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Metabolism Open Jun 2023In rodents, glomerular expression of insulin receptor substrate 1 (IRS1) is decreased in diabetic kidney disease (DKD) and reduced associated functioning is involved in...
BACKGROUND
In rodents, glomerular expression of insulin receptor substrate 1 (IRS1) is decreased in diabetic kidney disease (DKD) and reduced associated functioning is involved in the development and progression of DKD. This study aimed to evaluate the significance of glomerular IRS1 expression in DKD patients, and investigated whether glomerular IRS1 expression can reflect renal pathology and predict renal outcomes.
METHODS
This study included 10 patients who underwent renal biopsy and were diagnosed with DKD or minor glomerular abnormality (MGA). IRS1-positive cells were determined based on renal biopsy and immunostaining, and the associations of the number of these cells with baseline and prognostic parameters were analyzed.
RESULTS
IRS1-positive cells were significantly decreased in DKD than in MGA. IRS1 positivity tended to be negatively correlated with global glomerulosclerosis and tubulointerstitial fibrosis. The rate of change in estimated glomerular filtration rate before and 12 months after renal biopsy was positively correlated to the number of IRS1-positive cells. Furthermore, a tendency towards negative correlation was observed between the number of glomerular IRS1-positive cells and the proteinuria.
CONCLUSIONS
This study shows the glomerular IRS1-positive cell count was significantly decreased in DKD, and that the degree IRS1 positivity was partially correlated with renal pathology and function.
PubMed: 37025096
DOI: 10.1016/j.metop.2023.100240 -
Journal of Psychopathology and Clinical... Jan 2022In the present study we examined loneliness among individuals with and without social anxiety disorder (SAD), contexts that may moderate the experience of loneliness,...
In the present study we examined loneliness among individuals with and without social anxiety disorder (SAD), contexts that may moderate the experience of loneliness, and the temporal relationship between loneliness and social anxiety. We examined 88 individuals (44 with SAD and 44 without SAD) and used experience sampling (ES) methods, comprising of real-time measurement of naturally occurring events and participants' emotional reactions to them during participants' daily lives over the course of 21 days. Hierarchical linear models indicated that individuals with SAD reported significantly more loneliness compared to individuals without SAD. We also found that characteristics of social situations (negativity, positivity, and meaningfulness) were all positively and significantly associated with loneliness among individuals with SAD. Thus, social situations that were experienced as more negative, more positive, and more meaningful all resulted in increased loneliness for individuals with SAD. We also found a significant Positivity × Meaningfulness interaction that indicated that the effect of positivity was attenuated when meaningfulness was high. Notably, none of these effects were found for individuals without SAD. Finally, we found that for individuals with SAD, both anxiety and loneliness predicted changes in each other and combined to form a deleterious cycle. However, evidence for such a cycle was not found for individuals without SAD. The role of loneliness in the psychopathology of SAD and its maintenance, as well as clinical implications are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
Topics: Anxiety; Anxiety Disorders; Humans; Loneliness; Phobia, Social; Psychopathology
PubMed: 34843268
DOI: 10.1037/abn0000705 -
Acta Psychologica May 2023The need to further our understanding of positive affect dysregulation in depression has been widely acknowledged. Two related relevant concepts in this realm, are...
The need to further our understanding of positive affect dysregulation in depression has been widely acknowledged. Two related relevant concepts in this realm, are Avoidance Of Positivity (AOP; referring to avoidance behaviour towards positivity) and Fear Of Positivity (FOP; referring to anxious or unpleasant feelings related to positivity). However, traditionally manifestations of AOP and FOP are considered in isolation, and self-report scales used to measure both concepts show considerable content overlap. Therefore, the first study aim was to examine how AOP and FOP relate to one another, depressive symptomatology and anhedonia, through new clearly delineated scales. For exploratory purposes, general and state-specific versions were developed. The second aim was to uncover beliefs that underlie the tendency towards AOP/FOP. An adult community sample (n = 197) completed online measures of AOP, FOP, depressive symptoms and anhedonia, and answered open-ended questions about reasons for AOP and FOP. Cross-sectionally, preliminary evidence was found for AOP and FOP being positively associated with one another, depressive symptomatology and anhedonia. Even after controlling for depressive symptomatology, anhedonia remained positively associated with AOP and FOP. So, AOP and FOP may be viable candidate mechanisms maintaining anhedonia that are worth further investigation and may be appropriate to target during treatment. Answers to the open-ended questions (n = 77) reflected various beliefs underlying AOP/FOP, which were broader than simply anticipating negative consequences of feeling positive and also touched on themes of unworthiness and social inappropriateness of feeling positive. Some theoretical and clinical implications of different beliefs underlying AOP/FOP are discussed.
Topics: Adult; Humans; Anhedonia; Emotions; Fear; Anxiety; Self Report
PubMed: 37018932
DOI: 10.1016/j.actpsy.2023.103901 -
Frontiers in Psychology 2020Previous studies indicated that the balance of positive to negative affect (i.e., positivity ratio) is associated with subjective well-being and flourishing in the...
Previous studies indicated that the balance of positive to negative affect (i.e., positivity ratio) is associated with subjective well-being and flourishing in the general population. Moreover, a positivity ratio of 2.9 is considered a critical value discriminating between flourishing and non-flourishing individuals. To date, however, there is limited research on the positivity ratio on samples of teachers. The present study aimed to investigate whether the positivity ratio affects work engagement and well-being among teachers. Based on the broaden-and-build theory (Fredrickson, 2001) and work engagement model (Bakker and Demerouti, 2007), we predicted that positivity ratio (the ratio between positive and negative emotions) experienced by teachers would increase their work engagement, which in turn would positively affect their well-being. A sample of 1,335 teachers (762 women and 573 men) from Romania participated in the study. Results revealed that work engagement mediated the relationship between positivity ratio and well-being. Specifically, teachers with a higher ratio of positive to negative emotions reported more engagement (dedication, absorption, and vigor) and in consequence higher levels of subjective well-being (autonomy, environmental mastery, personal growth, self-acceptance, positive relations with others and purpose in life). Also, when investigating the positivity ratio according to participants' well-being, we found a mean of positivity ratio of 2.84 for the group of teachers with high levels of well-being, validating the proposed critical positivity ratio of 2.9. These findings support the importance of addressing positive emotions and positivity ratio in prevention and intervention programs with teachers.
PubMed: 32793041
DOI: 10.3389/fpsyg.2020.01608 -
Microbiology Spectrum Sep 2021Both the QuantiFERON-TB Gold Plus (QFT-Plus) and the QuantiFERON-TB Gold In-Tube (QFT-GIT) tests are interferon gamma (IFN-γ) release assays (IGRAs) intended to detect...
Both the QuantiFERON-TB Gold Plus (QFT-Plus) and the QuantiFERON-TB Gold In-Tube (QFT-GIT) tests are interferon gamma (IFN-γ) release assays (IGRAs) intended to detect cell-mediated immune responses to Mycobacterium tuberculosis antigens. In this study, we retrospectively analyzed performance data for both the QFT-GIT and QFT-Plus test systems from over 2 million samples. QFT-Plus and QFT-GIT testing was performed as specified in the respective package inserts at 23 Quest Diagnostics sites. Blood specimens were collected from individuals in all 50 states from November 2018 through December 2019. Retrospective analyses compared the proportion of positive, indeterminate, and conversion/reversion results. The overall proportion of QFT-positive results was 7% for both the QFT-Plus and QFT-GIT. The proportion of positive results was highest for QFT-GIT (7.5%) followed by the heparin 1-tube QFT-Plus (7.2%); a lower proportion of positives was observed with the 4-tube (all four QFT tubes were used in blood collection) QFT-Plus (6.0%). The proportions of indeterminate results for the 1-tube (heparin-only tube collection) and 4-tube QFT-Plus methods were less than 1% and 4%, respectively. This study indicates a higher proportion of positive results for M. tuberculosis than data from other studies. Additionally, the proportion of indeterminate QFT results were markedly lower when the sample was transported in one lithium-heparin tube instead of direct inoculation into 4 QFT-Plus tubes at the site of blood collection. In this study, we retrospectively analyzed results from both the QFT-GIT and QFT-Plus test systems from over 2 million blood specimens. The variables analyzed were (i) QFT positivity rates among various U.S. populations, (ii) indeterminate rates among various types of blood draws and how often an indeterminate result was resolved within 30 days after the initial draw, and (iii) the association of TB1 and TB2 antigen tubes with IGRA reversion and conversion events from serial QFT testing. This is, to our knowledge, the largest QFT study representing patients from an extensive geographic coverage across the United States and U.S. territories.
Topics: Adolescent; Adult; Aged; Antigens, Bacterial; Child; Child, Preschool; Female; Humans; Infant; Infant, Newborn; Interferon-gamma Release Tests; Male; Middle Aged; Mycobacterium tuberculosis; Retrospective Studies; Tuberculosis; United States; Young Adult
PubMed: 34319139
DOI: 10.1128/Spectrum.00096-21 -
Spatial and Spatio-temporal Epidemiology Aug 2020Identifying areas with low access to testing and high case burden is necessary to understand risk and allocate resources in the COVID-19 pandemic. Using zip code level... (Comparative Study)
Comparative Study
Identifying areas with low access to testing and high case burden is necessary to understand risk and allocate resources in the COVID-19 pandemic. Using zip code level data for New York City, we analyzed testing rates, positivity rates, and proportion positive. A spatial scan statistic identified clusters of high and low testing rates, high positivity rates, and high proportion positive. Boxplots and Pearson correlations determined associations between outcomes, clusters, and contextual factors. Clusters with less testing and low proportion positive tests had higher income, education, and white population, whereas clusters with high testing rates and high proportion positive tests were disproportionately black and without health insurance. Correlations showed inverse associations of white race, education, and income with proportion positive tests, and positive associations with black race, Hispanic ethnicity, and poverty. We recommend testing and health care resources be directed to eastern Brooklyn, which has low testing and high proportion positives.
Topics: Adult; Aged; Aged, 80 and over; COVID-19; COVID-19 Testing; Clinical Laboratory Techniques; Cluster Analysis; Communicable Diseases, Emerging; Coronavirus Infections; Disease Outbreaks; Female; Health Status Disparities; Healthcare Disparities; Humans; Male; Middle Aged; New York City; Pandemics; Pneumonia, Viral; Risk Assessment; Spatial Analysis; Urban Health; Urban Population
PubMed: 32807400
DOI: 10.1016/j.sste.2020.100355 -
Sexually Transmitted Diseases Jul 2017Repeat chlamydia detection after treatment is common, and there is concern that treatment failure may be a cause. (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Repeat chlamydia detection after treatment is common, and there is concern that treatment failure may be a cause.
METHODS
Within a randomized trial, we established a prospective cohort of 600 participants with anogenital chlamydia diagnoses (200 each of women, heterosexual men, and men who have sex with men [MSM]). Participants were invited for repeat testing at 3 months and to complete a behavioral survey at 4 months. Positive samples were analyzed for organism DNA load and genovar. We estimated repeat chlamydia positivity, reinfection and treatment failure rates, and investigated the biological and behavioral factors associated with a repeat positive test.
RESULTS
A total of 290 participants (100 women, 89 heterosexual men, 101 MSM) were retested at 1 to 4 months, with 43 repeat positives, including 26 classed as reinfection and 9 as treatment failures. Comparing MSM with heterosexual men and women combined, repeat positivity was higher (20.8% vs 11.6%, P = 0.04), and treatment failure was higher (6.9% vs 1.1%, P = 0.01), but there was no difference in reinfection rates (11.9% vs 7.4%, P = 0.21). Among MSM, the odds of repeat positivity increased by 90% with each additional log organism load in the original specimen (baseline) (adjusted odds ratio, 1.9; 95% confidence interval, 1.1-3.2). Among heterosexuals, the odds of repeat positivity decreased by 10% with each additional week delay in being retested for chlamydia (adjusted odds ratio, 0.9; 95% confidence interval, 0.8-0.9).
CONCLUSIONS
Positive retests were more common among MSM than heterosexuals. Treatment failure was more common in MSM with rectal chlamydia, reinforcing concerns about azithromycin treatment failure.
Topics: Adult; Anti-Bacterial Agents; Australia; Azithromycin; Chlamydia Infections; Chlamydia trachomatis; Female; Follow-Up Studies; Genital Diseases, Female; Genital Diseases, Male; Heterosexuality; Homosexuality, Male; Humans; Male; Mass Screening; Patient Compliance; Prospective Studies; Rectal Diseases; Recurrence; Treatment Failure; Young Adult
PubMed: 28608791
DOI: 10.1097/OLQ.0000000000000616 -
PloS One 2015Diagnostic clinical prediction rules (CPRs) are developed to improve diagnosis or decrease diagnostic testing. Whether, and in what situations diagnostic CPRs improve... (Comparative Study)
Comparative Study Meta-Analysis Review
BACKGROUND
Diagnostic clinical prediction rules (CPRs) are developed to improve diagnosis or decrease diagnostic testing. Whether, and in what situations diagnostic CPRs improve upon clinical judgment is unclear.
METHODS AND FINDINGS
We searched MEDLINE, Embase and CINAHL, with supplementary citation and reference checking for studies comparing CPRs and clinical judgment against a current objective reference standard. We report 1) the proportion of study participants classified as not having disease who hence may avoid further testing and or treatment and 2) the proportion, among those classified as not having disease, who do (missed diagnoses) by both approaches. 31 studies of 13 medical conditions were included, with 46 comparisons between CPRs and clinical judgment. In 2 comparisons (4%), CPRs reduced the proportion of missed diagnoses, but this was offset by classifying a larger proportion of study participants as having disease (more false positives). In 36 comparisons (78%) the proportion of diagnoses missed by CPRs and clinical judgment was similar, and in 9 of these, the CPRs classified a larger proportion of participants as not having disease (fewer false positives). In 8 comparisons (17%) the proportion of diagnoses missed by the CPRs was greater. This was offset by classifying a smaller proportion of participants as having the disease (fewer false positives) in 2 comparisons. There were no comparisons where the CPR missed a smaller proportion of diagnoses than clinical judgment and classified more participants as not having the disease. The design of the included studies allows evaluation of CPRs when their results are applied independently of clinical judgment. The performance of CPRs, when implemented by clinicians as a support to their judgment may be different.
CONCLUSIONS
In the limited studies to date, CPRs are rarely superior to clinical judgment and there is generally a trade-off between the proportion classified as not having disease and the proportion of missed diagnoses. Differences between the two methods of judgment are likely the result of different diagnostic thresholds for positivity. Which is the preferred judgment method for a particular clinical condition depends on the relative benefits and harms of true positive and false positive diagnoses.
Topics: Bias; Decision Support Techniques; Disease; Humans; Judgment; Risk Factors
PubMed: 26039538
DOI: 10.1371/journal.pone.0128233 -
Journal of Thrombosis and Haemostasis :... Sep 2020High incidence of thrombosis in COVID-19 patients indicates a hypercoagulable state. Hence, exploring the involvement of antiphospholipid antibodies (aPL) in these...
BACKGROUND
High incidence of thrombosis in COVID-19 patients indicates a hypercoagulable state. Hence, exploring the involvement of antiphospholipid antibodies (aPL) in these patients is of interest.
OBJECTIVES
To illustrate the incidence of criteria (lupus anticoagulant [LAC], anticardiolipin [aCL] immunoglobulin G [IgG]/IgM, antibeta2-glycoprotein I antibodies [aβ2GPI] IgG/IgM) and noncriteria (anti-phosphatidyl serine/prothrombin [aPS/PT], aCL, and aβ2GPI IgA) aPL in a consecutive cohort of critically ill SARS-CoV-2 patients, their association with thrombosis, antibody profile and titers of aPL.
PATIENTS/METHODS
Thirty-one consecutive confirmed COVID-19 patients admitted to the intensive care unit were included. aPL were measured at one time point, with part of the aPL-positive patients retested after 1 month.
RESULTS
Sixteen patients were single LAC-positive, two triple-positive, one double-positive, one single aCL, and three aCL IgG and LAC positive. Seven of nine thrombotic patients had at least one aPL. Sixteen of 22 patients without thrombosis were aPL positive, amongst them two triple positives. Nine of 10 retested LAC-positive patients were negative on a second occasion, as well as the double-positive patient. Seven patients were aPS/PT-positive associated to LAC. Three patients were aCL and aβ2GPI IgA-positive.
CONCLUSION
Our observations support the frequent single LAC positivity during (acute phase) observed in COVID-19 infection; however, not clearly related to thrombotic complications. Triple aPL positivity and high aCL/aβ2GPI titers are rare. Repeat testing suggests aPL to be mostly transient. Further studies and international registration of aPL should improve understanding the role of aPL in thrombotic COVID-19 patients.
Topics: Adult; Aged; Aged, 80 and over; Antibodies, Anticardiolipin; Antibodies, Antiphospholipid; Antiphospholipid Syndrome; Blood Coagulation; COVID-19; Critical Care; Critical Illness; Female; Humans; Immunoglobulin G; Immunoglobulin M; Intensive Care Units; Lupus Coagulation Inhibitor; Male; Middle Aged; Prothrombin; Thrombosis; beta 2-Glycoprotein I
PubMed: 32619328
DOI: 10.1111/jth.14994 -
Journal of Pathology Informatics 2021Human immunodeficiency virus (HIV) screening has improved significantly in the past decade as we have implemented tests that include antigen detection of p24....
BACKGROUND
Human immunodeficiency virus (HIV) screening has improved significantly in the past decade as we have implemented tests that include antigen detection of p24. Incorporation of p24 detection narrows the window from 4 to 2 weeks between infection acquisition and ability to detect infection, reducing unintentional spread of HIV. The fourth- and fifth-generation HIV (HIV5G) screening tests in low prevalence populations have high numbers of false-positive screens and it is unclear if orthogonal testing improves diagnostic and public health outcomes.
METHODS
We used a cohort of 60,587 HIV5G screening tests with molecular and clinical correlates collected from 2016 to 2018 and applied machine learning to generate a classifier that could predict likely true and false positivity.
RESULTS
The best classification was achieved by using support vector machines and transformation of results with principle component analysis. The final classifier had an accuracy of 94% for correct classification of false-positive screens and an accuracy of 92% for classification of true-positive screens.
CONCLUSIONS
Implementation of this classifier as a screening method for all HIV5G reactive screens allows for improved workflow with likely true positives reported immediately to reduce infection spread and initiate follow-up testing and treatment and likely false positives undergoing orthogonal testing utilizing the same specimen already drawn to reduce distress and follow-up visits. Application of machine learning to the clinical laboratory allows for workflow improvement and decision support to provide improved patient care and public health.
PubMed: 34934521
DOI: 10.4103/jpi.jpi_7_21