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“A biomarker-based scoring system to assess the presence of obstructive coronary artery disease in patients with myocardial infarction”
Get PDFAims: Approximately 10% of patients with myocardial infarction present with non-obstructive coronary arteries (MINOCA), whose characteristics differ from those with obstructive coronary lesions (MICAD). Inflammation plays a key role in myocardial infarction. This study aims to develop a biomarker-based index for accurate differentiation between MINOCA and MICAD. Methods: A prospective, observational cohort study including 111 patients admitted for myocardial infarction: 46 with MINOCA and 65 with MICAD. Blood samples were collected within the first 24 h to measure high-sensitivity C-reactive protein, interleukin-6, asymmetric dimethylarginine, and peak high-sensitivity troponin T. The association of these biomarkers with MICAD risk was analyzed using logistic regression. Scoring systems were developed using optimization algorithms to predict the diagnosis before coronary angiography, applied to both individual biomarkers and a combined index. Results: Patients had a mean age of 67 years (SD 13.3), with a male predominance (68.5%). Higher levels of IL-6 and high-sensitivity troponin T were significantly associated with increased MICAD risk (OR: 1.58; 95% CI: 1.01–2.46, and OR: 2.27; 95% CI: 1.61–3.26, respectively). As score increases, interleukin-6 and high-sensitivity troponin T increase the likelihood of MICAD classification, while higher asymmetric dimethylarginine levels reduce it. Each one-point increase in the combined index multiplies MICAD risk by six (OR:6.16, 95%CI: 2.72–13.95; p < 0.001). While individual indexes improved the diagnostic performance of biomarkers, the combined index demonstrated superior accuracy (AUC: 0.918). Conclusions: A biomarker-based scoring system was developed, achieving superior discriminatory capacity for differentiating MINOCA from MICAD compared to the individual analysis of biomarkers in absolute values or independent indexes.</p
Frailty Prevalence and Characterization Among Kidney Transplant Candidates in Spain:A Multicenter Study
Get PDFFrailty is a frequent condition among kidney transplant candidates (KTc) that confers poor outcomes after transplantation. We aimed to establish frailty prevalence in a representative sample of KTc in Spain. We conducted a multicenter cross-sectional study including 1194 KTc ≥50 years. Frailty was assessed by the FRAIL scale. Mean age was 64.2 years; 38.4% were female. Median Charlson comorbidity index (CCI) was 6 [4–7] and the total number of medications was 9 [7–12]. We found that 8.2% of patients were frail and 41.5% were pre-frail. Frailty was more frequent among females (60.2% of frail vs. 32.8% of robust; p < 0.001), hemodialysis patients (74.5% of frail vs. 67.1% of robust; p = 0.02), and those with a high burden of disease (54.6% of frail patients with CCI >6 vs. 29.3% of robust; p < 0.001). The multivariable analysis confirmed that frailty was associated with the female sex (OR 3.9 [2.5–6.2]); higher CCI (>6 OR 2.9 [1.6–54]); and the number of medications (OR –per medication- 1.13 [1.07–1.2]). Almost 50% of KTc in Spain are pre-frail or frail. Frailty is more prevalent between women and patients with high comorbidity burden. Identifying those candidates at risk is essential to establish risks and implement strategies to minimize them.</p
Safeguarding equity, access and inclusion in IELTS:a comprehensive review and audit of special arrangements offered to IELTS testtakers with accessibility requirements
No full textThis study undertook an in-depth review of the special arrangements (SAs) offered by the International English Language Testing System (IELTS). The aim was to audit the IELTS SAs in light of what was considered good policy and practice within the language testing and assessment profession at the time. It also sought to elicit stakeholder attitudes, perceptions and experiences of the range of IELTS accommodations offered.The researchers contextualised their study within current understandings of ethics, fairness, social justice and validity concerns in the field of language testing and assessment, especially as these concern test-takers with special educational needs who may require some form of testing accommodation, i.e., a departure from the standard test in terms of content, format, delivery or scoring approach. The descriptive review and evaluative audit of IELTS SAs drew upon recent frameworks developed and applied in the field of language testing and assessment, including a socio-cognitive framework for language test development and validation and tools for evaluating test fairness and contexts of use.Methodological approaches included: desk-based documentary analysis of publicly available material; consultation with professional experts in special educational needs and disability via questionnaire completion; application of analytical tools to the accommodated tasks for the four IELTS test components; survey questionnaires with targeted IELTS stakeholders; interviews with selected IELTS stakeholders (e.g., test designers, test takers, test centre staff) to elicit their attitudes, perceptions and lived experiences. Data analyses provided a full description of the different accommodation types offered (at that time) for IELTS test-takers with visual, hearing/speaking and specific learning difficulties, as well as provision for the use of assistive (access) technology in IELTS.The researchers highlighted some important issues to emerge from their study and made over 20 tentative recommendations for the IELTS Partners to consider for the future
History of health psychology
Get PDFThis chapter gives an overview of the history of health psychology, covering the development of the discipline across a number of countries, including the United States of America (USA), Europe, the United Kingdom (UK), Japan, Africa, Canada, Australia and New Zealand. It takes a look at the key influences on its development, changes to job opportunities, discussions on the need for training models to accommodate standardised skill sets, core journals and books that were published to assist knowledge transfer of this new discipline, and how the growth in countries where health psychology is well-established such as the UK, differ from less developed countries. It includes extracts from interviews with 53 Health Psychologists (mainly trained in the UK) as part of the Royal Society–funded Oral History of Health Psychology (OHHP) in the UK Project (funded 2016–2018), many of whom were involved in European and international developments. New oral testimony from this project, interviewed by the authors, is presented in this chapter for the first time, highlighted by the date on which people were interviewed as part of this historical work. The chapter concludes with practical tips to ensure that history continues to be able to be captured in the future on an international platform through good documentation at annual meetings and as part of professional network events, conferences, and peer-reviewed journals
Comment on “Effectiveness of Mind–Body Exercise in Older Adults With Sarcopenia and Frailty:A Systematic Review and Meta-Analysis” by Wan et al.
Get PDFAdherence to the mediterranean diet and physical activity in relation to sarcopenia:a cross-sectional epidemiological cohort study
Get PDFBackground: Adoption of healthy lifestyle habits has been proposed as successful strategies to counteract sarcopenia. Aims: To explore the association of physical activity (PA) and adherence to the mediterranean diet (MD), individually and synergically, with sarcopenia. Methods: The present cross-sectional study examined data of the Toledo Study of Healthy Ageing. Data of community-dwelling adults aged 65 + years were analyzed. Sarcopenia was defined according to the Foundation for the National Institutes of Health, standardized to our population (sFNIH) and the European Working Group on Sarcopenia (EWGSOP2). PA levels (Physical Activity Scale for the Elderly, PASE) and adherence to the MD (MEDiterranean Diet Adherence Screener-MEDAS) were estimated using self-reported instruments. Binary regression models were conducted to test associations. Results: Data of 1457 individuals (mean age 74.68 ± 5.77 years; 54.91% women) were analyzed. Among them, 331 (22.72%, sFNIH) and 202 (13.86%, EWGSOP2) met sarcopenia criteria. PA levels (ORs: 0.91–0.95, p < 0.05) and adherence to the MD (ORs: 0.82–0.86, p < 0.05) were significantly and negatively associated with the prevalence of sarcopenia, regardless of the definition used. Nevertheless, no significant interactions were observed among healthy lifestyle habits. According to sarcopenia-related domains, PA levels and adherence to the MD were negatively associated with dynapenia, meanwhile, PA levels were associated with low lean mass (sFNIH) and adherence to the MD was inversely associated with poor mobility. Conclusions: PA and adherence to the MD are independently associated with sarcopenia. Moreover, specific associations were observed between sarcopenia domains. Nevertheless, no significant interaction was observed between them.</p
Inadequate fluid replacement during prolonged cycling in the heat reduces performance independent of serum sodium concentrations
No full textHypohydration (≥2% body mass (BM) loss) impairs endurance performance and tends to result in both reduced total body water (TBW), and increased serum [Na+]. This study assessed the independent effect of TBW on cycling performance in the heat, by personalising Na+ and fluid ingestion to match serum [Na+] between conditions. Eleven male cyclists (35.0 ± 6.4 years, BM 76.0 ± 6.6 kg, lactate threshold (LT) 195 ± 20 W, VO˙2max 58 ± 5 ml·kg-1·min-1) were assessed for VO˙2max and LT (visit 1). In visit 2, participants completed 60 min of constant-load cycling (90% LT, 32°C, 50% rH) to determine sweat rate (1.2 ± 0.3 L.h-1) and electrolyte concentrations ([Na+] 46 ± 19 mmol.L-1, [K+] 4.0 ± 0.5 mmol.L-1). Post-exercise urine volume and electrolyte content were added to sweat losses to determine total losses. Experimental trials consisted of 180 min constant-load cycling (90% LT, 32°C, 50% rH), followed by a work-matched time-trial (TT). Baseline TBW was determined via bioelectrical impedance, with deuterium dilution-corrected regressions applied. During the 180 min bout, participants consumed 60% (60FR; 0.844 ± 0.202 L.h-1) or 80% (80FR; 1.125 ± 0.269 L.h-1) of projected total fluid losses. In each condition, participants consumed NaCl in capsules at a rate to maintain serum [Na+] (29.7 ± 26.3 mmol.h-1 in 80FR vs 4.3 ± 10.5 mmol.h-1 in 60FR, P = 0.003), based on projected losses and modelling equations (McCubbin, 2022), assuming baseline serum [Na+] was 140 mmol.L-1. TT completion time was 8 ± 10 % faster in 80FR (1793 ± 174 seconds vs 1968 ± 246 seconds, P = 0.023), with higher power output (254 ± 33 W vs 233 ± 32 W, P = 0.012), despite stable serum [Na+] across conditions (P=0.07). At 180 min, serum [Na+] was 139.37 ± 2.01 mmol.L-1 in 80FR vs 139.96 ± 2.28 mmol.L-1 in 60FR. BM loss was greater in 60FR at all time-points (P<0.05), including 180 min (2.5 ± 0.5 vs 1.5 ± 0.5 %) and post-TT (2.6 ± 0.9 vs 1.7 ± 0.8 %). TBW loss was greater in 60FR at all time-points (P<0.05), notably at 180 min (3.2 ± 0.8 vs 1.5 ± 0.9 %) and post-TT (3.3 ± 1.4 vs 1.9 ± 1.3 %). Results suggest reduced BM (>2%) and TBW (>3%) impair cycling performance in the heat, compared to maintaining losses within 2%, despite no difference in serum [Na+] between conditions. The data support individualising hydration strategies to mitigate fluid losses and ensure athletes can perform optimally in the heat
Navigating from ‘heroic’ leadership to a distributed leadership model in a virtual community of practice
Get PDFThird space workers face the dual forces of an often-flexible working space yet a tendency for their work to be ill-defined and for them to become professionally isolated. This case study discusses how a virtual Community of Practice (vCoP) acted against these challenges by allowing a group of professionals (Learning Developers) in a third space field to connect, experiment, and build collective identity. We further suggest that the approach we took can be emulated by other third space groups. However, we also evidence how our successes were contingent on the Distributed Leadership (DL) model we adopted. The way in which CoPs function (Wenger, 1998) was important to the formation of DL theory (Spillane, Halverson and Diamond, 2001). Vice versa, DL has been argued as facilitative for CoPs by allowing them to be self-driven by members’ interests, abilities, and willingness (Lester and Kezar, 2017). This article documents how DL became increasingly important through three critical junctures for our vCoP: formation, evolving identity, and leadership transfer. We show how power was progressively and beneficially transferred away from the founding coordinator, yet also demonstrate how coordination remained equally important as the vCoP matured. Not least, we argue that a careful balance of coordination and distribution is required to allow a CoP to evolve while holding true to its initial values and purpose. We urge third space professionals considering forming or participating in a CoP to attend carefully to both these elements of a DL model to safeguard the ethos of their CoP. <br/
An open-source multi-semantic annotation dataset and automated recognition tool for viral carcinogenesis factors
Get PDFIn-depth investigations into the characteristics of high-risk oncogenic viruses are critical for the early prevention and control of related cancers and the development of effective vaccines. The mechanism of viral carcinogenesis involves numerous risk factors such as viral genomic variations, lifestyle, and environmental influences. Based on literature data on eight oncogenic viruses, we have created a large-scale, semantically rich corpus of viral carcinogenic factors, including 551715 abstracts and 5821308 entities, using natural language processing technology combined with expert knowledge. We also developed a semantic filter to improve entity recognition performance. Moreover, transcriptomic data related to oncogenic viruses were collected. We performed gene differential expression analysis, feature gene identification, and immune microenvironment analysis. A visual knowledge platform, an open-source dataset, and a tool for automatically identifying internal and external semantic factors related to viral carcinogenesis are available at http://www.biomedinfo.cn:8281/. This study provides new insights into the key factors involved in the viral carcinogenesis process and helps researchers and clinicians quickly obtain clues for further experimental research and clinical validation.</p
'This may not reach you …’: letters as a location of narrative in Elizabeth Bowen’s fiction
No full textElizabeth Bowen writes in ‘Notes on Writing a Novel’ that ‘[n]othing can happen nowhere. The locale of the happening always colours the happening, and often, to a degree, shapes it’. Letters in Elizabeth Bowen’s novels, however, often occupy a liminal space – a ‘nowhere’, perhaps – they are often lost, and sometimes found. They play an important role in in the narrative of much of her fiction from delayed letters in The Hotel, hidden letters in The Little Girls, to an undeliverable letter in Eva Trout, or Changing Scenes. Lost, delayed, or found, the letters in Bowen’s fiction serve a narrative function; they impart knowledge, or the emotions of the letter writer secure, perhaps, in the knowledge that the letter won’t reach its intended recipient. They provide information about events and characters, and serve often to provide the impetus of the plot (which, according to Bowen, is the essential element of a novel – in fact, as she writes, ‘[t]he Pre-Essential’ element of good fiction.) These are letters which disrupt, and deliberately confuse; their late arrival may lead to misunderstanding and confusion, or might, by the withholding of the name of the narrattee, as in A World of Love, give rise to the emotions of envy and greed. Through a discussion of a number of letters, this paper will trace Bowen’s use of this narrative device, questioning and discussing their relevance to the furtherance of plot, as Bowen continues to experiment with form and function
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