Investigating two mobile just-in-time adaptive interventions to foster psychological resilience: research protocol of the DynaM-INT study.

BACKGROUND: Stress-related disorders such as anxiety and depression are highly prevalent and cause a tremendous burden for affected individuals and society. In order to improve prevention strategies, knowledge regarding resilience mechanisms and ways to boost them is highly needed. In the Dynamic Modelling of Resilience - interventional multicenter study (DynaM-INT), we will conduct a large-scale feasibility and preliminary efficacy test for two mobile- and wearable-based just-in-time adaptive interventions (JITAIs), designed to target putative resilience mechanisms. Deep participant phenotyping at baseline serves to identify individual predictors for intervention success in terms of target engagement and stress resilience. METHODS: DynaM-INT aims to recruit N = 250 healthy but vulnerable young adults in the transition phase between adolescence and adulthood (18-27 years) across five research sites (Berlin, Mainz, Nijmegen, Tel Aviv, and Warsaw). Participants are included if they report at least three negative burdensome past life events and show increased levels of internalizing symptoms while not being affected by any major mental disorder. Participants are characterized in a multimodal baseline phase, which includes neuropsychological tests, neuroimaging, bio-samples, sociodemographic and psychological questionnaires, a video-recorded interview, as well as ecological momentary assessments (EMA) and ecological physiological assessments (EPA). Subsequently, participants are randomly assigned to one of two ecological momentary interventions (EMIs), targeting either positive cognitive reappraisal or reward sensitivity. During the following intervention phase, participants' stress responses are tracked using EMA and EPA, and JITAIs are triggered if an individually calibrated stress threshold is crossed. In a three-month-long follow-up phase, parts of the baseline characterization phase are repeated. Throughout the entire study, stressor exposure and mental health are regularly monitored to calculate stressor reactivity as a proxy for outcome resilience. The online monitoring questionnaires and the repetition of the baseline questionnaires also serve to assess target engagement. DISCUSSION: The DynaM-INT study intends to advance the field of resilience research by feasibility-testing two new mechanistically targeted JITAIs that aim at increasing individual stress resilience and identifying predictors for successful intervention response. Determining these predictors is an important step toward future randomized controlled trials to establish the efficacy of these interventions.

Transfer of innovation on allergic rhinitis and asthma multimorbidity in the elderly (MACVIA-ARIA) - EIP on AHA Twinning Reference Site (GARD research demonstration project).

The overarching goals of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA) are to enable European citizens to lead healthy, active and independent lives whilst ageing. The EIP on AHA includes 74 Reference Sites. The aim of this study was to transfer innovation from an app developed by the MACVIA-France EIP on AHA reference site (Allergy Diary) to other reference sites. The phenotypic characteristics of rhinitis and asthma multimorbidity in adults and the elderly will be compared using validated information and communication technology (ICT) tools (i.e. the Allergy Diary and CARAT: Control of Allergic Rhinitis and Asthma Test) in 22 Reference Sites or regions across Europe. This will improve the understanding, assessment of burden, diagnosis and management of rhinitis in the elderly by comparison with an adult population. Specific objectives will be: (i) to assess the percentage of adults and elderly who are able to use the Allergy Diary, (ii) to study the phenotypic characteristics and treatment over a 1-year period of rhinitis and asthma multimorbidity at baseline (cross-sectional study) and (iii) to follow-up using visual analogue scale (VAS). This part of the study may provide some insight into the differences between the elderly and adults in terms of response to treatment and practice. Finally (iv) work productivity will be examined in adults.

Histiocytic necrotising lymphadenitis in mediastinum mimicking thymoma or lymphoma - case presentation and literature review of Kikuchi Fujimoto disease.

Kikuchi Fujimoto disease (KFD) as a rare self-limiting lymphadenopathy of short and benign course concerns most frequently the lymph nodes of the neck. The most common symptoms are painfulness of the diseased area, fever and night sweating. The etiology is not well understood, but in the role of pathogenesis viral, autoimmune and genetic factors are taken into account. In the presented case of 37-year-old female it was necessary to exclude diseases such as lymphoma or thymoma because of atypical mediastinal location of Kikuchi Fujimoto disease. After multidisciplinary consultation the lymph node was resected from the mediastinum with videothoracoscopic approach. The diagnosis was difficult for the pathologist because of the large percentage of necrosis of the lymph node but the image was typical for histiocytic necrotizing lymphadenitis. Two cases of patients with KFD limited to the mediastinum have been previously reported in the literature. This article presents the world's first reported case of this disease in the topographic location of the thymus. Furthermore, a review of current literature was made.

Unbounded Violation of Quantum Steering Inequalities.

We construct steering inequalities that exhibit unbounded violation. The concept was to exploit the relationship between steering violation and the uncertainty relation. To this end, we apply mutually unbiased bases and anticommuting observables, known to exhibit the strongest uncertainty. In both cases, we are able to procure unbounded violations. Our approach is much more constructive and transparent than the operator space theory approach employed to obtain large violation of Bell inequalities. Importantly, using anticommuting observables we are able to obtain a dichotomic steering inequality with unbounded violation. Thus far, there is no analogous result for Bell inequalities. Interestingly, both the dichotomic inequality and one of our inequalities cannot be directly obtained from existing uncertainty relations, which strongly suggest the existence of an unknown kind of uncertainty relation.

Bidirectional scatter measurements of a guided-mode resonant filter photonic crystal structure.

This work investigates the Bidirectional Scatter Distribution Function (BSDF) at incident angles other than normal and at 544-nm wavelength of a Guided Mode Resonance Filter (GMRF) Photonic Crystal (PC) structure designed for normally incident light at 532 nm. Strong out-coupling of PC diffraction orders into both the transmitted and reflected hemispheres was observed specifically at a 25.7° incidence angle, which we attribute to this incident angle/wavelength pair being a good match to the ( ± 1, 0) PC grating mode. BSDF measurements at incident angles of 15° and 35° also displayed some out-coupled diffraction, though much lower in magnitude, and are also attributed to being a weaker match to the ( ± 1, 0) PC grating mode. Three-dimensional finite-difference time-domain Maxwell's equation simulations demonstrate that since this GMRF was designed for complete destructive interference of the transmitted light upon normal incidence, stronger out-coupling of the diffraction is expected for modal solutions as the angle of incidence increases.

Occupational asthma due to spruce wood.

Workers exposed to a variety of wood dusts are known to experience work-related respiratory symptoms, including occupational asthma. There are, however, few reports of occupational asthma due to spruce wood. We present the case of a 31-year-old sawmill owner with severe asthma caused by exposure to spruce wood dust, who developed asthmatic symptoms after 2 years of working. Investigations included clinical examination, routine laboratory tests, spirometry, chest X-ray, total serum immunoglobulin E (IgE) and specific serum IgEs against various woods and other occupational allergens. Additionally, we monitored the peak expiratory flow rate (PEFR) and symptom score both at work and when off work. Specific serum IgE for spruce wood was detected (7.8 IU/ml). The results of PEFR and workplace symptom-score monitoring, coupled with an elevated eosinophil count in induced sputum, supported the diagnosis of occupational asthma. To our knowledge, this is the first well-documented case of occupational asthma induced by spruce wood dust. A type I immunological mechanism seems to be responsible.

Interventricular interaction as a possible mechanism for the presence of a biphasic systolic velocity profile in normal left ventricular free walls.

BACKGROUND: In normal subjects, systolic longitudinal regional velocity profiles (SVP) (measured both based on pulsed or tissue Doppler) have a non-uniform pattern. SVP from the right ventricle (RV), the septal (Sep) and the inferior wall are similar in shape and tend to be monophasic. Their shape differs markedly from the lateral wall (LW), the posterior wall and the anterior wall, which are biphasic. We studied the hypothesis that the double-peaked SVP in the left ventricular free walls are caused by interventricular interaction. This might have additional implication in understanding the measurements of the timing of SVP maxima in pathology as, for example, used to determine intraventricular dyssynchrony in heart failure. METHODS: 38 healthy individuals underwent a standard echo examination and a tissue Doppler study. SVP from the RV, Sep and LW basal segments were acquired in an apical four-chamber view. The amplitude and timing of the peak velocities were measured. If a double peak was present, the amplitude and timing of the dip was calculated. RESULTS: RV and Sep had a single systolic velocity peak, while the LW had two peaks with a clear dip between both peaks. The first peak in the LW was the earliest event in the cycle (119 (19) ms) followed by the peak Sep (123 (20) ms; p = 0.34). Peak RV velocity occurred at the same time as the dip in the LW (200 (30) vs 203 (30) ms, respectively; p = 0.53). CONCLUSION: Our study suggests that the biphasic SVP in the free walls is probably caused by interventricular interaction. Therefore the timing of maxima on SVP should be used with great caution when looking for intraventricular dyssynchrony as the peaks are influenced by RV function.

One or two drains after lobectomy? A comparison of both methods in the immediate postoperative period.

BACKGROUND: The conventional method of double chest tube drainage after lobectomy is well established. The aim of the study was to compare the efficacy of the two-drain versus the single-drain approach after this procedure. METHODS: The data of 183 consecutive patients who underwent lobectomy between January 2000 and May 2005 were analyzed: 93 had two drains and 90 had a single, midposition drain. All patients were operated on by one surgeon with the same surgical technique. RESULTS: Patients with one drain had a shorter hospital stay (7.6 days vs. 9.0 days; P = 0.001). There were no significant differences in the amount of drainage, the necessity of redrainage or broncho-aspiration, and postoperative mortality or complications. The period in which opioids (4.8 days vs. 5.6 days; P = 0.0001) and nonsteroidal anti-inflammatory drugs (6.8 days vs. 7.7 days; P = 0.002) were required was shorter in patients with one drain. The fourth postoperative day was more painful for patients with a double drain. The cost savings in the one-drain group were approximately 125 Euros per patient. CONCLUSION: A single-drain method is effective, reduces hospitalization times and the cost of treatment in patients who undergo lobectomy.

Surgical treatment of lung cancer in patients under 45 years of age.

AIM: The aim of the study was to evaluate the characteristics and prognosis of radical surgical treatment in young patients under the age of 45 with lung cancer. METHODS: We retrospectively analysed the data of 85 young patients and 211 older patients who underwent anatomical lung resections in Wroclaw Thoracic Surgery Centre. RESULTS: Less lobectomies were performed (p = 0.048), the incidence of carcinoid was significantly higher (p < 0.0001), stage I of lung cancer was observed less frequently (p = 0.023), the frequency of metastasis to subcarinal lymph nodes was higher (p = 0.007), a bronchial stump was microscopically infiltrated more frequently, the complete resection was noted rarer (p = 0.016) and 3-year survival rate of squamous cell carcinoma patients was worse in younger group (p = 0.017). The statistical significance was not observed between the frequency of recurrences and overall survival. CONCLUSIONS: Lung cancer in younger patients seems to be more advanced at the time of surgery. It is probable that the group of younger patients with squamous cell carcinoma will require additional treatment after surgery.

Regional differences in systolic active stress profiles in the normal beating heart. Assessment using an ultrasound based mathematical model.

UNLABELLED: Active stress (sigmaA) developed by cardiac muscle has been measured in isolated muscle preparations, under physiological loading conditions, by subtracting the passive stress (sigmaP) from the total stress (sigmaT). We previously developed a mechanical model based on M-mode ultrasound imaging to calculate these stresses in beating hearts. However, this model was based on one-dimensional imaging information and could not estimate regional differences in sigmaA. In the current study this model was improved by including two-dimensional B-mode echocardiographic data. METHODS: In a porcine model a micro-manometer tipped catheter was used to measure left-ventricular pressure (LVP) and B-mode ultrasound images were recorded in a short-axis view. On the ultrasound image points in the mid-wall were selected and tracked to completely define the deformation of the myocardium. A kinematic model of the LV was then constructed from the displacement vectors of these points. sigmaT was calculated from the LVP. The material parameters for an exponential stress/strain relation were estimated during the diastolic E-wave when it was assumed that sigmaA = 0. These parameters were used to calculate sigmaP during systole and by subtracting this from sigmaT, sigmaA was calculated. RESULTS: The timing and shape of sigmaA profiles match those obtained from isolated muscle experiments. SigmaA was higher and peaked sooner in the posterior wall than in the anterior wall. CONCLUSION: Regional active stress estimation is possible in normal beating hearts.

The effect of recombinant interleukin-8 on eosinophils' and neutrophils' migration in vivo and in vitro.

BACKGROUND: Interleukin-8 (IL-8) is a chemokine that causes chemotaxis of neutrophils, eosinophils and lymphocytes in vitro; however, its role as a chemoattractant in allergic inflammation is unclear. The objective of this study was to investigate the effect of nasal instillation of IL-8 on the influx of inflammatory cells. METHODS: Twelve patients suffering from seasonal allergic rhinitis hypersensitive to grass pollens, with average age 30.1 +/- 2.67 years were challenged both with diluent for IL-8 and IL-8 on a subsequent day, in two phases: before the pollen season (unprimed mucosa) and during the season (primed mucosa). The number of neutrophils, eosinophils and myeloperoxydase (MPO) levels in the nasal fluid collected after IL-8 or placebo challenge were determined. RESULTS: Challenge with IL-8 of primed nasal mucosa induced a significant influx of neutrophils (29 x 10(4) cells/ml at 0.5 h, 251 x 10(4) at 2 h and 334 x 10(4) at 3 h). Number of eosinophils in comparison with diluent challenge was not significant. There was no difference in MPO levels in the nasal lavage between IL-8 and diluent challenge of unprimed and primed mucosa. We did not find the relationship between MPO levels and the neutrophils number in the lavage (rank Spearman factor, RS = 0.258, P = 0.42). CONCLUSION: We have demonstrated that IL-8 causes influx of neutrophils but not eosinophils into nasal mucosa in vivo. MPO level seems to be of little value as a marker of neutrophil influx into nasal mucosa.

Acromegaly due to GHRH-secreting large bronchial carcinoid. Complete recovery following tumor surgery.

A case of acromegaly, secondary to GHRH secretion by a large bronchial carcinoid is reported. A 61-year-old woman presented with typical symptoms and signs of acromegaly for at least 10 years. She suffered from recurrent pneumonias, but repeated chest X-ray examinations failed to demonstrate the bronchial tumor. The diagnosis was confirmed by elevated GH, IGF-1 and GHRH secretion. We have shown an enlarged pituitary gland without focal lesions together with a cerebral meningioma on MRI and the presence of a bronchial carcinoid tumor. The latter was confirmed by histology carried out after bronchoscopy and tumor excision. We observed partial suppression of GH secretion following short-term oral bromocriptine administration in this patient. Surgical removal of the carcinoid tumor resulted in a complete clinical, hormonal and radiological cure of acromegaly. This case of acromegaly due to ectopic GHRH secretion by bronchial carcinoid differs from others described in the literature by an atypical large tumor size, the suppression of elevated GH secretion by oral bromocriptine and a concomitant meningioma.

Structural and Energetic Nonuniformities of Pyrocarbon-Mineral Adsorbents.

Several series of pyrocarbon-mineral adsorbents (carbosils) were studied using the nitrogen adsorption method to compute structural and energetic parameters within the scope of overall adsorption isotherm approximation applying a regularization procedure with consideration for surface heterogeneity. A portion of pyrocarbon deposits (graphene clusters) fills mesopores of the oxide supports, but another portion represents relatively large nonporous pyrocarbon globules formed on the outer surfaces of the oxide matrices. Contributions of these two types of pyrocarbon deposits depend on the nature of oxide matrices and carbonized precursors. The characteristics of pyrocarbon formed on the silica (silica gel, fumed silica) surfaces differ from those for deposits prepared on the surfaces of titania/silica and alumina/silica or by the pyrolysis of metal acetylacetonates (Zr(AcAc)(4), TiO(AcAc)(2), Ni(AcAc)(2), Zn(AcAc)(2), Cr(AcAc)(3), Co(AcAc)(2)) on mesoporous silica gel. The structural and energetic characteristics estimated using the adsorption method with consideration for the adsorbent heterogeneity are fruitful for comparative analysis of the (1)H NMR spectra of water adsorbed on carbosils from the gas phase or unfrozen in the aqueous suspensions at T < 273 K. Copyright 2001 Academic Press.

Symptomatic atrial pacemaker lead thrombosis: detection by echocardiography and successful surgical treatment.

Formation of thrombi on a permanent pacemaker lead is a rare complication of pacing. However, because of its serious outcome it should be suspected in a patient who reveals right-sided heart failure, dyspnea, or syncope. An early decision to perform an echocardiographic examination, followed by surgical or thrombolytic treatment can solve this clinical problem. In a 69-year-old woman with increasing signs of congestive heart failure, echocardiography revealed a mobile mass in the right atrium attached to the pacemaker lead. Because of threatened symptoms and large dimensions of the mass, urgent surgical removal of the endocardial lead was successfully performed.

Revision hip arthroplasty in aseptic loosening of total hip replacement.

Background. Problems encountered during revision hip arthroplasty are presented, based on 30 years of experience at the Orthopedic Clinic of the Medical University of Lodz.
Material and methods. During this period of time 96 cases (5,13%) with aseptic hip loosening were diagnosed. All patients were evaluated clinically based o the Merle d'Aubigne-Postel criteria, and radiologically by means of De Lee and Gruen migration zones.
Results. In our material hip loosening was most frequently observed in cases where a McKee-Farrar hip prosthesis had been used, and in cases with a PM uncemented acetabulum or uncemented Mittelmeier pin.
Conclusions. The study showed that surgical technique plays the most significant role in aseptic loosening of hip replacement. The aseptic loosening of hip prostheses should be diagnosed early, and revision hip arthroplasty should be performed as soon as possible. This surgery must be preformed in specialized centers with adequate equipment and a team of experienced surgeons.

Errors involved in the application of an imperfect peritoneal volume marker.

Peritoneal volume markers have been used in numerous studies on fluid transport in peritoneal dialysis. The basic assumption used was that the macromolecular marker was stable and that the free fraction of a label (usually radiolabel) was negligibly small. In this study are presented theoretical investigations on the errors involved in application of an imperfect volume marker containing free fraction of a label. These investigations were used in assessing the errors in calculation of peritoneal volume time course, V, and fluid absorption rate (estimated by volume marker clearance, kE) using data from 20 clinical dwell studies with 1.36% Dianeal dialysis solution and radioiodinated human serum albumin as a volume marker. It has been shown that with an in vitro measured 125I free fraction of 2.72%, the error of kE estimation was 11%. However, the maximal error in estimation of V was only 0.2%. In conclusion, the performed analysis implies that calculation of the peritoneal volume time course during the dwell (with correction for the volume marker elimination) is very reliable, and the existence of a free fraction of a volume marker label results in a negligibly small error. However, even small free fraction of the label results in a significant overestimation of the fluid absorption rate.

Characterization of Titania/Silica Gel by Means of Low-Pressure Nitrogen Adsorption.

Adsorbents synthesized by grafting of titania onto mesoporous silica gel surfaces at different temperatures were studied by means of nitrogen adsorption-desorption and water desorption. The pore size distribution f(R(p)) of titania/silica gel depends on the titania concentration (C(TiO(2))) and the temperature of titania synthesis. Nonuniformity of TiO(2) phase is maximal at a low C(TiO(2)) value (3.2 wt.% anatase deposited at 473 K), and two peaks of the fractal dimension distribution f(D) are observed at such a concentration of titania, but at larger C(TiO(2)) values, only one f(D) peak is seen. More ordered filling of pores and adsorption sites by nitrogen, reflecting in the shape of adsorption energy distributions f(E) at different pressures of adsorbate, is observed for adsorbent with titania (rutile+anatase) grafted on silica gel at a higher temperature (673 K). Copyright 2000 Academic Press.

Highly Dispersed X/SiO(2) and C/X/SiO(2) (X=Alumina, Titania, Alumina/Titania) in the Gas and Liquid Media.

Fumed oxides, such as silica, alumina, titania, and mixed X/silicas (X=Al(2)O(3) (AS), TiO(2) (TS), CVD-TiO(2), Al(2)O(3)/TiO(2) (AST)), pristine or covered by carbon deposits formed due to pyrolysis of cyclohexene, were studied using nitrogen adsorption-desorption, photon correlation spectroscopy particle sizing, and electrophoresis. A significant influence of the nature of surface-active sites and structural features of oxides (individual silica, mixed fumed, or prepared using chemical vapor deposition (CVD)) on the pyrolysis of cyclohexene is observed with respect to the pore size distributions due to differences between primary particles in aggregates and on their outer surfaces in the filling of channels by pyrocarbon, resulting also in a decrease in fractal dimension. Structural characteristics and dependences of the particle size distribution and electrokinetic potential of X/SiO(2) and C/X/SiO(2) on the pH of aqueous suspensions suggest that the carbon deposit covers mainly acidic sites at the X/SiO(2) interfaces and X phase patches possessing catalytic activity in pyrolysis, as the negative charge of particles is reduced by pyrocarbon grafting. Copyright 2000 Academic Press.

Cigarette consumption and sales of nicotine replacement products.

BACKGROUND: The first nicotine replacement product, Nicorette Gum, was marketed in 1984 as an adjuvant to help smokers quit smoking. In 1992, sales of nicotine patches were begun. Before 1996, nicotine gums and nicotine patches were prescribed by physicians and supplemented with behavioural counselling. Since 1996, nicotine gums and patches became available over the counter. OBJECTIVES: To examine the effect of sales of nicotine replacement products on national cigarette consumption. DESIGN: National time series quarterly cigarette consumption, sales of nicotine gums and patches data between 1976 and 1998 are used to estimate a time series autoregressive moving average intervention model. PARTICIPANTS: National reported statistics. MAIN OUTCOME MEASURES: Per capita cigarette sales. RESULTS: A 10% increase in sales of nicotine replacement products will lead to a 0.04% reduction in cigarette sales. The model indicates that a 0.076% reduction in cigarette consumption is associated with the availability of nicotine patches after 1992. The over the counter dummy variable (after 1996) has a negative sign, but is not significant, perhaps due to only a few quarters of data in the study period. CONCLUSIONS: Nicotine replacement products (nicotine gums and nicotine patches) play a significant role in reducing cigarette consumption, in addition to the negative effect of increasing cigarette price and the overall trend of declining cigarette consumption (as reflected by the time trend variable). The findings of this study suggest that additional efforts for promoting sales of nicotine replacement products will be another effective alternative to discouraging cigarette consumption.