The Association between Personality Factors and Metabolic Parameters among Patients with Non-Alcoholic-Fatty Liver Disease and Type 2 Diabetes Mellitus-A Cross-Sectional Study

BACKGROUND

The increasing prevalence of type 2 diabetes mellitus (T2DM) and non-alcoholic fatty liver disease (NAFLD) states a serious problem for public health. The introduction of effective methods of treatment and prevention is crucial to avoid complications of these diseases. Among them, we can specify psychological factors that affect everyday life and determine the patient's attitude towards therapy, and what follows, their compliance in treatment. The literature indicates these connections in various ways; in our study, we extend this view to include a broader perspective of human personality.

OBJECTIVE

We decided to investigate the associations between personality factors and metabolic parameters in patients with NAFLD and T2DM in order to better understand the patient's approach to the treatment of a chronic disease, such as those mentioned, and to establish the basis for further research implementing psychological interventions in the treatment of NAFLD and T2DM.

METHODS

One hundred participants with NAFLD and T2DM underwent blood tests and anthropometric measures. Each of them was asked to complete five questionnaires evaluating their personality properties.

RESULTS

We revealed that a rise in body mass index is related to a fall in the emotional intelligence factor of utilizing emotions, and a rise in emotional perception. The decrease in task-oriented coping style and a rise in emotion-oriented coping style are associated with a waist-hip ratio increase. The increase in fasting plasma glucose is predicted by a decrease in task-oriented coping style score. A fall in social diversion coping style score is associated with a high-density lipoprotein increase; in turn, a triglycerides increase is connected with a decline in rhythmicity score.

CONCLUSIONS

The personality factors are in relationship in the management of NAFLD and T2DM. They affect a patient's approach to treatment, which is very important, because we know lifestyle and dietary interventions are an important part of the treatment of these diseases. The compliance manifests by lifestyle modifications, taking medications regularly, measuring blood glucose, and inspection visits in outpatients' clinics are a large part of a diabetic's life. Future studies introducing psychological intervention to improve, e.g., coping styles or rhythmicity are needed to implement new methods of patient management.

Exploring the Impact of Nutrition on Non-Alcoholic Fatty Liver Disease Management: Unveiling the Roles of Various Foods, Food Components, and Compounds

There is a need to introduce standardized treatment options for non-alcoholic fatty liver disease (NAFLD) due to its global prevalence and the complications of this disease. Many studies have revealed that food-derived substances may be beneficial in dealing with this disease. Therefore, this review aims to evaluate the recently published studies on the food-derived treatment options for NAFLD. A comprehensive search of the PubMed database using keywords such as "NAFLD", "nutrition", "food", "derived", "therapy", and "guidelines" yielded 219 relevant papers for our analysis, published from 2004 to 2023. The results show the significant benefits of food-derived treatment in NAFLD therapy, including improvements in liver histology, hepatic fat amounts, anthropometric measures, lipid profile, and other metabolic measures. The availability of the substances discussed makes them a significant adjuvant in the treatment of this disease. The usefulness of Viusid as additional therapy to diet and physical activity should be emphasized due to improvements in liver histology; however, many other substances lead to a decrease in liver fat amounts including, e.g., berberine or omega-3 fatty acids. In addition, the synbiotic Protexin seems to be useful in terms of NAFLD treatment, especially because it is effective in both obese and lean subjects. Based on the latest research results, we suggest revising the therapeutic recommendations for patients suffering from NAFLD.

Type 2 Diabetes Mellitus, Non-Alcoholic Fatty Liver Disease, and Metabolic Repercussions: The Vicious Cycle and Its Interplay with Inflammation

The prevalence of metabolic-related disorders, such as non-alcoholic fatty liver disease (NAFLD) and type 2 diabetes mellitus (DM2), has been increasing. Therefore, developing improved methods for the prevention, treatment, and detection of these two conditions is also necessary. In this study, our primary focus was on examining the role of chronic inflammation as a potential link in the pathogenesis of these diseases and their interconnections. A comprehensive search of the PubMed database using keywords such as "non-alcoholic fatty liver disease", "type 2 diabetes mellitus", "chronic inflammation", "pathogenesis", and "progression" yielded 177 relevant papers for our analysis. The findings of our study revealed intricate relationships between the pathogenesis of NAFLD and DM2, emphasizing the crucial role of inflammatory processes. These connections involve various molecular functions, including altered signaling pathways, patterns of gene methylation, the expression of related peptides, and up- and downregulation of several genes. Our study is a foundational platform for future research into the intricate relationship between NAFLD and DM2, allowing for a better understanding of the underlying mechanisms and the potential for introducing new treatment standards.

What's New in the Treatment of Non-Alcoholic Fatty Liver Disease (NAFLD)

Non-alcoholic fatty liver disease (NAFLD) is a serious health problem due to its high incidence and consequences. In view of the existing controversies, new therapeutic options for NAFLD are still being sought. Therefore, the aim of our review was to evaluate the recently published studies on the treatment of NAFLD patients. We searched for articles in the PubMed database using appropriate terms, including "non-alcoholic fatty liver disease", "nonalcoholic fatty liver disease", "NAFLD", "diet", "treatment", "physical activity", "supplementation", "surgery", "overture" and "guidelines". One hundred forty-eight randomized clinical trials published from January 2020 to November 2022 were used for the final analysis. The results show significant benefits of NAFLD therapy associated with the use of not only the Mediterranean but also other types of diet (including low-calorie ketogenic, high-protein, anti-inflammatory and whole-grain diets), as well as enrichment with selected food products or supplements. Significant benefits in this group of patients are also associated with moderate aerobic physical training. The available therapeutic options indicate, above all, the usefulness of drugs related to weight reduction, as well as the reduction in insulin resistance or lipids level and drugs with anti-inflammatory or antioxidant properties. The usefulness of therapy with dulaglutide and the combination of tofogliflozin with pioglitazone should be emphasized. Based on the results of the latest research, the authors of this article suggest a revision of the therapeutic recommendations for NAFLD patients.

The association between affective temperaments and depressive symptoms in a population of medical university students, Poland

Background

Compared to their peers, medical students are more exposed to stress, and many present symptoms of depression, making them a group prone to experiencing mental illnesses.

Objective

This study investigates a potential link between the occurrence of symptoms of depression and the dominating type of affective temperament in young people studying at a medical university.

Methods

One hundred thirty-four medical students were surveyed using two validated questionnaires; the Polish versions of Beck's Depression Inventory-II (BDI-II) and the Temperament Evaluation of the Memphis, Pisa, and San Diego Autoquestionnaire (TEMPS-A).

Results

The data analysis revealed a significant link between symptoms of depression and affective temperaments, most significantly in subjects with an anxious temperament.

Conclusion

This study confirms the role of various affective temperaments as a risk factor for mood disorders, specifically depression.

The development and validation of a dysphagia-specific quality-of-life questionnaire for patients with head and neck cancer: the M. D. Anderson dysphagia inventory

OBJECTIVE

To design a reliable and validated self-administered questionnaire whose purpose is to assess dysphagia's effects on the quality of life (QOL) of patients with head and neck cancer.

DESIGN

Cross-sectional survey study.

METHODS

Focus groups were convened for questionnaire development and design. The M. D. Anderson Dysphagia Inventory (MDADI) included global, emotional, functional, and physical subscales. One hundred consecutive adult patients with a neoplasm of the upper aerodigestive tract who underwent evaluation by our Speech Pathology team completed the MDADI and the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36). Speech pathologists completed the Performance Status Scale for each patient. Validity and reliability properties were calculated. Analysis of variance was used to assess how well the MDADI discriminated between groups of patients.

RESULTS

The internal consistency reliability of the MDADI was calculated using the Cronbach alpha coefficient. The Cronbach alpha coefficients of the MDADI subscales ranged from 0.85 to 0.93. Test-retest reliability coefficients of the subscales ranged from 0.69 to 0.88. Spearman correlation coefficients between the MDADI subscales and the SF-36 subscales demonstrated construct validity. Patients with primary tumors of the oral cavity and oropharynx had significantly greater swallowing disability with an adverse impact on their QOL compared with patients with primary tumors of the larynx and hypopharynx (P<.001). Patients with a malignant lesion also had significantly greater disability than patients with a benign lesion (P<.001).

CONCLUSIONS

The MDADI is the first validated and reliable self-administered questionnaire designed specifically for evaluating the impact of dysphagia on the QOL of patients with head and neck cancer. Standardized questionnaires that measure patients' QOL offer a means for demonstrating treatment impact and improving medical care. The development and validation of the MDADI and its use in prospective clinical trials allow for better understanding of the impact of treatment of head and neck cancer on swallowing and of swallowing difficulty on patients' QOL.

Assigning time-linked exposure status to controls in unmatched case-control studies: alcohol use and nearly lethal suicide attempts

In case-control studies, determination of alcohol consumption by cases immediately prior to the injury event is often conceptually straightforward. However, determination of consumption status by controls is difficult because they lack a reference point, especially when cases and controls are not individually matched. We describe a method of assigning alcohol consumption status to controls using a 24-hour drinking history, the distribution in time of case events, and the random assignment of a specific time period to each control subject. This methodology offers a practical approach for determining alcohol consumption status among control subjects immediately prior to a case event, when controls lack a reference point and have not been individually matched to cases. Published in 2001 by John Wiley & Sons, Ltd.

The synthesis and structure of the derivatives of 2-deoxy-2-hydroxyimino-D-lyxo-hexopyranosyl-L-cysteine and -thiophenol

3,4,6-Tri-O-acetyl-2-deoxy-2-hydroxyimino-beta and -alpha-D-lyxo-hexopyranosides of thiophenol (3, 4) and the methyl ester of N-benzoyl-L-cysteine have been synthesised by condensation of 3,4,6-tri-O-acetyl-2-deoxy-2-nitroso-alpha-D-galactopyranosyl chloride with thiophenol and the L-cysteine derivative, respectively. The conformation of the sugar residue and configuration of the anomeric centre as well as of the hydroxyimino group were established on the basis of the 1H NMR (DQF-COSY, ROESY, TOCSY) spectrometric techniques and polarimetric data. Additionally, the structure of S-[3,4,6-tri-O-acetyl-2-deoxy-2-(Z)-hydroxyimino-beta-D-lyxo -hexopyranosyl]-thiophenol (3) was supported by X-ray diffraction data.

Outcome evaluation of a multi-component violence-prevention program for middle schools: the Students for Peace project

This study evaluated the effect of Students for Peace, a multi-component violence-prevention intervention, on reducing aggressive behaviors among students of eight middle schools randomly assigned into intervention or control conditions. The intervention, based on Social Cognitive Theory, included the formation of a School Health Promotion Council, training of peer mediators and peer helpers, training of teachers in conflict resolution, a violence-prevention curriculum, and newsletters for parents. All students were evaluated in the spring of 1994, 1995 and 1996 (approximately 9000 students per evaluation). Sixth graders in 1994 were followed through seventh grade in 1995 or eighth grade in 1996 or both (n = 2246). Cohort and cross-sectional evaluations indicated little to no intervention effect in reducing aggressive behaviors, fights at school, injuries due to fighting, missing classes because of feeling unsafe at school or being threatened to be hurt. For all variables, the strongest predictors of violence in eighth grade were violence in sixth grade and low academic performance. Although ideal and frequently recommended, the holistic approach to prevention in schools in which teachers, administrators and staff model peaceful conflict resolution is difficult to implement, and, in this case, proved ineffective. The Students for Peace experience suggests that interventions begin prior to middle school, explore social environmental intervention strategies, and involve parents and community members.

Padres Trabajando por la Paz: a randomized trial of a parent education intervention to prevent violence among middle school children

This paper reports the results of a randomized trial to test the effectiveness of a theoretically derived intervention designed to increase parental monitoring among Hispanic parents of middle school students. Role model story newsletters developed through the process of Intervention Mapping were mailed to half of a subsample of parents whose children participated in Students for Peace, a comprehensive violence prevention program. The results indicated that parents in the experimental condition (N = 38) who had lower social norms for monitoring at baseline reported higher norms after the intervention than the parents in the control condition (N = 39) (P = 0.009). Children of parents in the experimental group reported slightly higher levels of monitoring at follow-up across baseline values, whereas control children who reported moderate to high levels of monitoring at pre-test reported lower levels at follow-up (P = 0.04). These newsletters are a population-based strategy for intervention with parents that show some promise for comprehensive school-based interventions for youth.

A cancer risk model with adaptive repair

The cancer risk model described herein first appeared in 1982. The model provides a plausible mechanism with biological underpinnings that might reasonably explain observed phenomena in cancer dose-response studies that are not being addressed by the risk models currently in use. This article is a summary and explanation of the features of the model that relate to hormesis. Data from several saccharin studies served in large part to motivate the original research, and were used to illustrate beneficial low-dose effects that could be explained by the model. The model itself is a function of linear ratios of the administered dose x. Linear ratios arise naturally from non-linear Michaelis-Menten kinetics, as described in the next section. The one-hit cancer risk model is used to illustrate the hormetic concepts brought out by linear ratios. The one-hit model is modified to account for repair and for non-linear kinetics, by using a linear ratio of the administered dose instead of the actual administered dose, and by expressing the probability that a 'hit' is repaired as a linear ratio of the administered dose. The phenomenon of hormesis - or low-dose beneficial effects-has been widely observed and accepted. Yet none of the cancer risk models currently in wide use have attempted to accommodate hormetic effects. The modified one-hit model developed herein does not attempt to account for elimination or detoxification, but nevertheless it provides plausible explanations for certain classes of observed hormetic phenomena associated with experimental testing of carcinogenic substances in animals.

The students for peace project: a comprehensive violence-prevention program for middle school students

Students for Peace is a three-year project (October 1993- September 1996) designed to evaluate a comprehensive, school-based intervention that seeks to prevent violence among sixth-, seventh-, and eighth-grade students in a large urban school district in Texas. This study examines the hypothesis that students exposed to a two-year multiple-component intervention will reduce aggressive behavior compared to students who receive the district's "usual care" of violence prevention activities. Students for Peace is based largely on Social Learning. Theory (SLT), which addresses both the psychosocial dynamics underlying health behavior and the methods of promoting behavior change, while emphasizing cognitive processes and their effect on behavior. SLT explains human behavior in terms of a model in which three factors-behavior, social-environmental influences, and personal factors (such as personality, perceptions and expectations, and affect)-all interact. Theoretically, an individual's behavior is uniquely determined by a combination of these factors; thus, these factors become the elements for intervention strategies. The intervention program includes four main components: (1) modification of the school environment, (2) a violence-prevention curriculum, (3) peer leadership, and (4) parent education. Students for Peace is using a nested cross-sectional and cohort design in which school is the unit of design, allocation, and analysis. Eight schools, four intervention and four control, are participating. In May 1994, a questionnaire was administered to all students in school the day of the survey. A posttest evaluation was taken in the spring of 1995 and will be followed by a final posttest in spring 1996. A total of 8,865 students responded to the baseline survey. Nearly all variables indicated comparability between treatment and control conditions. As a population, Students for Peace participants are largely Hispanic (65%) or African American (19%). Violence-related variables indicated 30-day fighting prevalence, 23%; 12-month prevalence of injuries due to fighting, 14%; 30-day hand-gun carrying prevalence, 11%; 30-day prevalence of taunts and threats at school, 27%, and threats going to and from school, 26%. Overall, the data from Year 1 activities indicate a population in need of violence-prevention intervention. The challenge is to mold existing district resources into a theoretically sound program of interventions. If that program is found effective, the district will already have the necessary documentation, personnel, and skills for broader dissemination.

Violence prevention in middle schools: a pilot evaluation

PURPOSE

To evaluate the effect of a violence prevention curriculum and of trained peer leaders on self-reported aggressive behaviors, knowledge about violence and conflict-resolution skills, self-efficacy, and attitudes among 223 6th graders.

METHODS

The effect of two intervention groups (violence prevention curriculum taught by the teacher with or without the assistance of trained peer leaders) and one control group were compared. Ten 6th grade classes (four control and six intervention classes) of four middle schools participated in the study. Students were evaluated before and shortly after the implementation of the curriculum, as well as 3 months later.

RESULTS

The intervention reduced self-reported aggressive behaviors among boys, but this reduction was significant only in two of the six intervention classes. Both interventions had an overall significant effect on increasing knowledge about violence and skills to reduce violence. After the intervention, students also developed a more negative attitude toward responding violently when provoked. Attitude change was stronger among students from the teacher plus peer leader group. No intervention effect was observed on self-efficacy nor on attitudes toward skills to reduce violence. Changes were not maintained over time.

CONCLUSIONS

Results emphasize the need for continuous and comprehensive interventions, follow-up evaluations, and careful selection of peer leaders. Aggressive behaviors, not knowledge alone, should be used as the main dependent variable.

Effect of active management of labor on the incidence of cesarean section for dystocia in nulliparas

The hypothesis that introduction of a defined policy of managing labor in nulliparas, active management of labor, would reduce the incidence of cesarean section (CS) for dystocia was examined by the introduction of active management at Hermann Hospital, the University of Texas affiliated hospital in Houston. The study was conducted over four consecutive 6-month periods. Observational data were accumulated for the year preceding introduction of active management, which served as the control period. The overall incidence of CS in nulliparas in the two control periods was 23 and 25%, and declined significantly to 20 and 17.7% in the intervention periods. The incidence of CS for dystocia fell significantly from 13 and 15% to 10 and 8.1%, whereas the incidence for other indications was unchanged. There were no significant differences in perinatal outcome judged by incidence of fetal death in labor, neonatal death associated with asphyxia, rate of admission to neonatal care with a diagnosis of asphyxia, or incidence of neonatal seizure. The data suggest that active management of labor reduces the incidence of cesarean section significantly and that these results can be achieved without detriment to mother or child.

A cluster classification for histologic diagnoses of CNS tumors in an epidemiologic study

This paper introduces a method which was utilized to sort multiple pathologic diagnoses pertaining to brain tumors into clusters of equivalent diagnostic terms for an epidemiological study of brain cancer. The method enabled the medical record abstractors to ascertain cases for the study. It enabled the reviewing pathologist to identify differences between original and reviewed diagnoses. It identified the large range of classification systems of brain tumors used by practicing pathologists as a factor contributing to confusion of data if slide reviews are not incorporated into epidemiological studies, and demonstrated how the use of a cluster classification alleviates this problem.

Determinants of head injury mortality: importance of the low risk patient

Data were obtained prospectively for 7,912 head-injured patients admitted from 1980 to 1981 to 41 hospitals in 3 U.S. metropolitan areas. Highly significant independent predictors of mortality were motor score, number of reactive eyes, systolic blood pressure, abdominal injury, chest injury, age, and hospital unit (hospital or group of hospitals). The difference between the number of deaths observed and the number expected, by hospital unit, ranged from 43% below expectation to 52% above expectation. The 2 hospital units with the lowest mortality had only 1 death, where 9.4 would be expected, in patients whose risk of death was estimated to be less than 10%. In the single hospital with clearly excess mortality, however, the standardized mortality ratios were 208, 135, and 144% for the risk groups whose probabilities of death were 0 to 50, 50 to 80, and 80 to 100%, respectively. The lack of deaths in those hospitals with the best mortality experience and the excess mortality in the hospital with the worst mortality experience appear to be explained largely by differences in patients who, by clinical criteria, seem to be at low risk for death, and not by severely injured patients.