A Retrospective Study Assessing the Effect of Infections in Myocardial Infarction Patients: Mortality and Complications

Background: There is a well-established relationship between myocardial infarction and infection. Multiple articles describe the increased risk of myocardial infarction, both type 1 and 2, following an infectious process. However few articles have described the relation between concomitant myocardial infarction and infections on same admission mortality and complications. Methods: The aim is to assess the effect of an acquired or concomitant infection on complications and mortality during hospitalized cases of myocardial infarction. 1197 patients of different types of myocardial infarction were studied in correlation to infectious processes. Cultures from different sites were collected and isolation of various bacterial agents were studied. Mortality and various complications were compared between infected and non-infected subjects. Pearson's chi squared test was used to compare percentages (or the Fisher exact test when expected values were lower than 5). Moreover, means were compared through ANOVA, after checking data normality and homoscedasticity. A likelihood ratio backward stepwise method was used to conduct dichotomous logistic regressions, taking dichotomous outcomes as dependent variables, and sociodemographic and biological characteristics as independent variables (potential confounders).Results: Wound, sputum, blood and urine infections were associated with increased same admission mortality and complications. Microorganisms were then studied alone regardless of the site of infection and it was shown that Escherichia Coli, Escherichia Coli ESBL, Candida Albicans, Pseudomonas Aeruginosa and Staphylococcus of any type were significantly associated with same admission complications when associated with myocardial infarction. Length of stay was significantly elevated in patients with concomitant infection and it increased with the addition of positive cultures from different sites. Conclusion: Concomitant infections with myocardial infarction significantly increase the risk of same admission complications, mortality and length of stay regardless of the site of infection and type of microorganisms.

Do Personality Traits Influence the Association Between Depression and Dementia in Old Age?

Depression and personality traits are independent predictors of dementia or cognitive impairment. Despite the well-established relationship between these two psychosocial factors and dementia, no research has been documented on how personality traits can influence dementia in older adults exhibiting depressive symptoms. This study explores the influence of personality traits on the association between change in depression and dementia in old age. A population-based longitudinal cohort study involving two waves of data collected 5 years apart, containing 2210 American older adults, from the National Social Life, Health, and Aging Project to explore if personality traits influence how change in depression predicts the development of dementia. We assessed these relationships while adjusting for sociodemographic characteristics. Change in depression increased the likelihood of dementia at T2 by 4.2% (AOR = 1.04, p = 0.019) in the co-variate adjusted model. Personality traits, overall, did not influence how depression predicts the development of dementia. However, agreeableness individually nullified the effect of depression on the development of dementia, whereas extraversion was the only personality trait that significantly predicted dementia. Prosocial behaviors should be promoted in old age as these appear to be protective. In addition, early life education and a strong social support can keep the depression–dementia spectrum at bay in old age.

My Manager Moved! Manager Mobility and Subordinates’ Career Outcomes

How do managers’ moves across jobs affect the subordinates they leave behind? Manager mobility disrupts established manager-subordinate relationships, as subordinates must now learn to work with a replacement. We explore how this relational disruption affects subordinates’ objective career success—specifically, their financial rewards and subsequent promotion chances. We argue that manager mobility may have both positive and negative implications for subordinate outcomes. The loss of an established relationship may reduce subordinates’ performance and managers’ propensity to reward them; on the other hand, relational disruption may make subordinates more willing and able to seek out valuable opportunities elsewhere in the organization. We also argue that these effects are likely to be greatest for those subordinates who had worked with the previous manager for longer. Using eight years of personnel data from the U.S. offices of a Fortune 500 healthcare company, we show how managers’ mobility is associated with a decrease in subordinates’ financial rewards but an increase in their promotion prospects.

Variability of the Sea Surface Microlayer Across a Filament’s Edge and Potential Influences on Gas Exchange

Major uncertainties in air-sea gas flux parameterizations may arise from a yet unpredictable sea surface microlayer (SML). Its influence on gas exchange is twofold as organic matter, in particular surfactants, on one side and organisms enriched in the SML on the other can alter air-sea gas fluxes. However, spatial heterogeneity of the SML and its potential consequences for gas exchange are not well understood. This study examines the SML’s surfactant pool and the dynamics of microbial enrichment across the sharp hydrological front of a newly upwelled filament off Mauritania. The front was marked by a distinct decrease in temperature and salinity compared to the stratified water column outside the filament. Distinct chemical and microbial SML properties were observed and associated with the filament. Overall, organic matter in the SML was significantly higher concentrated inside the filament and in equivalence to the underlying water. Degradation indices derived from total amino acids (TAA) composition indicated production of fresh organic matter inside and increased degradation outside the filament. Moreover, a shift in the microbial community was observed, for instance Synechococcus spp. prevailed outside the filament. Autotrophic and heterotrophic microorganisms preferably colonized the SML outside the filament. Organic matter enrichment in the SML depended largely on the chemical nature of biomolecules. Total organic carbon (TOC), total nitrogen and total combined carbohydrates were only slightly enriched while glucose, TAA and surfactants were considerably enriched in the SML. Surfactant concentration was positively correlated to TAA, in particular to arginine and glutamic acid, indicating that fresh organic matter components enhanced surface activity. Further, TOC and surfactant concentration correlated significantly (r2 = 0.47, p-value < 0.001). The lower limit of this linear correlation hits approximately the lowest TOC concentration expected within the global surface ocean. This suggests that surfactants are primarily derived from autochthonous production and most refractory components are excluded. Using a previously established relationship between surfactants and CO2 gas exchange (Pereira et al., 2018), we estimated that surfactants suppressed gas exchange by 12% inside the filament. This could be of relevance for freshly upwelled filaments, which are often supersaturated in greenhouse gases.

Ideology and utopia: the national state structure of the USSR (presented on the example of the North Caucasus territories)

The model of the national-state and territorial structure of the USSR was implemented in strict accordance with the Marxist-Leninist theory of socioeconomic formations. According to this theory, every society goes through several stages of development: the primitive system, slavery, feudalism, capitalism, and communism. This is a naturally progressive process. Based on the works of Engels, Soviet scientists created a theory of the development of ethnic communities. Each formation had to correspond to a certain type of ethnic group. Guided by the "right of nations to self-determination," each nation was to receive its own statehood. This model existed before the collapse of the USSR. Since the 1980s it began to crumble, various ethnic groups, or rather their elites, were dissatisfied with their status. The autonomous regions of the North Caucasus began to transform into republics. The republics wanted to get the status of an ally. Administrative transformations did not improve the economy and living standards but on the contrary, led to increased bureaucratic growth. However, National Societies believed that the key was to appoint “their own” (a person with whom they had an established relationship and understanding) boss. Different peoples within the same autonomy often clashed. At the end of the twentieth-century tensions grew in the North Caucasus. It became obvious that the formation of territorial units along ethnic lines did not justify itself, however, this structure is preserved at the present time due to the fear of destabilization of the situation.

The single copy of the gravitational holonomy

The double copy is a well-established relationship between gravity and gauge theories. It relates perturbative scattering amplitudes as well as classical solutions, and recently there has been mounting evidence that it also applies to non-perturbative information. In this paper, we consider the holonomy properties of manifolds in gravity and prescribe a single copy of gravitational holonomy that differs from the holonomy in gauge theory. We discuss specific cases and give examples where the single copy holonomy group is reduced. Our results may prove useful in extending the classical double copy. We also clarify previous misconceptions in the literature regarding gravitational Wilson lines and holonomy.

Specialised dental services and referral pathways

The term ‘oral health’ not only defines a state of being free from oral and facial pain, diseases and disorders, but alsoencapsulates the impact that such disease may have on an individual’s quality of life, considering both the functional (biting, chewing, smiling, speaking) and psychosocial aspects of wellbeing. Despite the well-established relationship between oral health and overall health and wellbeing, the separation of medicine and dentistry, both educationally and organisationally, results in unmet health needs and poorer patient outcomes. This article aims to give an overview of available dental services, referral pathways and how general practitioner and dentists can work together to provide holistic, patient-centred care.

Patients’ Perspectives of Telemedicine Appointments for Psoriatic Arthritis During The COVID-19 Pandemic: Results of a Patient-Driven Pilot Survey

BackgroundOver recent years the lack of patient involvement in the design, set-up and implementation of clinical research studies has been well recognised; as such there has been a drive within research communities to increase patient participation. Anecdotally, patient perspectives on telemedicine differ widely, with variation in whether patients feel remote consultations are beneficial. By means of a patient-driven survey, we aimed to formally evaluate patient perspectives on its benefits and pitfalls, focusing on patients with psoriatic arthritis (PsA).MethodsAn e-survey was developed by two patient representatives on the BritPACT steering committee, with a view to determining unmet needs and the perceived impact on clinical care of virtual consultations amongst patients with PsA. Results128 patients responded to the e-survey. 109 patients rated the effectiveness of their telemedicine appointment and, of these, 18% felt their virtual consultation was very/extremely effective compared to a face-to-face consultation and 49% felt it was somewhat/equally as effective; furthermore, 48% (51/107) felt that such virtual consultations would be of benefit to them after the pandemic. 36% of respondents felt their virtual consultation was not as effective as a face-to-face review. Themes identified from open-ended questions included the lack of visual cues, lack of physical examination and effect on rapport and ease of open communication as the main pitfalls of virtual consultations. Patients with well-controlled symptoms appeared more satisfied with remote reviews compared to those with active disease, though on the whole respondents recognised the benefits, such as saving travel time and costs. Those who had an established relationship with their health professional appeared less concerned regarding virtual consultations though a recurring view was that newly diagnosed patients should have face-to-face appointments to build rapport and improve symptom control at an early stage.ConclusionsOverall patients’ perspectives on virtual consultations varied widely though patients with well-controlled symptoms and those who had a previously established relationship with their healthcare professionals and well-controlled disease appeared more satisfied with remote reviews. Patient-driven surveys may improve our true understanding of patients’ perspectives by improving engagement and honesty compared to surveys constructed by healthcare providers.

INFLUENCE OF DRUGS "IMUNOFAN" AND "FOSPRENIL" ON MORPHOLOGICAL COMPOSITION OF BLOOD OF CALVES

The aim of the work was to study the effect of immunomodulators "Imunofan" and "Fosprenil" on the intensity of nitric oxide (II) formation and the morphological composition of blood in calves. Increased levels of stable nitric oxide (II) metabolites in the blood plasma of calves after the use of immunomodulators indicates the participation of NO in nonspecific immunity reactions. Also the established relationship between the level of stable nitric oxide (II) metabolites and the number of stab neutrophils proves that NO is one of the regulators of neutrophil activity.

Obesity paradox in joint replacement for osteoarthritis — truth or paradox?

Obesity is associated with an increased risk of cardiovascular disease (CVD) and other adverse health outcomes. In patients with pre-existing heart failure or coronary heart disease, obese individuals have a more favourable prognosis compared to individuals who are of normal weight. This paradoxical relationship between obesity and CVD has been termed the ‘obesity paradox’. This phenomenon has also been observed in patients with other cardiovascular conditions and diseases of the respiratory and renal systems. Taking into consideration the well-established relationship between osteoarthritis (OA) and CVD, emerging evidence shows that overweight and obese individuals undergoing total hip or knee replacement for OA have lower mortality risk compared with normal weight individuals, suggesting an obesity paradox. Factors proposed to explain the obesity paradox include the role of cardiorespiratory fitness (“fat but fit”), the increased amount of lean mass in obese people, additional adipose tissue serving as a metabolic reserve, biases such as reverse causation and confounding by smoking, and the co-existence of older age and specific comorbidities such as CVD. A wealth of evidence suggests that higher levels of fitness are accompanied by prolonged life expectancy across all levels of adiposity and that the increased mortality risk attributed to obesity can be attenuated with increased fitness. For patients about to have joint replacement, improving fitness levels through physical activities or exercises that are attractive and feasible, should be a priority if intentional weight loss is unlikely to be achieved.