Gut Microbiota and Biomarkers of Endothelial Dysfunction in Cirrhosis

Our aim was to study the association of endothelial dysfunction biomarkers with cirrhosis manifestations, bacterial translocation, and gut microbiota taxa. The fecal microbiome was assessed using 16S rRNA gene sequencing. Plasma levels of nitrite, big endothelin-1, asymmetric dimethylarginine (ADMA), presepsin, and claudin were measured as biomarkers of endothelial dysfunction, bacterial translocation, and intestinal barrier dysfunction. An echocardiography with simultaneous determination of blood pressure and heart rate was performed to evaluate hemodynamic parameters. Presepsin, claudin 3, nitrite, and ADMA levels were higher in cirrhosis patients than in controls. Elevated nitrite levels were associated with high levels of presepsin and claudin 3, the development of hemodynamic circulation, hypoalbuminemia, grade 2-3 ascites, overt hepatic encephalopathy, high mean pulmonary artery pressure, increased abundance of Proteobacteria and Erysipelatoclostridium, and decreased abundance of Oscillospiraceae, Subdoligranulum, Rikenellaceae, Acidaminococcaceae, Christensenellaceae, and Anaerovoracaceae. Elevated ADMA levels were associated with higher Child-Pugh scores, lower serum sodium levels, hypoalbuminemia, grade 2-3 ascites, milder esophageal varices, overt hepatic encephalopathy, lower mean pulmonary artery pressure, and low abundance of Erysipelotrichia and Erysipelatoclostridiaceae. High big endothelin-1 levels were associated with high levels of presepsin and sodium, low levels of fibrinogen and cholesterol, hypocoagulation, increased Bilophila and Coprobacillus abundances, and decreased Alloprevotella abundance.

Usability and feasibility of PreventS-MD web app for stroke prevention

BACKGROUND

Most strokes and cardiovascular diseases (CVDs) are potentially preventable if their risk factors are identified and well controlled. Digital platforms, such as the PreventS-MD web app (PreventS-MD) may aid health care professionals (HCPs) in assessing and managing risk factors and promoting lifestyle changes for their patients.

METHODS

This is a mixed-methods cross-sectional two-phase survey using a largely positivist (quantitative and qualitative) framework. During Phase 1, a prototype of PreventS-MD was tested internationally by 59 of 69 consenting HCPs of different backgrounds, age, sex, working experience, and specialties using hypothetical data. Collected comments/suggestions from the study HCPs in Phase 1 were reviewed and implemented. In Phase 2, a near-final version of PreventS-MD was developed and tested by 58 of 72 consenting HCPs using both hypothetical and real patient (n = 10) data. Qualitative semi-structured interviews with real patients (n = 10) were conducted, and 1 month adherence to the preventive recommendations was assessed by self-reporting. The four System Usability Scale (SUS) groups of scores (0-50 unacceptable; 51-68 poor; 68-80.3 good; >80.3 excellent) were used to determine usability of PreventS-MD.

FINDINGS

Ninety-nine HCPs from 27 countries (45% from low- to middle-income countries) participated in the study, and out of them, 10 HCPs were involved in the development of PreventS before the study, and therefore were not involved in the survey. Of the remaining 89 HCPs, 69 consented to the first phase of the survey, and 59 of them completed the first phase of the survey (response rate 86%), and 58 completed the second phase of the survey (response rate 84%). The SUS scores supported good usability of the prototype (mean score = 80.2; 95% CI [77.0-84.0]) and excellent usability of the final version of PreventS-MD (mean score = 81.7; 95% CI [79.1-84.3]) in the field. Scores were not affected by the age, sex, working experience, or specialty of the HCPs. One-month follow-up of the patients confirmed the high level of satisfaction/acceptability of PreventS-MD and (100%) adherence to the recommendations.

INTERPRETATION

The PreventS-MD web app has a high level of usability, feasibility, and satisfaction by HCPs and individuals at risk of stroke/CVD. Individuals at risk of stroke/CVD demonstrated a high level of confidence and motivation in following and adhering to preventive recommendations generated by PreventS-MD.

Hydrogen Inhalation Reduces Lung Inflammation and Blood Pressure in the Experimental Model of Pulmonary Hypertension in Rats

Hydrogen has been shown to exhibit selective antioxidant properties against hydroxyl radicals, and exerts antioxidant and anti-inflammatory effects. The monocrotaline-induced model of pulmonary hypertension is suitable for studying substances with antioxidant activity because oxidative stress is induced by monocrotaline. On day 1, male Wistar rats were subcutaneously injected with a water-alcohol solution of monocrotaline or a control with an only water-alcohol solution. One group of monocrotaline-injected animals was placed in a plastic box that was constantly ventilated with atmospheric air containing 4% of molecular hydrogen, and the two groups of rats, injected with monocrotaline or vehicle, were placed in boxes ventilated with atmospheric air. After 21 days, hemodynamic parameters were measured under urethane narcosis. The results showed that, although hydrogen inhalation had no effect on the main markers of pulmonary hypertension induced by monocrotaline injection, there was a reduction in systemic blood pressure due to its systolic component, and a decrease in TGF-β expression, as well as a reduction in tryptase-containing mast cells.

Screening for Pregnancy-Related Anxiety: Evaluation of the Pregnancy-Related Anxiety Scale-Screener Using Rasch Methodology

Pregnancy-related anxiety has been linked to many maternal and child-related negative outcomes. However, there is an absence of free, well-validated screeners for this condition. The Pregnancy-related Anxiety Scale-Screener (PrAS-Screener) was evaluated using robust Rasch methodology. This study also aimed to develop a shorter version to meet the need of settings governed by professional guidelines stipulating the use of brief instruments. Data from 400 pregnant women (M_age = 27.82, SD = 5.38) were subjected to Rasch analyses and the resulting Rasch models confirmed in a second sample (N = 400, M_age = 26.29, SD = 4.95). After minor modifications, the original 15-item PrAS-Screener demonstrated good fit, unidimensionality, excellent targeting, invariance, and internal consistency. After removal of items with content overlap, an 11-item version was developed, with this version showing good fit, unidimensionality, reasonable targeting, and sound internal consistency. The PrAS-Screeners show promise as psychometrically sound clinical scales for screening pregnancy-related anxiety.

A novel approach to investigate depression symptoms in the aging population using generalizability theory

As depression is common in older people and confers significant risk for dementia, its accurate assessment is essential. The 15-item Geriatric Depression Scale (GDS-15) is a widely used assessment tool for measuring depression in aged populations, and its psychometric properties have been recently improved using Rasch analysis. However, its temporal reliability and ability to distinguish between dynamic and enduring symptoms of depression have not been examined using the appropriate methodology. Generalizability theory (G theory) is a suitable method to distinguish between enduring and dynamic symptoms of depression and to evaluate the reliability of the GDS-15 scores and sources of measurement error. We applied G theory to the longitudinal GDS-15 data of 354 participants from the Sydney Memory and Ageing Study, collected biennially over 10 years, from individuals aged 70 years and older. The GDS-15 demonstrated strong reliability and generalizability of its test scores in measuring enduring symptoms of depression (G_a = 0.82, G_r = 0.90) across the sample population and occasions, and indicated that depression scores significantly increased over time. In addition, three identified dynamic symptoms of depression, namely helplessness, hopelessness, and loss of interest in activities, did not affect the overall reliability of the GDS-15. Thus, the GDS-15 is a reliable measure for assessing enduring symptoms of depression and can be used to evaluate the efficacy of depression treatments and monitor depression levels over time in older adults. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Cross-cultural validation of the stroke riskometer using generalizability theory

The Stroke Riskometer mobile application is a novel, validated way to provide personalized stroke risk assessment for individuals and motivate them to reduce their risks. Although this app is being used worldwide, its reliability across different countries has not yet been rigorously investigated using appropriate methodology. The Generalizability Theory (G-Theory) is an advanced statistical method suitable for examining reliability and generalizability of assessment scores across different samples, cultural and other contexts and for evaluating sources of measurement errors. G-Theory was applied to the Stroke Riskometer data sampled from 1300 participants in 13 countries using two-facet nested observational design (person by item nested in the country). The Stroke Riskometer demonstrated strong reliability in measuring stroke risks across the countries with coefficients G relative and absolute of 0.84, 95%CI [0.79; 0.89] and 0.82, 95%CI [0.76; 0.88] respectively. D-study analyses revealed that the Stroke Riskometer has optimal reliability in its current form in measuring stroke risk for each country and no modifications are required. These results suggest that the Stroke Riskometer's scores are generalizable across sample population and countries permitting cross-cultural comparisons. Further studies investigating reliability of the Stroke Riskometer over time in longitudinal study design are warranted.

Atomic Layer Deposition of Ni-Co-O Thin-Film Electrodes for Solid-State LIBs and the Influence of Chemical Composition on Overcapacity

Nanostructured metal oxides (MOs) demonstrate good electrochemical properties and are regarded as promising anode materials for high-performance lithium-ion batteries (LIBs). The capacity of nickel-cobalt oxides-based materials is among the highest for binary transition metals oxide (TMOs). In the present paper, we report the investigation of Ni-Co-O (NCO) thin films obtained by atomic layer deposition (ALD) using nickel and cobalt metallocenes in a combination with oxygen plasma. The formation of NCO films with different ratios of Ni and Co was provided by ALD cycles leading to the formation of nickel oxide (a) and cobalt oxide (b) in one supercycle (linear combination of a and b cycles). The film thickness was set by the number of supercycles. The synthesized films had a uniform chemical composition over the depth with an admixture of metallic nickel and carbon up to 4 at.%. All samples were characterized by a single NixCo1-xO phase with a cubic face-centered lattice and a uniform density. The surface of the NCO films was uniform, with rare inclusions of nanoparticles 15–30 nm in diameter. The growth rates of all films on steel were higher than those on silicon substrates, and this difference increased with increasing cobalt concentration in the films. In this paper, we propose a method for processing cyclic voltammetry curves for revealing the influence of individual components (nickel oxide, cobalt oxide and solid electrolyte interface—SEI) on the electrochemical capacity. The initial capacity of NCO films was augmented with an increase of nickel oxide content.

Is the Rivermead Post-Concussion Symptoms Questionnaire a Reliable and Valid Measure to Assess Long-Term Symptoms in Traumatic Brain Injury and Orthopedic Injury Patients? A Novel Investigation Using Rasch Analysis

Persistent post-concussion syndrome (PCS) symptoms are known to last years after traumatic brain injury (TBI), and similar symptoms are increasingly being documented among those who have not experienced a TBI. There remains however, a dearth of empirical evidence on the structural composition of symptoms beyond the post-acute symptom phase after TBI, and little is known about the potential use of PCS symptom scales to measure PCS-like symptoms in non-TBI individuals. Our objective was therefore to examine the psychometric performance and dimensionality of the Rivermead Post-Concussion Symptoms Questionnaire (RPQ) as a measure of long-term PCS symptoms among a TBI and non-TBI sample. A case-control sample of 223 patients with injury, consisting of age- and sex-matched TBI participants (n = 109) and orthopedic participants (n = 114) were recruited from a regional trauma registry in New Zealand (NZ), and assessed at mean 2.5 years post-injury. Results from the Rasch analysis showed that the RPQ achieved fit to the Rasch model, demonstrating very good reliability (Person Separation Index [PSI] = 0.87), thereby indicating that the measure can be used reliably for individual and group assessment of symptoms among both TBI and orthopedic patients. In this study we demonstrated evidence of a unidimensional construct of PCS symptoms in both groups, which helps alleviate previous uncertainty about factor structure, and permits the calculation of a total RPQ score. Conversion of ordinal to interval total scores presented within are recommended for clinicians and researchers, to improve instrument precision, and to facilitate the interpretation of change scores and use of parametric methods in data analysis.

The pregnancy-related anxiety scale: A validity examination using Rasch analysis

BACKGROUND

Pregnancy-related anxiety is increasingly recognised as a common condition that is associated with many deleterious outcomes for both the mother and infant (e.g., preterm birth, postnatal depression). Limitations in the psychometric properties and/or breadth of existing scales for pregnancy-related anxiety highlight the need for a psychometrically sound measure to facilitate effective screening and possible early interventions. The recently developed Pregnancy-related Anxiety Scale (PrAS) was evaluated using Rasch analysis to explore how the scale's psychometric properties could be fine-tuned.

METHOD

A sample of 497 pregnant women completed the PrAS. Data were subjected to Rasch analysis, and the resulting scale structure examined using Confirmatory Factor Analysis.

RESULTS

After minor modifications, the Rasch model with 33-items and 8-factors demonstrated good fit, unidimensionality and excellent targeting and internal consistency. Confirmatory Factor Analysis confirmed the final structure, and Cronbach's alpha demonstrated excellent reliability.

LIMITATIONS

The use of the same sample for all analyses was a potential limitation due to the possibility of sample-specific influences.

CONCLUSIONS

The Rasch analysis further supports the internal construct validity of the PrAS. Ordinal to interval score conversions provide added precision to the analysis of the PrAS scores. The Rasch results, together with previous validation evidence, point to the PrAS as a comprehensive and psychometrically sound screening scale for pregnancy-related anxiety. The PrAS offers clinicians the ability to screen for pregnancy-related anxiety. The subscales provide additional insights into a woman's pregnancy-related anxiety and her specific areas of concern, enabling more targeted interventions.

Dimensionality and scaling properties of the Patient Categorisation Tool in patients with complex rehabilitation needs following acquired brain injury

OBJECTIVE

To investigate the scaling properties of the Patient Categorisation Tool (PCAT) as an instrument to measure complexity of rehabilitation needs.

DESIGN

Psychometric analysis in a multicentre cohort from the UK national clinical database.

PATIENTS

A total of 8,222 patents admitted for specialist inpatient rehabilitation following acquired brain injury.

METHODS

Dimensionality was explored using principal components analysis with Varimax rotation, followed by Rasch analysis on a random sample of n = 500.

RESULTS

Principal components analysis identified 3 components explaining 50% of variance. The partial credit Rasch model was applied for the 17-item PCAT scale using a "super-items" methodology based on the principal components analysis results. Two out of 5 initially created super-items displayed signs of local dependency, which significantly affected the estimates. They were combined into a single super-item resulting in satisfactory model fit and unidimensionality. Differential item functioning (DIF) of 2 super-items was addressed by splitting between age groups (<65 and ≥ 65 years) to produce the best model fit (χ2/df = 54.72, p = 0.235) and reliability (Person Separation Index (PSI) = 0.79). Ordinal-to-interval conversion tables were produced.

CONCLUSION

The PCAT has satisfied expectations of the unidimensional Rasch model in the current sample after minor modifications, and demonstrated acceptable reliability for individual assessment of rehabilitation complexity.

Rasch Analysis of the Edmonton Symptom Assessment System

CONTEXT

The Edmonton Symptom Assessment System (ESAS) is a widely used multisymptom assessment tool in cancer and palliative care settings, but its psychometric properties have not been widely tested using modern psychometric methods such as Rasch analysis.

OBJECTIVES

To apply Rasch analysis to the ESAS in a community palliative care setting and determine its suitability for assessing symptom burden in this group.

METHODS

ESAS data collected from 229 patients enrolled in a community hospice service were evaluated using a partial credit Rasch model with RUMM2030 software (RUMM Laboratory Pty, Ltd., Duncraig, WA). Where disordered thresholds were discovered, item rescoring was undertaken. Rasch model fit and differential item functioning were evaluated after each iterative phase.

RESULTS

Uniform rescoring was necessary for all 12 items to display ordered thresholds. The best model fit was achieved after item rescoring and combining three pairs of locally dependent items into three superitems (χ² = 29.56 [27]; P = 0.33) that permitted ordinal-to-interval conversion.

CONCLUSION

The ESAS satisfied unidimensional Rasch model expectations in a 12-item format after minor modifications. This included uniform rescoring of the disordered response categories and creating superitems to improve model fit and clinical utility. The accuracy of the ESAS scores can be improved by using ordinal-to-interval conversion tables published in the article.

Sympathoinhibitory action of rilmenidine in conscious sinoaortically denervated rats

The responses of mean arterial pressure (MAP), heart rate (HR), and renal sympathetic nerve activity (RSNA) to rilmenidine administration and changes in these responses after idazoxan or yohimbine pretreatment were investigated in conscious sinoaortically denervated rats. Intravenous (i.v.) injection of rilmenidine (300 and 600 micrograms/kg) dose-dependently reduced MAP (16 and 24%, respectively) and RSNA (31 and 56%, respectively), whereas bradycardia was similar at both doses of the drug. Intracisternal (i.c.) pretreatment with idazoxan (5 micrograms/kg), alpha 2-adrenoceptor antagonist with a high affinity to imidazoline receptors (IR) prevented rilmenidine-induced decreases in MAP but not in RSNA and HR. Rilmenidine (300 micrograms/kg i.c.) significantly decreased MAP by 24%, RSNA by 32%, and HR by 13%. Pretreatment with idazoxan (1 microgram/kg i.c.) significantly attenuated the hypotensive and sympathoinhibitory effects of rilmenidine, whereas i.c. pretreatment with equimolar to 10-fold higher doses of yohimbine, an alpha 2-antagonist that binds poorly with IR, did not. Both idazoxan and yohimbine failed to affect the rilmenidine-induced bradycardia, however. We concluded that (a) rilmenidine exhibits more marked hypotensive effect when injected i.c. than when injected i.v., (b) a part of the inhibitory effect of i.v.-injected rilmenidine on RSNA may be exerted through idazoxan-insensitive mechanisms which might be activated by peripheral action of the drug, and (c) the hypotensive action of rilmenidine relates more to the interaction with IR than with alpha 2-adrenoceptors.