Levetiracetam Prophylaxis Therapy for Brain Tumor-Related Epilepsy (BTRE) Is Associated With a Higher Psychiatric Burden

Purpose: Brain tumor-related epilepsy (BTRE) is a condition characterized by the development of seizures in the context of an undergoing oncological background. Levetiracetam (LEV) is a third-generation anti-seizure medication (ASM) widely used in BTRE prophylaxis. The study evaluated LEV neuropsychiatric side effects (SEs) in BTRE prophylaxis.Method: Twenty-eight patients with brain tumors were retrospectively selected and divided into two groups. In one group, we evaluated patients with a BTRE diagnosis using LEV (BTRE-group). The other group included patients with brain tumors who never had epilepsy and used a prophylactic ASM regimen with LEV (PROPHYLAXIS-group). Neuropsychiatric SEs of LEV were monitored using the Neuropsychiatric Inventory Questionnaire (NPI-Q) at the baseline visit and the 6- and 12-month follow-up.Results: Eighteen patients of the BTRE-group and 10 patients of the PROPHYLAXIS-group were included. Compared to the BTRE-group, the PROPHYLAXIS-group showed a higher severity of neuropsychiatric symptoms. According to Linear Mixed Models (LMM), a multiplicative effect was observed for the interaction between group treatment and time. For the caregiver distress score (CDS), only a time-effect was observed.Conclusion: Prophylactic ASM with LEV is associated with an increased frequency of neuropsychiatric SE. Accurate epileptological evaluations in patients with brain tumors are mandatory to select who would benefit most from ASM.

Individual and joint effects of trehalose and glutamate on diabetic retinopathy: a propensity score-matched case-control study

Although previous studies demonstrate that trehalose can help maintain glucose homeostasis in healthy humans, its role and joint effect with glutamate on diabetic retinopathy (DR) remain unclear. We aimed to comprehensively quantify the associations of trehalose and glutamate with DR. This study included 69 pairs of DR and matched type 2 diabetic (T2D) patients. Serum trehalose and glutamate were determined via ultra-performance liquid chromatography-electrospray ionization-tandem mass spectrometry system. Covariates were collected by a standardized questionnaire, clinical examinations and laboratory assessments. Individual and joint association of trehalose and glutamate with DR were quantified by multiple conditional logistic regression models. The adjusted odds of DR averagely decreased by 86% [odds ratio (OR): 0.14; 95% confidence interval (CI): 0.06,0.33] with per interquartile range increase of trehalose. Comparing with the lowest quartile, adjusted OR (95% CI) were 0.20 (0.05,0.83), 0.14 (0.03,0.63) and 0.01 (<0.01,0.05) for participants in the 2nd, 3rd and 4th quartiles of trehalose, respectively. In addition, as compared to their counterparts, T2D patients with lower trehalose (<median) and higher glutamate (≥ median) had the highest odds of DR (OR: 36.81; 95% CI: 6.75, 200.61). Apparent super-multiplicative effect of trehalose and glutamate on DR was observed, whereas relative excess risk due to interaction (RERI) was not significant. The study suggests that trehalose is beneficial to inhibit the occurrence of DR and synergistically decreases the risk of DR with reduced glutamate. Our findings also provide new insights into the mechanisms of DR and further longitudinal studies are required to confirm these findings.

Wage Dynamics and Economic Growth: Russian Realities

The article deals with the relationship between the economic growth of Russia and the dynamics of average wages. A joint analysis of wages, GDP, salary output and labor productivity in the Russian Federation for the period 2000–2019 was carried out. The type and parameters of the regression equations connecting these indicators are determined. The analysis allows us to conclude that it is advisable to increase real wages, despite the accompanying slow growth of labor productivity and a decrease in salary. The main argument in favor of this statement is the multiplicative effect that occurs when the average salary in the economy increases. The paper shows that the increase in wages, in addition to the usually taken into account direct multiplicative effect, determined by an increase in the disposable income of the population, there is an additional induced multiplicative effect. The induced effect is explained by the increase in economic activity of the population proved on the Russian statistics with the growth of wages, which leads to an increase in the number of employees, and hence the wage fund and, accordingly, personal disposable income. Thus, by increasing wages, it is possible to improve the financial situation of the employed population, attract additional labor resources to the economy, and achieve GDP growth. The article presents calculations that allow us to estimate the contribution of the direct and induced multiplicative effect to the GDP of Russia for the period of 2000–2017. Based on these calculations, it can be argued that in the Russian Federation at the beginning of the XXI century, the gross domestic product, due to the multiplicative effect of changes in average wages in the first year after such a change, increased or decreased in some years by 6–7%. Although the induced multiplicative effect, as it turned out, is relatively small, there is no reason to neglect it. At the current very low rate of GDP growth, one has to take into account every tenth of a percent of such growth, and calculations have shown that the induced effect calculated for the first year after the change in wages in the period under review reached 0,6% of GDP. The calculations also showed that due to the increase in labor activity associated with an increase in the average salary, the number of people employed in the “white” labor market in Russia in some years increased by about 1%.

Public policy on city center revitalization based on the Town Centre Management concept

Nowadays, it is impossible to ensure sustainable development of the state without using innovative policies of territorial development, one of which is a city revitalization policy. This article defines the main causes of city center degradation and typical approaches to revitalizing city centers in Europe and North America. The New Urbanism principles are outlined as regards city center revitalization, with an emphasis on their potential importance for sustainable urban development. The evolution of Town Centre Management (TCM) and the features of its application are characterized by authors with a focus on the mechanisms of anti-crisis management professionalization in the conditions of degrading city centers. A model of the public policy on city center revitalization based on the TCM concept is presented, which envisages the functioning of a TCM manager (office) of (with a list of the main tasks); objectives and the sequence of policy implementation stages; application of tools for public participation and a public-private partnership in this process; city center revival through an integrated effect on various spheres (community, economy, space and environment), and, as a result, achievement of a multiplicative effect for the promotion and development of the entire city. The study used a set of general scientific and specialized methods that are based on the modern scientific principles of public administration and its related sciences (geography, economics, sociology, culturology, etc.), and interdisciplinary and systematic approaches.

Association between multimorbidity and mortality in a cohort of patients admitted to hospital with COVID-19 in Scotland

Objectives We investigated the association between multimorbidity among patients hospitalised with COVID-19 and their subsequent risk of mortality. We also explored the interaction between the presence of multimorbidity and the requirement for an individual to shield due to the presence of specific conditions and its association with mortality. Design We created a cohort of patients hospitalised in Scotland due to COVID-19 during the first wave (between 28 February 2020 and 22 September 2020) of the pandemic. We identified the level of multimorbidity for the patient on admission and used logistic regression to analyse the association between multimorbidity and risk of mortality among patients hospitalised with COVID-19. Setting Scotland, UK. Participants Patients hospitalised due to COVID-19. Main outcome measures Mortality as recorded on National Records of Scotland death certificate and being coded for COVID-19 on the death certificate or death within 28 days of a positive COVID-19 test. Results Almost 58% of patients admitted to the hospital due to COVID-19 had multimorbidity. Adjusting for confounding factors of age, sex, social class and presence in the shielding group, multimorbidity was significantly associated with mortality (adjusted odds ratio 1.48, 95%CI 1.26–1.75). The presence of multimorbidity and presence in the shielding patients list were independently associated with mortality but there was no multiplicative effect of having both (adjusted odds ratio 0.91, 95%CI 0.64–1.29). Conclusions Multimorbidity is an independent risk factor of mortality among individuals who were hospitalised due to COVID-19. Individuals with multimorbidity could be prioritised when making preventive policies, for example, by expanding shielding advice to this group and prioritising them for vaccination.

Development of a method for estimating the effect of transformation of the normalized frequency mismatch function of a coherent bundle of radio pulses on the quality of radar frequency resolution

The necessity of studying the influence of the transformation of the frequency mismatch function of a coherent bundle of radio pulses on the quality of solving the radar frequency resolution problem is substantiated. This solution determines the effectiveness of radar observation of high-speed and maneuvering individual and group aerodynamic objects. The method is based on explicit expressions for calculating the normalized frequency mismatch function of a coherent bundle of radio pulses, taking into account its transformation due to the radial motion of high-speed and maneuvering individual and group aerodynamic objects. The estimation of the potential frequency resolution of bundles with different numbers of radio pulses with typical parameters for a coherent pulse radar is carried out. Possible values of frequency resolution under the additive effect of uncorrelated internal noise of the radar receiver and the multiplicative effect of correlated phase fluctuations of the radar signal are estimated. With an insignificant multiplicative effect of correlated phase fluctuations, a twofold increase in the number of radio pulses in a bundle provides an improvement in the frequency resolution (reduction of the width of the normalized frequency mismatch function) by 100 %. With the predominant multiplicative effect of these fluctuations, a twofold increase in the number of radio pulses results in an improvement in the frequency resolution by about 40 %. The developed method is of great theoretical and practical importance for the further development of the radar theory of high-speed and maneuvering individual and group aerodynamic objects.

Psychological pressure and compounded errors during elite-level tennis

Objectives: In the context of Grand Slam tennis, we sought to examine how situational pressure and prior errors can disrupt subsequent performance in elite performers. Methods: A retrospective analysis of more than 650,000 points across 12 Grand Slam tennis tournaments from 2016-2019 was conducted to identify pressurised in-game moments and unforced errors. A scoring system was used to index situational pressure based on the current match situation (e.g., break points, stage of the match) on a point-by-point basis. The occurrence of performance errors was identified based on double faults and unforced errors, as instances of controllable mistakes. Results: A mixed effects logistic regression model revealed that an increase in the pressure index (a 1-5 score) significantly increased the probability of a performance error (ps&lt;.001), as did an error on the preceding point (OR=1.2, 95%CI [1.17, 1.23], p&lt;.001). A multiplicative effect of pressure and prior errors also emerged, as the negative impact of prior errors on performance was greater when situational pressure was already high, in line with the predictions of Attentional Control Theory: Sport (ACTS). Analyses of the distribution of winners and unforced errors across individual players revealed that winning players were as susceptible to pressure and prior errors as losing players. Conclusions: These findings extend our understanding of how ongoing feedback from prior mistakes may further exacerbate the effects of pressure on performance.

Combination of vaping, cannabis and smoking exposure: shorter time to bullous lung disease and pneumothorax

We present a 25-year-old Hispanic man with left-sided pleuritic chest pain and dyspnea for three days. His Chest radiograph and CTA revealed bilateral apical bullous disease with a 2.5 cm deep left sided pneumothorax. He was managed with 100% oxygen via non-rebreather mask and did not require invasive decompression. Patient reported a one-year history of vaping along with tobacco and cannabis smoking exposure from his late teen years. The pneumothorax improved and he was discharged to the pulmonary clinic. The authors review the multiplicative effect of vaping on smoking cannabis and tobacco leading to early apical bullous lung disease. Patients with such significant smoking/vaping history may benefit from prolonged pulmonary and addiction medicine follow-up given the clinical bullous lung disease and risk for continued smoking/vaping. The case emphasizes the potential exponential effect of combining vaping with tobacco and marijuana smoke on lung health leading to disease at extremely young ages.

Increased Transmissibility of SARS-CoV-2 Lineage B.1.1.7 by Age and Viral Load: Evidence from Danish Households

Aim The aim of this study was to estimate the household transmissibility of SARSCoV-2 for lineage B.1.1.7 compared with other lineages, by age and viral load. Furthermore, we wanted to estimate whether there is a multiplicative or additive effect of the increased transmissibility of B.1.1.7 compared with other lineages. Background New lineages of SARS-CoV-2 are of potential concern due to higher transmissibility, risk of severe outcomes, and/or escape from neutralizing antibodies. Lineage B.1.1.7 has been estimated to be more transmissible than other previously known lineages, but the association between transmissibility and risk factors, such as age of primary case and viral load is still unknown. Methods We used comprehensive administrative data from Denmark, comprising the full population, all SARS-CoV-2 RT-PCR tests, and all WGS lineage data (January 11 to February 7, 2021), to estimate household transmissibility stratified by lineage B.1.1.7 and other lineages. Results We included 5,241 households with primary cases; 808 were infected with SARS-CoV-2 lineage B.1.1.7 and 4,433 were infected with other lineages. The attack rate was 38% in households with a primary case infected with B.1.1.7 and 27% in households with a primary case infected with other lineages. Primary cases infected with B.1.1.7 had an increased transmissibility of 1.5-1.7 times that of primary cases infected with other lineages. The increased transmissibility of B.1.1.7 was multiplicative across age and viral load. Conclusions The results found in this study add new knowledge that can be used to mitigate the further spread of SARS-CoV-2 lineage B.1.1.7, which is becoming increasingly widespread in numerous countries. Our results clarify that the transmissibility of B.1.1.7 should be included as a multiplicative effect in mathematical models used as a tool for decision makers. The results may have important public health implications, as household transmission may serve as a bridge between otherwise separate transmission domains, such as schools and physical workplaces, despite implemented non-pharmaceutical interventions.