent fuel of fusion ...machines using deuterium tritium mixtures. The PERMCAT process takes advantage of simultaneously unlocking chemically bound tritium via heterogeneously catalysed isotope exchange reactions and removing tritium via its selective permeation through the membrane. The PERMCAT reactor operated in the counter-current isotope swamping mode allows a very low tritium activity at the outlet of the component to be maintained.
Two main issues have been solved to achieve efficient and reliable PERMCAT operation. Firstly, the mechanical design has to cope with the elongation and deformation of the membrane resulting from thermal expansion and lattice parameter increase under operation with hydrogen. Secondly, the catalyst material has to be chosen in order to promote isotope exchange reactions while minimising the numerous side reactions that occur especially when the mixture contains carbon oxides. This paper presents a general overview of the R&D performed at the Tritium Laboratory Karlsruhe for PERMCAT technology. Technical solutions to solve both issues together with relevant experimental results including processing tests with tritium are discussed.
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