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Park SH, Pinto-Powell R, Thesen T, Lindqwister A, Levy J, Chacko R, Gonzalez D, Bridges C, Schwendt A, Byrum T, Fong J, Shasavari S, Hassanpour S. Preparing healthcare leaders of the digital age with an integrative artificial intelligence curriculum: a pilot study. Med Educ Online 2024; 29:2315684. [PMID: 38351737 PMCID: PMC10868429 DOI: 10.1080/10872981.2024.2315684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 02/02/2024] [Indexed: 02/16/2024]
Abstract
Artificial intelligence (AI) is rapidly being introduced into the clinical workflow of many specialties. Despite the need to train physicians who understand the utility and implications of AI and mitigate a growing skills gap, no established consensus exists on how to best introduce AI concepts to medical students during preclinical training. This study examined the effectiveness of a pilot Digital Health Scholars (DHS) non-credit enrichment elective that paralleled the Dartmouth Geisel School of Medicine's first-year preclinical curriculum with a focus on introducing AI algorithms and their applications in the concurrently occurring systems-blocks. From September 2022 to March 2023, ten self-selected first-year students enrolled in the elective curriculum run in parallel with four existing curricular blocks (Immunology, Hematology, Cardiology, and Pulmonology). Each DHS block consisted of a journal club, a live-coding demonstration, and an integration session led by a researcher in that field. Students' confidence in explaining the content objectives (high-level knowledge, implications, and limitations of AI) was measured before and after each block and compared using Mann-Whitney U tests. Students reported significant increases in confidence in describing the content objectives after all four blocks (Immunology: U = 4.5, p = 0.030; Hematology: U = 1.0, p = 0.009; Cardiology: U = 4.0, p = 0.019; Pulmonology: U = 4.0, p = 0.030) as well as an average overall satisfaction level of 4.29/5 in rating the curriculum content. Our study demonstrates that a digital health enrichment elective that runs in parallel to an institution's preclinical curriculum and embeds AI concepts into relevant clinical topics can enhance students' confidence in describing the content objectives that pertain to high-level algorithmic understanding, implications, and limitations of the studied models. Building on this elective curricular design, further studies with a larger enrollment can help determine the most effective approach in preparing future physicians for the AI-enhanced clinical workflow.
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Affiliation(s)
- Soo Hwan Park
- Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | | | - Thomas Thesen
- Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | | | - Joshua Levy
- Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Rachael Chacko
- Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | | | - Connor Bridges
- Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Adam Schwendt
- Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Travis Byrum
- Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Justin Fong
- Geisel School of Medicine at Dartmouth, Hanover, NH, USA
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Staubach P, Bilo B, Fluhr JW, Krause K, Kulthanan K, Salman A, Katelaris C, Bernstein JA, Maurer M, Mann C. UCOMB-real life data: treatment strategies for chronic urticaria patients with comorbidities. J DERMATOL TREAT 2024; 35:2329784. [PMID: 38508226 DOI: 10.1080/09546634.2024.2329784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2024]
Abstract
BACKGROUND There is a lack of real-life safety data on treatment options for chronic urticaria in the presence of comedication and comorbidities. METHODS We present a single-center UCARE pilot study of 212 outpatients with chronic urticaria. Patients were divided into three groups according to different CU therapies according to international guidelines. RESULTS Of 212 patients, 108 (mean age 48.9 years, 71.3% female) had 59 comorbidities, including cardiovascular, autoimmune and malignant diseases. Patients were followed for a mean of 24.6 months (SD ± 21.3). Urticaria therapies were divided into three groups: A: 105 (97.2%) with omalizumab and 2nd generation antihistamines), B: 16 patients (14.8%): dual therapy with antihistamines and cyclosporine in 10 (9.3%), montelukast in five (4. 6%), dapsone in four (3.7%), hydroxychloroquine in one patient (0.9%), C: 12 (11.1%) patients received a third drug for 4.9 months (SD ± 3.2) and one quadruple therapy (2.1 months). 10 out of 12 (83.3%) patients received montelukast, two (16.7%) cyclosporine, two (16.7%) dapsone and one (8.3%) hydroxychloroquine as a third drug for chronic urticaria. CONCLUSIONS Combining treatment modalities for chronic urticaria and comorbidities are available and feasible with a good safety profile.
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Affiliation(s)
- Petra Staubach
- Department of Dermatology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Benedikt Bilo
- Department of Dermatology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Joachim W Fluhr
- Urticaria Center of Reference and Excellence (UCARE), Institute of Allergology IFA, Charité - Universitätsmedizin Berlin, Berlin, Germany
- Fraunhofer Insitute for Translational Medicine and Pharmacology, ITMP Berlin, Immunology and Allergology IA, Berlin, Germany
| | - Karoline Krause
- Urticaria Center of Reference and Excellence (UCARE), Institute of Allergology IFA, Charité - Universitätsmedizin Berlin, Berlin, Germany
- Fraunhofer Insitute for Translational Medicine and Pharmacology, ITMP Berlin, Immunology and Allergology IA, Berlin, Germany
| | - Kanokvalai Kulthanan
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Andac Salman
- Department of Dermatology, Acıbadem University School of Medicine, Istanbul, Turkey
| | - Connie Katelaris
- Department of Medicine, Campbelltown Hospital and Western Sydney University Sydney, Campbelltown, Australia
| | - Jonathan A Bernstein
- Division of Rheumatology, Allergy and Immunology, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Marcus Maurer
- Urticaria Center of Reference and Excellence (UCARE), Institute of Allergology IFA, Charité - Universitätsmedizin Berlin, Berlin, Germany
- Fraunhofer Insitute for Translational Medicine and Pharmacology, ITMP Berlin, Immunology and Allergology IA, Berlin, Germany
| | - Caroline Mann
- Department of Dermatology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
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Hong JY, Shin SH, Koh YG, Seok J, Park KY. Efficacy and safety of a novel 785 nm picosecond neodymium-doped yttrium aluminum garnet laser for the treatment of facial benign pigmented lesions in Asian skin: a pilot study. J DERMATOL TREAT 2024; 35:2293640. [PMID: 38108131 DOI: 10.1080/09546634.2023.2293640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 12/05/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND AND OBJECTIVES Benign pigmented lesions and a general uneven tone in people with skin of color are growing issues that have been presented to dermatologists. To the best of our knowledge, this is the first controlled study to examine the efficacy and safety of using the newly introduced 785 nm neodymium-doped yttrium aluminum garnet (Nd:YAG) picosecond laser to treat facial benign pigmented lesions in Asian patients with diffractive lens array. MATERIALS AND METHODS A 785 nm Nd:YAG picosecond laser was used to treat 15 healthy female volunteers older than 18 years who had Fitzpatrick skin types II-IV and facial benign pigmented lesions. Each volunteer received five weekly treatments in dual modes. The clinical improvement was assessed by independent investigators and by objectively measuring the melanin index. RESULTS After the treatment, the melanin and erythema indices decreased, and the pigmented lesions showed clinical improvements. No serious adverse effects were observed during the study period. CONCLUSIONS A 785 nm Nd:YAG picosecond laser may be safe and effective in treating facial benign pigmented lesions in Asian skin.
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Affiliation(s)
- Ji Yeon Hong
- Department of Dermatology, Chungnam National University Sejong Hospital, Chungnam National University College of Medicine, Sejong, Korea
| | - Sun Hye Shin
- Department of Dermatology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea
| | - Young Gue Koh
- Department of Dermatology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea
| | - Joon Seok
- Department of Dermatology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea
| | - Kui Young Park
- Department of Dermatology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea
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Kim K, Kim HH, Joo JB, Kim OK, Park SW, Suh GH, Ro WB, Lee CM. Evaluation of the clinical usefulness of pancreatic alpha amylase as a novel biomarker in dogs with acute pancreatitis: a pilot study. Vet Q 2024; 44:1-7. [PMID: 38497337 PMCID: PMC10949834 DOI: 10.1080/01652176.2024.2326007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 02/10/2024] [Indexed: 03/19/2024] Open
Abstract
Pancreatic alpha amylase (P-AMY) is used as a biomarker of acute pancreatitis (AP) in human medicine. To our knowledge, there are no studies evaluating the usefulness of P-AMY in dogs with AP. In this study, we evaluated the diagnostic value of P-AMY, currently not verified in veterinary medicine. The AP group (n = 40) consisted of dogs with AP diagnosed using clinical signs and laboratory examinations, including abnormal canine pancreatic lipase (cPL) concentration, and compatible abdominal ultrasound examination at first presentation. Evaluation of the canine AP severity (CAPS) score was performed. The control group (n = 38) was composed of normal dogs without any abnormalities in clinical findings, blood exams or diagnostic imaging. The correlation of P-AMY with cPL was confirmed by Pearson's correlation analysis (r = 0.564, p < .001). The sensitivity and specificity for the most appropriate cut-off values of P-AMY were recorded similar to the values of DGGR. The dogs with AP and CAPS ≥11 had significantly higher serum P-AMY (p = .016) contrary to DGGR lipase and cPL. Furthermore, there was a significant difference in the median P-AMY dependent on the presence of systemic inflammatory response syndrome (p = .001). P-AMY showed similar level of diagnostic accuracy along with sensitivity and specificity compared to DGGR lipase. In addition, P-AMY showed a significant association with CAPS score, contrary to cPL and DGGR lipase. Along with other biomarkers associated with AP, P-AMY has the potential of usefulness as a supportive diagnostic and prognostic biomarker of AP in dogs.
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Affiliation(s)
- Keon Kim
- Department of Veterinary Internal Medicine, College of Veterinary Medicine and BK21 FOUR program, Chonnam National University, Gwangju, Korea
| | - Hee-hong Kim
- Department of Veterinary Internal Medicine, College of Veterinary Medicine and BK21 FOUR program, Chonnam National University, Gwangju, Korea
- Cool-pet Animal Hospital, Daegu, Korea
| | - Jae-Beom Joo
- Department of Veterinary Internal Medicine, College of Veterinary Medicine and BK21 FOUR program, Chonnam National University, Gwangju, Korea
| | - Ock-Kyu Kim
- Department of Veterinary Internal Medicine, College of Veterinary Medicine and BK21 FOUR program, Chonnam National University, Gwangju, Korea
| | - Sin-Wook Park
- Department of Veterinary Internal Medicine, College of Veterinary Medicine and BK21 FOUR program, Chonnam National University, Gwangju, Korea
| | - Guk-Hyun Suh
- Department of Veterinary Internal Medicine, College of Veterinary Medicine and BK21 FOUR program, Chonnam National University, Gwangju, Korea
| | - Woong-Bin Ro
- Department of Veterinary Internal Medicine, College of Veterinary Medicine and BK21 FOUR program, Chonnam National University, Gwangju, Korea
| | - Chang-Min Lee
- Department of Veterinary Internal Medicine, College of Veterinary Medicine and BK21 FOUR program, Chonnam National University, Gwangju, Korea
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Acikgöz AS, Gök K, Tüten A, Kaya B, Hamzaoğlu K, Kolomuç Gayretli T, Malik E, Güralp O. Evaluation of serum levels of soluble vascular endothelial (sVE)-Cadherin in early- and late-onset preeclampsia serum sVE-Cadherin levels in preeclampsia. J Matern Fetal Neonatal Med 2024; 37:2326304. [PMID: 38499386 DOI: 10.1080/14767058.2024.2326304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/20/2024]
Abstract
OBJECTIVE Endothelial dysfunction is a major feature of preeclampsia. sVE-cadherin plays a role in the preservation and regulation of the endothelial barrier. For that reason, to evaluation of sVE-cadherin may help elucidate the disease pathophysiology of preeclampsia. METHODS The sample size was calculated as a minimum of 46 pregnant women for each group based on serum sVE-Cadherin levels in a pilot study of 10 preeclamptic and 10 control groups. Hundred-twenty pregnancies complicated with early-onset (n = 60) and late-onset (n = 60) preeclampsia were compared with 120 gestational-age (GA)-matched (±1 week) uncomplicated pregnancies. The venous blood sampling was performed upon preeclampsia diagnosis prior to the onset of the labor in the preeclampsia group and the matching (±1 week) pregnancy week in the control group. Demographic and biochemical parameters were evaluated. RESULTS Mean serum sVE-Cadherin was significantly higher in women with EOPE compared to that of the GA-matched control group (5.86 ± 1.57 ng/mL vs. 2.28 ± 0.80 ng/mL, p < 0.001), in women with LOPE compared to that of the GA-matched control group (3.11 ± 0.97 ng/mL vs. 1.69 ± 0.87 ng/mL, p < 0.001), and in women with EOPE compared to that of LOPE group (5.86 ± 1.57 ng/mL vs. 3.11 ± 0.97 ng/mL, p < 0.001) after correction for GA. Serum sVE-Cadherin positively correlated with systolic and diastolic blood pressure and a negative correlation with gestational age at sampling. CONCLUSION The serum level of sVE-Cadherin was higher in women with preeclampsia than that of GA-matched healthy pregnant women, in women with EOPE compared to that of LOPE. sVE-Cadherin is an important marker in early-onset pre-eclampsia with severe clinical findings.
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Affiliation(s)
- Abdullah Serdar Acikgöz
- Department of Obstetrics and Gynecology, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Koray Gök
- Department of Obstetrics and Gynecology, Sehit Prof. Dr. Ilhan Varank Sancaktepe Training and Research Hospital, University of Health Sciences Turkey, Istanbul, Turkey
| | - Abdullah Tüten
- Department of Obstetrics and Gynecology, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Barış Kaya
- Department of Obstetrics and Gynecology, Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey
| | - Kübra Hamzaoğlu
- Department of Obstetrics and Gynecology, Şişli Hamidiye Etfal Training and Research Hospital, İstanbul, Turkey
| | - Tuğba Kolomuç Gayretli
- Department of Obstetrics and Gynecology, Etlik Zubeyde Hanim Women's Health Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Eduard Malik
- Carl von Ossietzky Oldenburg University, University Hospital for Gynecology and Obstetrics, Oldenburg, Germany
| | - Onur Güralp
- Carl von Ossietzky Oldenburg University, University Hospital for Gynecology and Obstetrics, Oldenburg, Germany
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Brath MSG, Sahakyan M, Mark EB, Rasmussen HH, Østergaard LR, Frøkjær JB, Weinreich UM, Jørgensen ME. Ethnic differences in CT derived abdominal body composition measures: a comparative retrospect pilot study between European and Inuit study population. Int J Circumpolar Health 2024; 83:2312663. [PMID: 38314517 PMCID: PMC10846476 DOI: 10.1080/22423982.2024.2312663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 01/28/2024] [Indexed: 02/06/2024] Open
Abstract
Understanding ethnic variations in body composition is crucial for assessing health risks. Universal models may not suit all ethnicities, and there is limited data on the Inuit population. This study aimed to compare body composition between Inuit and European adults using computed tomography (CT) scans and to investigate the influence of demographics on these measurements. A retrospective analysis was conducted on 50 adults (29 Inuit and 21 European) who underwent standard trauma CT scans. Measurements focused on skeletal muscle index (SMI), various fat indices, and densities at the third lumbar vertebra level, analyzed using the Wilcoxon-Mann-Whitney test and multiple linear regression. Inuit women showed larger fat tissue indices and lower muscle and fat densities than European women. Differences in men were less pronouncehd, with only Intramuscular fat density being lower among Inuit men. Regression indicated that SMI was higher among men, and skeletal muscle density decreased with Inuit ethnicity and age, while visceral fat index was positively associated with age. This study suggests ethnic differences in body composition measures particularly among women, and indicates the need for Inuit-specific body composition models. It higlights the importance of further research into Inuit-specific body composition measurements for better health risk assessment.
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Affiliation(s)
- Mia Solholt Godthaab Brath
- Department of Respiratory Medicine, Aalborg University Hospital, Aalborg, Denmark
- Respiratory Research Aalborg, Reaal, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Marina Sahakyan
- Department of Radiology, Aalborg University Hospital, Aalborg, Denmark
| | - Esben Bolvig Mark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
- Mech-Sense, Department. of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark
| | - Henrik Højgaard Rasmussen
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
- Danish Nutrition Science Center, Department. of Gastroenterology & Hepatology, Aalborg University Hospital, Aalborg, Denmark
- Center for Nutrition and Intestinal Failure, Department. of Gastroenterology & Hepatology, Aalborg University Hospital, Aalborg, Denmark
- The Dietitians and Nutritional Research Unit, EATEN, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark
| | - Lasse Riis Østergaard
- Medical Informatics group, Department. of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - Jens Brøndum Frøkjær
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
- Department of Radiology, Aalborg University Hospital, Aalborg, Denmark
| | - Ulla Møller Weinreich
- Department of Respiratory Medicine, Aalborg University Hospital, Aalborg, Denmark
- Respiratory Research Aalborg, Reaal, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Marit Eika Jørgensen
- Clinical Epidemiology, Steno Diabetes Center Copenhagen, Gentofte, Denmark
- Institute of Health and Nature, University of Greenland, Nuuk, Greenland
- Steno Diabetes Center Greenland, Queen Ingrid’s Hospital, Nuuk, Greenland
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Edvinsson C, Björnsson O, Erlandsson L, Hansson SR. Predicting intensive care need in women with preeclampsia using machine learning - a pilot study. Hypertens Pregnancy 2024; 43:2312165. [PMID: 38385188 DOI: 10.1080/10641955.2024.2312165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 01/02/2024] [Indexed: 02/23/2024]
Abstract
BACKGROUND Predicting severe preeclampsia with need for intensive care is challenging. To better predict high-risk pregnancies to prevent adverse outcomes such as eclampsia is still an unmet need worldwide. In this study we aimed to develop a prediction model for severe outcomes using routine biomarkers and clinical characteristics. METHODS We used machine learning models based on data from an intensive care cohort with severe preeclampsia (n=41) and a cohort of preeclampsia controls (n=40) with the objective to find patterns for severe disease not detectable with traditional logistic regression models. RESULTS The best model was generated by including the laboratory parameters aspartate aminotransferase (ASAT), uric acid and body mass index (BMI) with a cross-validation accuracy of 0.88 and an area under the curve (AUC) of 0.91. Our model was internally validated on a test-set where the accuracy was lower, 0.82, with an AUC of 0.85. CONCLUSION The clinical routine blood parameters ASAT and uric acid as well as BMI, were the parameters most indicative of severe disease. Aspartate aminotransferase reflects liver involvement, uric acid might be involved in several steps of the pathophysiologic process of preeclampsia, and obesity is a well-known risk factor for development of both severe and non-severe preeclampsia likely involving inflammatory pathways..[Figure: see text].
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Affiliation(s)
- Camilla Edvinsson
- Division of Obstetrics and Gynecology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
- Division of Anaesthesia and Intensive Care, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
- Department of Anaesthesia and Intensive Care, Helsingborg Hospital, Helsingborg, Sweden
| | - Ola Björnsson
- Division of Mathematical Statistics, Centre for Mathematical Sciences, Lund University, Lund, Sweden
- Department of Energy Sciences, Faculty of Engineering, Lund University, Lund, Sweden
| | - Lena Erlandsson
- Division of Obstetrics and Gynecology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Stefan R Hansson
- Division of Obstetrics and Gynecology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
- Department of Obstetrics and Gynecology, Skåne University Hospital, Lund/Malmö, Sweden
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Merenstein D, Tan T, Herbin Smith K. Exploratory Pilot Studies to Demonstrate Mechanisms of Preventing Antibiotic-Associated Diarrhea and the Role for Probiotics. Ann Fam Med 2024; 21. [PMID: 38271205 DOI: 10.1370/afm.22.s1.4766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2024] Open
Abstract
Context: Probiotics are live microorganisms that, when administered in adequate amounts, confer a health benefit on the host. One of the most common indications for probiotic treatment is the prevention of antibiotic-associated diarrhea (AAD). Unfortunately, many probiotic products used for AAD are not supported by rigorous independent research, and often results in non-evidence-based usage. Additionally, it is not clear when is the most appropriate time to take a probiotic when on an antibiotic course. Objectives: The primary aim is to determine the ability of BB-12 to impact antibiotic-induced reduction in short chain fatty acid concentration (SCFA), as reflected by the levels of acetate on day 14. Secondarily to determine the ability of BB-12 to impact antibiotic-induced disruption of the gut microbiota with 16S rDNA profiling, with the addition of the time variable of probiotic consumption. Study Design and Interventions: A five group randomized controlled trial, finished in December 2022, we are currently analyzing all the data, but will be finished much prior to NAPCRG. All participants were given a 7-day prescription for amoxicillin-clavulanic acid 875mg taken twice daily. One group received no other interventions. While the other participants were broken into 4 groups. Two groups consumed the yogurt intervention (either yogurt+probiotic or control yogurt) four hours after the antibiotic and two groups consumed the yogurt intervention (either yogurt+probiotic or control yogurt) concomitantly with antibiotics. This timing question is important, as it is unknown if the optimal time for patients to administer probiotics is concurrently with, or after four hours following antibiotic consumption. Setting: Capital Areal Primary Care Practice Based Research Network. Population Studied: 118 participants, ages 18-65 years, generally healthy. Outcome Measures: Change in SCFA among the five groups, microbiome reduced disruption and clinically diagnosed diarrhea. Results: Study is complete and analysis is underway. Should have full results by end of July 2023, much before NAPCRG. .
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Ostrea MC, Rosales RL, Joya-Tanglao M. Efficacy and safety of apomorphine pump infusion in Filipino patients insufficiently controlled on oral anti-Parkinson medications: an open-label, pilot study. Int J Neurosci 2024; 134:131-136. [PMID: 35722686 DOI: 10.1080/00207454.2022.2090352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 06/10/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Apomorphine hydrochloride is used in the management of advanced Parkinson disease (PD), either as a rescue medication for off periods during levodopa therapy or as a maintenance pump medication. This is the first study to describe the effects of apomorphine in Filipino patients with PD. OBJECTIVE To evaluate the safety and efficacy of apomorphine ampules (APO-go®) pump infusion in the treatment of motor fluctuations in patients inadequately controlled on oral anti-Parkinson medications. METHODS Patients diagnosed with PD who developed motor fluctuations with levodopa were evaluated at baseline and at the end of the study using the Modified Hoehn and Yahr (H&Y) Scale, the Unified Parkinson's Disease Rating Scale (UPDRS) and the Abnormal Involuntary Movement Scale (AIMS). After initial assessment, patients were administered 20 ampules of apomorphine hydrochloride 10 mg/mL by infusion pump over 20 days. Intention-to-treat (ITT) analysis included all patients who completed at least one posttreatment assessment. Motor disability based on modified H&Y scores, motor function and complications of therapy pre- and posttreatment were compared using Wilcoxon Signed Rank test. Chi-squared test was used to compare outcomes by age and sex. Frequencies of adverse reactions were recorded to evaluate the tolerability of the medication. RESULTS Ten patients (mean age 63 ± 9.7 years), 3 male and 7 female, were enrolled in the study. Patients were given apomorphine for at most 16 days. The doses used were 2.5 mg/0.50 mL (n = 2), 3 mg/0.60 mL (n = 6), 4 mg/0.80 mL (n = 1) and 7 mg/1.40 mL (n = 1). After obtaining the threshold dose, two patients discontinued treatment. Eight of nine patients showed significant improvement in H&Y scores after treatment (p < 0.017). There was marked improvement after 10 days of treatment in at least five of 10 patients in terms of motor function using UPDRS, which included tremor (p < 0.034), rigidity (p < 0.002), facial expression (p < 0.014), finger taps (p < 0.008), foot taps (p < 0.014) and gait (p < 0.006). Significant changes from pre- to posttreatment scores in the frequency of dyskinesias (p < 0.010) and dystonia (p < 0.025) were observed. Nine focus areas of AIMS showed significant improvements in the muscles of facial expression (p < 0.020), upper (p < 0.016) and lower extremities (p < 0.010), incapacitation by abnormal movement (p < 0.010) and patients' awareness of abnormal movements (p < 0.039). Six patients experienced adverse events, none of which were related to the study drug. CONCLUSION Apomorphine hydrochloride pump infusion therapy is potentially effective and safe in the treatment of motor fluctuations in Filipino patients with PD. This pilot study springboards safe engagements of Filipino PD patients in multicenter, large-scale trials.
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Affiliation(s)
- Marc C Ostrea
- Center for Neuro-diagnostic and Therapeutic Services, Metropolitan Medical Center, Manila, Philippines
| | - Raymond L Rosales
- Center for Neuro-diagnostic and Therapeutic Services, Metropolitan Medical Center, Manila, Philippines
- Research Center for Health Sciences, Faculty of Medicine and Surgery, University of Santo Tomas, Manila, Philippines
- Saint Luke's Medical Centre, Institute for Neurosciences, Quezon City, Philippines
| | - Michelle Joya-Tanglao
- Center for Neuro-diagnostic and Therapeutic Services, Metropolitan Medical Center, Manila, Philippines
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Jallouli S, Ghroubi S, Dhia IB, Yahia A, Elleuch MH, Sakka S, Mhiri C, Hammouda O. Effect of melatonin intake on postural balance, functional mobility and fall risk in persons with multiple sclerosis: a pilot study. Int J Neurosci 2024; 134:137-147. [PMID: 35708140 DOI: 10.1080/00207454.2022.2090353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 06/03/2022] [Indexed: 10/18/2022]
Abstract
AIM To assess the safety and the effect of a nocturnal melatonin (MEL) ingestion on postural balance, functional mobility and fall risk the following morning in adults with multiple sclerosis (MS). METHODS Fourteen adults with relapsing-remitting MS (RR-MS) (28.36 ± 6.81 years) were evaluated before and after nocturnal ingestion of MEL (6 mg) or placebo (PLA). Evaluations included a posturographic test of static bipedal postural balance with dual-task in eyes open (EO) and eyes closed conditions, and a clinical test of unipedal balance. The physical performance tests were: Timed Up and Go test (TUGT) (mobility), Four Square Step Test (FSST) (fall risk), and Timed 25-foot walk test (T25FWT) (walking speed). Cognitive performance [Montreal Cognitive Assessment (MoCA) and Simple Reaction Time (SRT) tests] and sleep quality [Spiegel's sleep questionnaire (SSQ)] were also assessed. RESULTS In EO condition, MEL decreased the posturographic parameters [center of pressure (CoP) sway area (CoPAr), CoP path length (CoPL) and CoPL in the mediolateral axis (CoPLX)] more than PLA by 15.82% (p = 0.0006), 12.48% (p = 0.0004) and 14.25% (p = 0.0002), respectively. Durations of TUGT and FSST decreased following MEL session more than the PLA one by 14.52% (p = 0.017) and 19.85% (p = 0.0006), respectively. MEL increased the unipedal stance time, SSQ and MoCA scores more than PLA by 49.81% (p = 0.04), 32.21% (p = 0.004) and 11.87% (p = 0.008), respectively. CONCLUSION This pilot study showed that acute nocturnal MEL ingestion seems to be safe for enhancing postural balance, fun mobility and fall risk in RR-MS adults probably through improving sleep quality and cognitive function.
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Affiliation(s)
- Sonda Jallouli
- Research laboratory: Evaluation and Management of Musculoskeletal System Pathologies, LR20ES09, Faculty of Medicine, University of Sfax, Sfax, Tunisia
- High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
| | - Sameh Ghroubi
- Research laboratory: Evaluation and Management of Musculoskeletal System Pathologies, LR20ES09, Faculty of Medicine, University of Sfax, Sfax, Tunisia
- Department of Physical Medicine and Functional Rehabilitation, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Imen Ben Dhia
- Research laboratory: Evaluation and Management of Musculoskeletal System Pathologies, LR20ES09, Faculty of Medicine, University of Sfax, Sfax, Tunisia
- High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
| | - Abdelmoneem Yahia
- Research laboratory: Evaluation and Management of Musculoskeletal System Pathologies, LR20ES09, Faculty of Medicine, University of Sfax, Sfax, Tunisia
- Department of Physical Medicine and Functional Rehabilitation, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Mohamed Habib Elleuch
- Research laboratory: Evaluation and Management of Musculoskeletal System Pathologies, LR20ES09, Faculty of Medicine, University of Sfax, Sfax, Tunisia
- Department of Physical Medicine and Functional Rehabilitation, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Salma Sakka
- Laboratory of Neurogenetics, Parkinson's Disease and Cerebrovascular Disease (LR12SP19), Habib Bourguiba University Hospital, University of Sfax, Sfax, Tunisia
| | - Chokri Mhiri
- Laboratory of Neurogenetics, Parkinson's Disease and Cerebrovascular Disease (LR12SP19), Habib Bourguiba University Hospital, University of Sfax, Sfax, Tunisia
| | - Omar Hammouda
- Interdisciplinary Laboratory in Neurosciences, Physiology and Psychology: Physical Activity, Health and Learning (LINP2), Paris Nanterre University, Nanterre, France
- Research Laboratory, Molecular Bases of Human Pathology, LR19ES13, Faculty of Medicine, University of Sfax, Sfax, Tunisia
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11
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Gonzalez-Urbistondo F, Alperi A, Moris C, Avanzas P. μQFR in ASET Pilot Studies: More Assets in the decision-making process for stable ischemic heart disease. Int J Cardiol 2024; 403:131880. [PMID: 38373682 DOI: 10.1016/j.ijcard.2024.131880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 02/15/2024] [Indexed: 02/21/2024]
Affiliation(s)
| | - Alberto Alperi
- Área del Corazón, Hospital Universitario Central de Asturias, Oviedo, Spain; Instituto de Investigación Sanitaria del Principado de Asturias, ISPA, Oviedo, Spain.
| | - Cesar Moris
- Área del Corazón, Hospital Universitario Central de Asturias, Oviedo, Spain; Instituto de Investigación Sanitaria del Principado de Asturias, ISPA, Oviedo, Spain; Departamento de Medicina, Universidad de Oviedo, Oviedo, Spain
| | - Pablo Avanzas
- Área del Corazón, Hospital Universitario Central de Asturias, Oviedo, Spain; Instituto de Investigación Sanitaria del Principado de Asturias, ISPA, Oviedo, Spain; Departamento de Medicina, Universidad de Oviedo, Oviedo, Spain; Centro de Investigación en Red de Enfermedades Cardiovasculares (CIBERCV), Spain
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12
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Weber C, Müller A, Freigang M, von der Hagen M, Günther R. 'Reading the palm' - A pilot study of grip and finger flexion strength as an outcome measure in 5q spinal muscular atrophy. Brain Dev 2024; 46:189-198. [PMID: 38331667 DOI: 10.1016/j.braindev.2024.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 01/07/2024] [Accepted: 01/10/2024] [Indexed: 02/10/2024]
Abstract
BACKGROUND Innovative RNA modifying and gene replacement therapies are currently revolutionizing the therapeutic landscape in 5q-associated spinal muscular atrophy (SMA). In order to provide individual recommendations for choice of treatment and therapy (dis-) continuation, objective outcome measures are needed. The purpose of this study was to determine whether maximum isometric voluntary grip and finger flexion strength is a useful sensitive outcome measure in children and adult patients with SMA. METHODS In this non-interventional, longitudinal pilot study, we assessed grip and finger flexion strength on 39 patients with SMA II and III (n = 16 children, mean age = 10.0; n = 23 adults, mean age = 38.4) using the Weber hand and finger dynamometer HFD 200. Grip and finger flexion strength, clinical examinations and motor function scores (Revised Upper Limb Module, Hammersmith Functional Motor Scale Expanded) were assessed over a 12-month treatment period concurrent with the nusinersen treatment. RESULTS Grip and finger flexion strength was highly associated with motor function and disease severity, SMA type and SMN2 copy number. During nusinersen treatment, grip and finger flexion strength significantly increased in children and adults with SMA. CONCLUSION Grip and finger flexion strength measured with the HFD 200 is a promising sensitive outcome measure for SMA.
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Affiliation(s)
- Constanze Weber
- Department of Neurology, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Dresden, Germany.
| | - Anne Müller
- Department of Neurology, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Dresden, Germany; Department of Neuropediatrics, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Dresden, Germany.
| | - Maren Freigang
- Department of Neurology, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Dresden, Germany.
| | - Maja von der Hagen
- Department of Neuropediatrics, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Dresden, Germany.
| | - René Günther
- Department of Neurology, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Dresden, Germany; German Center for Neurodegenerative Diseases (DZNE) Dresden, Dresden, Germany.
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13
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Curtin C, Bandini LG, Forquer M, Cullen P, Rancaño KM, Must A, Schreck K, Bowling AB, Askenazy N, Wei X, Irish C, Stanish HI. A remotely-delivered pilot and feasibility program to promote physical and food literacy in adolescents with intellectual disabilities. J Appl Res Intellect Disabil 2024; 37:e13228. [PMID: 38520166 DOI: 10.1111/jar.13228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 02/01/2024] [Accepted: 03/04/2024] [Indexed: 03/25/2024]
Abstract
BACKGROUND Youth with intellectual disabilities experience disparities in physical activity and diet quality. Physical and food literacy are hypothesised to support adoption of healthy lifestyles; however, few such interventions have been developed for this population. METHOD Participants with intellectual disabilities ages 12-16 years were recruited for a 12-week online sports skills and nutrition education intervention. Feasibility, acceptability, and preliminary efficacy were assessed by attendance, satisfaction, and pre-post measures of motor skills, perceived competence and motivation for physical activity, classifying foods, making healthy choices, and food consumption. RESULTS Six teens participated in the program and attended 87.5% of the sessions. Satisfaction data suggested that the program was well-received by both teens and parents. Trends toward improvements on physical activity and nutrition outcome measures were observed. CONCLUSIONS Preliminary data from this pilot study suggest that physical and food literacy in youth with intellectual disabilities can be improved, which in turn may contribute to the adoption of healthy lifestyles.
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Affiliation(s)
- C Curtin
- E.K. Shriver Center, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - L G Bandini
- E.K. Shriver Center, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - M Forquer
- George Washington University, Washington, DC, USA
| | - P Cullen
- E.K. Shriver Center, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - K M Rancaño
- Tufts University School of Medicine, Boston, Massachusetts, USA
| | - A Must
- Tufts University School of Medicine, Boston, Massachusetts, USA
| | - K Schreck
- Boston University, Boston, Massachusetts, USA
| | - A B Bowling
- Merrimack College, North Andover, Massachusetts, USA
| | - N Askenazy
- Boston University, Boston, Massachusetts, USA
| | - X Wei
- Boston University, Boston, Massachusetts, USA
| | - C Irish
- Brighton, Massachusetts, USA
| | - H I Stanish
- University of Massachusetts Boston, Boston, Massachusetts, USA
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Turgeon S, MacKenzie A, Batcho CS, D'Amour J. Making physical activity fun and accessible to adults with intellectual disabilities: A pilot study of a gamification intervention. J Appl Res Intellect Disabil 2024; 37:e13213. [PMID: 38404069 DOI: 10.1111/jar.13213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 01/24/2024] [Accepted: 01/29/2024] [Indexed: 02/27/2024]
Abstract
BACKGROUND Only about 9% of individuals with intellectual disabilities reach the government's physical activity (PA) recommendations. Combining gamification and technology seems particularly promising in overcoming personal and environmental barriers to PA participation. METHOD Eighteen adults with varying levels of intellectual disabilities completed a pilot study to assess the initial effects of a cycling gamification intervention on levels of PA, fitness, psychosocial outcomes, and challenging behaviours. The study comprised three designs: pre-post single group, AB single-case, and qualitative. Social validity, implementation barriers and facilitators were also explored. RESULTS Nearly all 18 participants cycled daily. Time and distance cycled daily increase during the intervention while a decrease in stereotyped behaviours was observed. Participants and staff found the intervention enjoyable and socially valid. CONCLUSIONS Results of the multiple-design study suggest that gamification interventions may be a suitable, enjoyable, and promising way to contribute to PA participation of adults with intellectual disabilities.
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Affiliation(s)
- Stéphanie Turgeon
- Département de psychoéducation et de psychologie, Université du Québec en Outaouais, Gatineau, Canada
| | - Alexandra MacKenzie
- Département de psychoéducation et de psychologie, Université du Québec en Outaouais, Gatineau, Canada
| | - Charles Sebiyo Batcho
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Quebec, Canada
- School of Rehabilitation Sciences, Faculty of Medicine, Université Laval, Quebec, Canada
| | - Jason D'Amour
- Département de psychologie, Université du Québec à Trois Rivières, Quebec, Canada
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15
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Boss RD, Maddox K, Thorndike D, Keppel K, Batson L, Smith B, Weaver MS, Munoz-Blanco S. Building clinician-parent partnerships to improve care for chronically critically Ill children: A pilot project. Patient Educ Couns 2024; 122:108152. [PMID: 38232672 DOI: 10.1016/j.pec.2024.108152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 01/05/2024] [Accepted: 01/10/2024] [Indexed: 01/19/2024]
Abstract
OBJECTIVE Multicenter pilot to assess feasibility, acceptability, and educational value of videos for families and clinicians regarding unique inpatient challenges of pediatric chronic critical illness. METHODS Videos were developed for 3 hospitalization timepoints: 1) chronic critical illness diagnosis, 2) transfers, 3) discharge. Parents of hospitalized children, and interdisciplinary clinicians, were recruited to watch videos and complete surveys. RESULTS 33 parents (16 English-speaking, 17 Spanish-speaking) and 34 clinicians participated. Enrollment was better for families than clinicians (78% vs. 43%). Video acceptability was high: families and clinicians endorsed verisimilitude of depicted hospitalization challenges for chronic critical illness. All families felt the videos would help other families, all clinicians felt they would help other clinicians. Families gained expectations for the hospital course, discovered resources for hospitalization challenges, and learned there are other families in similar situations. Clinicians learned to recognize chronic critical illness, and how families experience hospitalizations, transfers, and discharges. CONCLUSION Educational videos about pediatric chronic critical illness were overall feasible, acceptable, and educational for hospitalized families and clinicians. PRACTICE IMPLICATIONS Just-in-time hospital education about pediatric chronic critical illness is valuable to families and clinicians; next steps are to assess potential to reduce gaps in care of children with chronic critical illness.
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Affiliation(s)
- Renee D Boss
- Johns Hopkins School of Medicine, 600 N. Wolfe St, Baltimore, MD 21287 USA; Johns Hopkins Berman Institute of Bioethics, 1801 Ashland Ave, Baltimore, MD 21287 USA.
| | - Katherine Maddox
- The University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390 USA
| | - Dorte Thorndike
- Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD 21205 USA
| | - Kristopher Keppel
- Johns Hopkins School of Medicine, 600 N. Wolfe St, Baltimore, MD 21287 USA
| | - Lora Batson
- Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD 21205 USA
| | - Brandon Smith
- Johns Hopkins School of Medicine, 600 N. Wolfe St, Baltimore, MD 21287 USA
| | | | - Sara Munoz-Blanco
- Johns Hopkins School of Medicine, 600 N. Wolfe St, Baltimore, MD 21287 USA; The University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390 USA
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Lau K, Yamaguchi T, Shibata K, Nishi T, Fernie G, Fekr AR. Machine learning prediction of footwear slip resistance on glycerol-contaminated surfaces: A pilot study. Appl Ergon 2024; 117:104249. [PMID: 38368655 DOI: 10.1016/j.apergo.2024.104249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 02/06/2024] [Accepted: 02/09/2024] [Indexed: 02/20/2024]
Abstract
Slippery surfaces due to oil spills pose a significant risk in various environments, including industrial workplaces, kitchens, garages, and outdoor areas. These situations can lead to accidents and falls, resulting in injuries that range from minor bruises to severe fractures or head trauma. To mitigate such risks, the use of slip resistant footwear plays a crucial role. In this study, we aimed to develop an Artificial Intelligence model capable of classifying footwear as having either high or low slip resistance based on the geometric characteristics and material parameters of their outsoles. Our model was trained on a unique dataset comprising images of 37 indoor work footwear outsoles made of rubber. To evaluate the slip resistant property of the footwear, all samples were tested using a cart-type friction measurement device, and the static and dynamic Coefficient of Frictions (COFs) of each outsole was determined on a glycerol-contaminated surface. Machine learning techniques were implemented, and a classification model was developed to determine high and low slip resistant footwear. Among the various models evaluated, the Support Vector Classifier (SVC) obtained the best results. This model achieved an accuracy of 0.68 ± 0.15 and an F1-score of 0.68 ± 0.20. Our results indicate that the proposed model effectively yet modestly identified outsoles with high and low slip resistance. This model is the first step in developing a model that footwear manufacturers can utilize to enhance product quality and reduce slip and fall incidents.
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Affiliation(s)
- Kaylie Lau
- Toronto Rehabilitation Institute, University Health Network, Toronto, Canada; University of Toronto, Institute of Biomaterials and Biomedical Engineering, Toronto, Canada.
| | - Takeshi Yamaguchi
- Tohoku University, Department of Finemechanics, Sendai, Miyagi, Japan; Tohoku University, Graduate School of Biomedical Engineering, Sendai, Miyagi, Japan
| | - Kei Shibata
- National Institute of Occupational Safety and Health, Japan, Kiyose, Tokyo, Japan
| | - Toshiaki Nishi
- Tohoku University, Department of Finemechanics, Sendai, Miyagi, Japan
| | - Geoff Fernie
- Toronto Rehabilitation Institute, University Health Network, Toronto, Canada; University of Toronto, Institute of Biomaterials and Biomedical Engineering, Toronto, Canada
| | - Atena Roshan Fekr
- Toronto Rehabilitation Institute, University Health Network, Toronto, Canada; University of Toronto, Institute of Biomaterials and Biomedical Engineering, Toronto, Canada
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Zuidema C, Paulsen M, Simpson CD, Jovan SE. Evaluation of Orthotrichum lyellii moss as a biomonitor of diesel exhaust. Sci Total Environ 2024; 922:171306. [PMID: 38423310 PMCID: PMC10964952 DOI: 10.1016/j.scitotenv.2024.171306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 02/11/2024] [Accepted: 02/25/2024] [Indexed: 03/02/2024]
Abstract
Exhaust from diesel combustion engines is an important contributor to urban air pollution and poses significant risk to human health. Diesel exhaust contains a chemical class known as nitrated polycyclic aromatic hydrocarbons (nitro-PAHs) and is enriched in 1-nitropyrene (1-NP), which has the potential to serve as a marker of diesel exhaust. The isomeric nitro-PAHs 2-nitropyrene (2-NP) and 2-nitrofluoranthene (2-NFL) are secondary pollutants arising from photochemical oxidation of pyrene and fluoranthene, respectively. Like other important air toxics, there is not extensive monitoring of nitro-PAHs, leading to gaps in knowledge about relative exposures and urban hotspots. Epiphytic moss absorbs water, nutrients, and pollutants from the atmosphere and may hold potential as an effective biomonitor for nitro-PAHs. In this study we investigate the suitability of Orthotrichum lyellii as a biomonitor of diesel exhaust by analyzing samples of the moss for 1-NP, 2-NP, and 2-NFL in the Seattle, WA metropolitan area. Samples were collected from rural parks, urban parks, residential, and commercial/industrial areas (N = 22 locations) and exhibited increasing concentrations across these land types. Sampling and laboratory method performance varied by nitro-PAH, but was generally good. We observed moderate to moderately strong correlation between 1-NP and select geographic variables, including summer normalized difference vegetation index (NDVI) within 250 m (r = -0.88, R2 = 0.77), percent impervious surface within 50 m (r = 0.83, R2 = 0.70), percent high development land use within 500 m (r = 0.77, R2 = 0.60), and distance to nearest secondary and connecting road (r = -0.75, R2 = 0.56). The relationships between 2-NP and 2-NFL and the geographic variables were generally weaker. Our results suggest O. lyellii is a promising biomonitor of diesel exhaust, specifically for 1-NP. To our knowledge this pilot study is the first to evaluate using moss concentrations of nitro-PAHs as biomonitors of diesel exhaust.
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Affiliation(s)
- Christopher Zuidema
- Department of Environmental and Occupational Health Sciences, University of Washington, 4225 Roosevelt Way NE, Seattle, WA 98105, USA; Pacific Northwest Research Station, USDA Forest Service, 400 N 34th St., Seattle, WA 98103, USA
| | - Michael Paulsen
- Department of Environmental and Occupational Health Sciences, University of Washington, 4225 Roosevelt Way NE, Seattle, WA 98105, USA
| | - Christopher D Simpson
- Department of Environmental and Occupational Health Sciences, University of Washington, 4225 Roosevelt Way NE, Seattle, WA 98105, USA
| | - Sarah E Jovan
- Pacific Northwest Research Station, USDA Forest Service, 1220 SW 3(rd) Ave., Suite 1410, Portland, OR 97204, USA.
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Murray G, Shmidheiser M. Virtual reality immerses you in your mind: the experience and stress-reduction benefits of VR mindfulness modules in persons with TBI. Brain Inj 2024; 38:355-360. [PMID: 38318793 DOI: 10.1080/02699052.2024.2311334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 01/24/2024] [Indexed: 02/07/2024]
Abstract
OBJECTIVE This pilot study tested the feasibility and stress reduction effectiveness of a one-time virtual reality mindfulness module (VRMM) in individuals with mild-to-moderate traumatic brain injury (TBI). METHODS Thirty-eight participants participated in a pilot study utilizing a mixed methods convergent parallel design. Pretest and posttest stress levels were collected; participants engaged in a brief 4-question qualitative interview. Mann Whitney U and Wilcoxon Signed Rank Tests were used. Qualitative analysis utilized grounded theory. RESULTS Post-VRMM, two-thirds (24) of participants had a statistically significant decrease in stress levels. A key qualitative finding indicated that participants found the immersiveness and realism of the VR environments helpful in compensating for cognitive deficits resulting from TBI. There were no adverse side effects reported, indicating that well-designed VRMMs that minimize motion-induced adverse effects are well tolerated in persons with TBI. CONCLUSION A guided mindfulness activity in a VR environment was well tolerated, and participants overall found VRMM effective in reducing stress levels. VR-based environments have potential to harness guided mindfulness practice and may support persons with TBI to enhance concentration. Further application of this technology in TBI rehabilitation is promising and warrants future research to explore the benefit of VR in improving rehabilitation outcomes.
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Affiliation(s)
- Gillian Murray
- Social Worker, Drucker Brain Injury Center, MossRehab, Elkins Park, Pennsylvania, USA
| | - Max Shmidheiser
- Owner and Founder, Oasis Neurobehavioral Health, PLLC, Wynnewood, Pennsylvania, USA
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Madanlal D, Guinard C, Nuñez VP, Becker S, Garnham J, Khayachi A, Léger S, O'Donovan C, Singh S, Stern S, Slaney C, Trappenberg T, Alda M, Nunes A. A pilot study examining the impact of lithium treatment and responsiveness on mnemonic discrimination in bipolar disorder. J Affect Disord 2024; 351:49-57. [PMID: 38280568 DOI: 10.1016/j.jad.2024.01.146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 01/09/2024] [Accepted: 01/14/2024] [Indexed: 01/29/2024]
Abstract
INTRODUCTION Mnemonic discrimination (MD), the ability to discriminate new stimuli from similar memories, putatively involves dentate gyrus pattern separation. Since lithium may normalize dentate gyrus functioning in lithium-responsive bipolar disorder (BD), we hypothesized that lithium treatment would be associated with better MD in lithium-responsive BD patients. METHODS BD patients (N = 69; NResponders = 16 [23 %]) performed the Continuous Visual Memory Test (CVMT), which requires discriminating between novel and previously seen images. Before testing, all patients had prophylactic lithium responsiveness assessed over ≥1 year of therapy (with the Alda Score), although only thirty-eight patients were actively prescribed lithium at time of testing (55 %; 12/16 responders, 26/53 nonresponders). We then used computational modelling to extract patient-specific MD indices. Linear models were used to test how (A) lithium treatment, (B) lithium responsiveness via the continuous Alda score, and (C) their interaction, affected MD. RESULTS Superior MD performance was associated with lithium treatment exclusively in lithium-responsive patients (Lithium x AldaScore β = 0.257 [SE 0.078], p = 0.002). Consistent with prior literature, increased age was associated with worse MD (β = -0.03 [SE 0.01], p = 0.005). LIMITATIONS Secondary pilot analysis of retrospectively collected data in a cross-sectional design limits generalizability. CONCLUSION Our study is the first to examine MD performance in BD. Lithium is associated with better MD performance only in lithium responders, potentially due to lithium's effects on dentate gyrus granule cell excitability. Our results may influence the development of behavioural probes for dentate gyrus neuronal hyperexcitability in BD.
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Affiliation(s)
- Dhanyaasri Madanlal
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Christian Guinard
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada; Faculty of Computer Science, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Vanessa Pardo Nuñez
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Suzanna Becker
- Department of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, Ontario, Canada
| | - Julie Garnham
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Anouar Khayachi
- Montreal Neurological Institute, Department of Neurology & Neurosurgery, McGill University, Montreal, Quebec, Canada
| | - Simon Léger
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Claire O'Donovan
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Selena Singh
- Department of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, Ontario, Canada
| | - Shani Stern
- Sagol Department of Neurobiology, Faculty of Natural Sciences, University of Haifa, Israel
| | - Claire Slaney
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Thomas Trappenberg
- Faculty of Computer Science, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Martin Alda
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Abraham Nunes
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada; Faculty of Computer Science, Dalhousie University, Halifax, Nova Scotia, Canada.
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Wu X, Zheng Q, Shen F, Song J, Luo Y, Fei X, Jiang W, Xie S, Ma X, Kuai L, Wang R, Ding X, Li M, Luo Y, Li B. The therapeutic efficacy and mechanism action of Si Cao formula in the treatment of psoriasis: A pilot clinical investigation and animal validation. J Ethnopharmacol 2024; 323:117662. [PMID: 38160866 DOI: 10.1016/j.jep.2023.117662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 12/17/2023] [Accepted: 12/24/2023] [Indexed: 01/03/2024]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Psoriasis is a chronic inflammation and relapsing disease that affected approximately 100 million individuals worldwide. In previous clinical study, it was observed that the topical application of Si Cao Formula (SCF) ameliorated psoriasis skin lesions and reduced the recurrence rate of patients over a period of three months. However, the precise mechanism remains unclear. AIM OF THE STUDY The objective of this study was to assess the effectiveness and safety of SCF in patients diagnosed with psoriasis and explore the molecular mechanisms that contribute to SCF's therapeutic efficacy in psoriasis treatment. MATERIALS AND METHODS A randomized, controlled, and pilot clinical study was performed. This study assessed 30 individuals diagnosed with mild to moderate plaque psoriasis. 15 of them underwent local SCF treatment, the others received calcipotriol intervention. The outcome measure focused on Psoriasis Area and Severity Index (PASI), Dermatology Life Quality Index (DLQI), and recurrence rate. In addition, IMQ-induced psoriasis-like mice model were used to assess the impact of SCF on ameliorating epidermal hyperplasia, suppressing angiogenesis, and modulating immune response. Furthermore, we performed bioinformatics analysis on transcriptome data obtained from skin lesions of mice model. This analysis allowed us to identify the targets and signaling pathways associated with the action of SCF. Subsequently, we conducted experimental validation to confirm the core targets. RESULTS Our clinical pilot study demonstrated that SCF could ameliorate skin lesions in psoriasis patients with comparable efficacy of calcipotriol in drop of PASI and DLQI scores. SCF exhibited a significantly reduced recurrence rate within 12 weeks (33.3%). Liquid Chromatography Mass Spectrometry (LC-MS) identified 41 active constituents of SCF (26 cations and 15 anions). Animal experiments showed SCF ameliorates the skin lesions of IMQ-induced psoriasis like mice model and suppresses epidermal hyperkeratosis and angiogenesis. There were 845 up-regulated and 764 down-regulated DEGs between IMQ and IMQ + SCF groups. GO analysis revealed that DEGs were linked to keratinization, keratinocyte differentiation, organic acid transport epidermal cell differentiation, and carboxylic acid transport interferon-gamma production. KEGG pathway analysis showed that SCF may play a vital part through IL-17 and JAK/STAT signaling pathway. In addition, SCF could reduce the number of positive cells expressing PCNA, CD31, pSTAT3, CD3, and F4/80 within the epidermis of psoriatic lesions, as well as the expression of Il-17a and Stat3 in IMQ-induced psoriasis mice. CONCLUSIONS Our research suggests that SCF serves as a reliable and efficient local approach for preventing and treating psoriasis. The discovery of plausible molecular mechanisms and therapeutic targets associated with SCF may support its broad implementation in clinical settings.
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Affiliation(s)
- Xinxin Wu
- Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, 200443, China
| | - Qi Zheng
- Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, 200443, China
| | - Fang Shen
- Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, 200443, China
| | - Jiankun Song
- Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, 200443, China
| | - Yue Luo
- Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, 200443, China
| | - Xiaoya Fei
- Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, 200443, China
| | - Wencheng Jiang
- Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, 200443, China
| | - Shaoqiong Xie
- Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, 200443, China
| | - Xin Ma
- Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, 200443, China; Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200437, China
| | - Le Kuai
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200437, China; Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Ruiping Wang
- Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, 200443, China
| | - Xiaojie Ding
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200437, China; Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Miao Li
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200437, China; Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Ying Luo
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200437, China; Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, 201203, China.
| | - Bin Li
- Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, 200443, China; Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, 201203, China.
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21
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Pinto JV, Crippa JAS, Ceresér KM, Vianna-Sulzbach MF, Silveira Júnior ÉDM, Santana da Rosa G, Testa da Silva MG, Hizo GH, Simão Medeiros L, Santana de Oliveira CE, Bristot G, Campos AC, Guimarães FS, Hallak JEC, Zuardi AW, Yatham LN, Kapczinski F, Kauer-Sant’Anna M. Cannabidiol as an Adjunctive Treatment for Acute Bipolar Depression: A Pilot Study: Le cannabidiol comme traitement d'appoint de la dépression bipolaire aiguë : une étude pilote. Can J Psychiatry 2024; 69:242-251. [PMID: 37920963 PMCID: PMC10924581 DOI: 10.1177/07067437231209650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2023]
Abstract
OBJECTIVE The treatment of bipolar depression remains challenging due to the limited effective and safe therapeutic options available; thus, developing newer treatments that are effective and well tolerable is an urgent unmet need. The objective of the present trial was to test 150 to 300 mg/day of cannabidiol as an adjunctive treatment for bipolar depression. METHOD A randomized, double-blind, placebo-controlled pilot study to assess the efficacy of adjunctive cannabidiol in bipolar depression was used. Efficacy parameters were changes in the Montgomery-Åsberg Depression Rating Scale (MADRS) from baseline to week 8. Secondary outcomes included response and remission rates, changes in anxiety and psychotic symptoms, and changes in functioning. Patients continued double-blind treatment until week 12 to monitor for adverse effects, laboratory analysis, and manic symptoms. Study registry: NCT03310593. RESULTS A total of 35 participants were included. MADRS scores significantly decreased from baseline to the endpoint (placebo, -14.56; cannabidiol, -15.38), but there was no significant difference between the groups. Similarly, there were no other significant effects on the secondary outcomes. However, an exploratory analysis showed a significant effect of cannabidiol 300 mg/day in reducing MADRS scores from week 2 to week 8 (placebo, -6.64; cannabidiol, -13.72). There were no significant differences in the development of manic symptoms or any other adverse effects. CONCLUSION Cannabidiol did not show significantly higher adverse effects than placebo. Despite the negative finding on the primary outcome, an exploratory analysis suggested that cannabidiol should be further studied in bipolar depression in higher doses of at least 300 mg/day and under research designs that could better control for high placebo response.
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Affiliation(s)
- Jairo Vinícius Pinto
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
- Graduate Programme in Psychiatry and Behavioural Sciences, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
- University Hospital, Federal University of Santa Catarina, Florianópolis, SC, Brazil
| | - José Alexandre S. Crippa
- Department of Neuroscience and Behavioural Sciences, University of São Paulo, Ribeirão Preto, SP, Brazil
- National Institute for Science and Technology in Translational Medicine (INCT–TM), CNPq/FAPESP/CAPES, Ribeirão Preto, Brazil
| | - Keila Maria Ceresér
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
- Graduate Programme in Psychiatry and Behavioural Sciences, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Miréia Fortes Vianna-Sulzbach
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
- Graduate Programme in Psychiatry and Behavioural Sciences, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Érico de Moura Silveira Júnior
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
- Graduate Programme in Psychiatry and Behavioural Sciences, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Gabriel Santana da Rosa
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | | | - Gabriel Henrique Hizo
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
- Graduate Programme in Biochemistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Leonardo Simão Medeiros
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | | | - Giovana Bristot
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
- Graduate Programme in Biochemistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Alline Cristina Campos
- National Institute for Science and Technology in Translational Medicine (INCT–TM), CNPq/FAPESP/CAPES, Ribeirão Preto, Brazil
- Department of Pharmacology, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Francisco Silveira Guimarães
- National Institute for Science and Technology in Translational Medicine (INCT–TM), CNPq/FAPESP/CAPES, Ribeirão Preto, Brazil
- Department of Pharmacology, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Jaime E. C. Hallak
- Department of Neuroscience and Behavioural Sciences, University of São Paulo, Ribeirão Preto, SP, Brazil
- National Institute for Science and Technology in Translational Medicine (INCT–TM), CNPq/FAPESP/CAPES, Ribeirão Preto, Brazil
| | - Antonio W. Zuardi
- Department of Neuroscience and Behavioural Sciences, University of São Paulo, Ribeirão Preto, SP, Brazil
- National Institute for Science and Technology in Translational Medicine (INCT–TM), CNPq/FAPESP/CAPES, Ribeirão Preto, Brazil
| | - Lakshmi N. Yatham
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Flávio Kapczinski
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
- Graduate Programme in Psychiatry and Behavioural Sciences, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
- National Institute for Science and Technology in Translational Medicine (INCT–TM), CNPq/FAPESP/CAPES, Ribeirão Preto, Brazil
- Department of Psychiatry and Behavioral Neuroscience, McMaster University, Hamilton, ON, Canada
| | - Márcia Kauer-Sant’Anna
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
- Graduate Programme in Psychiatry and Behavioural Sciences, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
- Graduate Programme in Biochemistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
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22
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Park D. Effect of using an 8-figure shoulder brace on arm swing angle and gait parameters in chronic stroke patients: a pilot randomized controlled study. Top Stroke Rehabil 2024; 31:293-300. [PMID: 37651200 DOI: 10.1080/10749357.2023.2253626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 08/27/2023] [Indexed: 09/02/2023]
Abstract
BACKGROUND The 8-figure shoulder brace during treadmill training (8-FSBTT) intervention can stabilize the shoulder joint, improve the upright of the thoracic spine, induces a change in the angle of the arm during walking, and consequently improve walking ability in stroke patients. OBJECTIVES Our objective is to compare the effects of a 4-week program of 8-FSBTT with those of only treadmill training (OT) on arm swing angle, and gait parameters (gait speed, cadence, and both side stride lengths) in chronic stroke patients. METHODS Participants were randomized to either the 8-FSBTT (n = 11) or OT (n = 11) group. Patients in both groups underwent standard physiotherapy for 30 min per session. In addition, 8-FSBTT and OT interventions were performed 10 min, 5 times per week for 4 weeks. Arm swing angle, gait speed, cadence, and both side stride lengths were measured after 4 weeks of training. RESULTS After 4 weeks of training, the 8-FSBTT group showed significant improvement in all outcome measures compared with baseline (p < 0.05). Furthermore, Arm swing angle, gait speed, cadence, and both side stride lengths showed greater improvement in the 8-FSBTT group compared to the OT group (p < 0.05). CONCLUSIONS This study demonstrated that 8-FSBTT training, combined with standard physiotherapy, improved Arm swing angle, gait speed, cadence, and both side stride lengths in the chronic stroke patients.
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Affiliation(s)
- Donghwan Park
- Department of Physical Therapy, College of Health Sciences, Kyungnam University, Changwon, South Korea
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23
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Coats CS, Goedel WC, Sims-Gomillia CE, Arnold TL, Wrenn-Jones I, Buck B, Chan PA, Mena LA, Nunn AS. "Make it more than a pill, make it an experience of health:" results from an open pilot intervention to retain young African American men who have sex with men in PrEP care. AIDS Care 2024; 36:472-481. [PMID: 37331017 PMCID: PMC10773530 DOI: 10.1080/09540121.2023.2221422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 05/30/2023] [Indexed: 06/20/2023]
Abstract
Uptake and retention in clinical care for pre-exposure prophylaxis (PrEP) is suboptimal, particularly among young African American men who have sex with men (MSM) in the Deep South. We conducted a two-phase study to develop and implement an intervention to increase PrEP persistence. In Phase I, we conducted focus groups with 27 young African American MSM taking PrEP at a community health center in Jackson, Mississippi to elicit recommendations for the PrEP persistence intervention. We developed an intervention based on recommendations in Phase I, and in Phase II, ten participants were enrolled in an open pilot. Eight participants completed Phase II study activities, including a single intervention session, phone call check-ins, and four assessments (Months 0, 1, 3, and 6). Exit interviews demonstrated a high level of acceptability and satisfaction with the intervention. These formative data demonstrate the initial promise of a novel intervention to improve PrEP persistence among young African American MSM.
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Affiliation(s)
- Cassandra Sutten Coats
- Department of Behavioral and Social Sciences, School of Public Health, Brown University, Providence, Rhode Island
| | - William C. Goedel
- Department of Epidemiology, School of Public Health, Brown University, Providence, Rhode Island
| | - Courtney E. Sims-Gomillia
- Department of Population Health Science, University of Mississippi Medical Center, Jackson, Mississippi
| | - Trisha L. Arnold
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, Rhode Island
| | - Isa Wrenn-Jones
- Department of Population Health Science, University of Mississippi Medical Center, Jackson, Mississippi
| | - Byron Buck
- Department of Population Health Science, University of Mississippi Medical Center, Jackson, Mississippi
| | - Philip A. Chan
- Department of Medicine, Warren Alpert Medical School, Brown University, Providence, Rhode Island
| | - Leandro A. Mena
- Department of Population Health Science, University of Mississippi Medical Center, Jackson, Mississippi
| | - Amy S. Nunn
- Department of Behavioral and Social Sciences, School of Public Health, Brown University, Providence, Rhode Island
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24
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Sam AE, Weber Z, Peña A, Henderson C, King JM, Carr NR. A pilot study to evaluate clinical factors associated with iron and ferritin elevations during pediatric extracorporeal membrane oxygenation. Perfusion 2024; 39:585-592. [PMID: 36725017 DOI: 10.1177/02676591231154750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Introduction: Elevations in serum ferritin and serum iron occur during pediatric extracorporeal membrane oxygenation (ECMO). Previous reports attribute the elevation to frequent red blood cell transfusions and/or hemolysis. Chronic transfusion can cause iron deposition in tissues leading to multisystem organ dysfunction. This study aims identify clinical factors associated with elevated ferritin and iron in pediatric ECMO patients, along with post-decannulation magnetic resonance imaging (MRI) assessment of iron deposition in liver and brain.Methods: Prospective, pilot study, using descriptive statistics to investigate potential associations between patient characteristics, serum ferritin and iron levels, and post-decannulation hepatic and basal ganglia iron deposition.Results: In this study, nine patients (100%) had elevated serum ferritin levels during ECMO. High ferritin levels were more common with veno-arterial than with veno-venous cannulation (p = 0.026) and were also associated with high plasma free hemoglobin levels (p < 0.001). Five patients presented with elevated serum iron levels. High serum iron levels were associated with higher daily (p = 0.016) and cumulative transfusion volumes (p = 0.013) as well ECMO duration beyond 7 days. MRI scans were performed on three patients with no evidence of abnormal iron deposition detected in the liver or brain.Conclusions: This pilot study shows that during pediatric ECMO, elevations in serum ferritin and serum iron occur and those elevations may be related to the cannulation modality, ECMO duration, amount of hemolysis, and volume of red blood cell transfusions. Further investigation is warranted to fully understand the implications of elevated serum iron and ferritin in pediatric ECMO.
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Affiliation(s)
- Ashley E Sam
- Brooke Army Medical Center, Fort Sam Houston, Texas, USA
- Department of Anesthesia, Critical Care, and Pain Medicine, Boston Children's Hospital, Boston, MA, USA
| | - Zachary Weber
- Brooke Army Medical Center, Fort Sam Houston, Texas, USA
- National Capital Consortium, Bethesda, MD, USA
| | - Alejandra Peña
- University Medical Center, Lubbock, TX, USA
- University of Texas Health Science Center San Antonio Joe and Teresa Lozano Long School of Medicine, San Antonio, TX, USA
| | - Cody Henderson
- Children's Hospital of San Antonio, San Antonio, TX, USA
| | | | - Nicholas R Carr
- Brooke Army Medical Center, Fort Sam Houston, Texas, USA
- Department of Pediatrics, University of Utah, Salt Lake City, UT, USA
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25
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Spadi J, Scherf-Clavel M, Leutritz AL, Hütz B, Matentzoglu M, Nieberler M, Kurlbaum M, Hahner S, Bartmann C, McNeill RV, Kittel-Schneider S. Changes in Psychotropic Drug Concentrations Across the Menstrual Cycle: A Pilot Study. Ther Drug Monit 2024; 46:195-202. [PMID: 38321601 DOI: 10.1097/ftd.0000000000001182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 11/13/2023] [Indexed: 02/08/2024]
Abstract
BACKGROUND The escalating prescription of psychopharmacological medications to women of reproductive age underscores the growing significance of sex-specific variations in pharmacotherapy. Despite this, clinical trials have largely overlooked these differences. Preliminary data indicate sex-specific variations in the neurobiology of affective disorders and in the metabolism, pharmacodynamics, and kinetics of therapeutic drugs. This underscores the imperative for a more nuanced exploration of menstrual cycle-dependent fluctuations in psychotropic drugs. This pilot study aimed to investigate drug and hormone fluctuations in female patients with affective disorders, aiming to enhance comprehension of the interplay between cycle-related hormone fluctuations and pharmacokinetics. The ultimate goal is to facilitate more effective and safer pharmacological therapy in the future. METHODS Blood samples were collected from 27 patients and 27 age-matched control participants at 3 distinct time points (early follicular phase, ovulation, and late luteal phase) during each menstrual cycle. Depressive and manic symptoms were assessed, and hormone concentrations were measured in the entire sample, while drug concentrations were assessed solely in the affective disorder sample using mass spectrometry. RESULTS Significant variations in drug concentration were observed throughout the menstrual cycle for bupropion, with a trend toward altered concentration for venlafaxine. Moreover, notable differences in hormone concentrations were identified between patients and controls, even after accounting for the impact of contraceptive use, diagnoses, and medication. CONCLUSIONS This pilot study reinforces previously reported data, underscoring the significance of sex-specific pharmacological therapy approaches. It provides further evidence supporting the interaction among sex hormones, drugs, and symptoms of affective disorders.
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Affiliation(s)
- Julia Spadi
- Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, University Hospital of Würzburg, Würzburg, Germany
| | - Maike Scherf-Clavel
- Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, University Hospital of Würzburg, Würzburg, Germany
| | - Anna Linda Leutritz
- Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, University Hospital of Würzburg, Würzburg, Germany
| | - Barbara Hütz
- Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, University Hospital of Würzburg, Würzburg, Germany
| | - Maria Matentzoglu
- Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, University Hospital of Würzburg, Würzburg, Germany
| | - Matthias Nieberler
- Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, University Hospital of Würzburg, Würzburg, Germany
| | - Max Kurlbaum
- Department of Endocrinology, Department of Internal Medicine, University Hospital of Würzburg, Würzburg, Germany
| | - Stefanie Hahner
- Department of Endocrinology, Department of Internal Medicine, University Hospital of Würzburg, Würzburg, Germany
| | - Catharina Bartmann
- Department of Gynaecology and Obstetrics, University Hospital of Würzburg, Würzburg, Germany; and
| | - Rhiannon V McNeill
- Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, University Hospital of Würzburg, Würzburg, Germany
| | - Sarah Kittel-Schneider
- Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, University Hospital of Würzburg, Würzburg, Germany
- Department of Psychiatry and Neurobehavioural Science, University College Cork, Cork, Ireland
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26
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Park HJ, Winant AJ, Lee EY, Kim WG, Shashi K, Stamoulis C, Paltiel HJ. Contrast-Enhanced Ultrasound of the Chest in Children and Adolescents: A Pilot Study for Assessment of Added Diagnostic Value. J Ultrasound Med 2024; 43:697-711. [PMID: 38189176 DOI: 10.1002/jum.16395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 10/30/2023] [Accepted: 11/28/2023] [Indexed: 01/09/2024]
Abstract
OBJECTIVES To determine the added diagnostic value of contrast-enhanced ultrasound (CEUS) in pediatric chest abnormalities by comparing interpretation of CEUS studies and confidence level to conventional US studies. METHODS CEUS studies in patients with a variety of clinically suspected chest abnormalities performed between 2016 and 2020 were reviewed and compared to same-day conventional US studies. Examinations were independently interpreted by 4 radiologists blinded to clinical and other imaging data. Rater confidence was classified as low, moderate, or high. Diagnostic accuracy was determined by comparing image interpretation to patient outcome as the ground truth. Interobserver agreement was also assessed. RESULTS Sixteen patients (10 male) with 18 CEUS studies were included. Median rater agreement with ground truth was significantly higher for CEUS (100%) than conventional US (50%; P = .004). Median rater confidence was high (3.0) for CEUS, and low-moderate (1.5) for conventional US (P < .001). CEUS sensitivity (54.6-81.8%) and specificity (63.4-100.0%) were greater than conventional US (45.5-72.7% and 12.5-63.5%, respectively). CEUS false positives (0-4) and false negatives (2-5) were fewer than conventional US (4-7 and 3-6, respectively). Except for one rater pair where agreement was substantial (κ = .78, P < .01), inter-rater agreement for CEUS for all other rater pairs was nonsignificant (κ = .25-0.51, P ≥ .07). Agreement for conventional US was moderate and statistically significant for 3 rater pairs (κ = .55-0.78) and nonsignificant for the remaining 3 rater pairs (P ≥ .06). CONCLUSIONS CEUS adds diagnostic value to the assessment of a variety of chest abnormalities. The data support further evaluation of the role of CEUS as a non-invasive, problem-solving technique in children.
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Affiliation(s)
- Halley J Park
- Department of Radiology, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Abbey J Winant
- Department of Radiology, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Edward Y Lee
- Department of Radiology, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Wendy G Kim
- Department of Radiology, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Kumar Shashi
- Department of Radiology, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Catherine Stamoulis
- Department of Pediatrics, Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Harriet J Paltiel
- Department of Radiology, Boston Children's Hospital, Boston, Massachusetts, USA
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Abstract
OBJECTIVE The use of sexual activity to self-injure has been proposed in research literature but remains underexplored. The purpose of this pilot study was to determine the feasibility of identifying sexual activity as self-injury in a U.S. college-based sample and to provide a preliminary examination of sexual activity as self-injury to inform future study on this topic. METHOD A cross-sectional descriptive pilot study was conducted to assess for recognition of and attitudes toward sexual behavior as self-injury and to identify participant-reported experiences of sexual activity to self-injure. RESULTS A total of 50 participants completed the online survey. Thirteen (26%) participants reported they had heard of the concept of "sex as self-injury." Six (12%) participants reported ever having used sexual activity to cause physical or psychological harm to themselves. Participants reported intentions for engaging in sexual activity to self-injure, including causing physical pain, reliving past self-harm or trauma, showing vulnerability, proving self-worth, pleasing or wanting to feel needed by their partner, and suicidal ideation. CONCLUSION Sexual activities have been used by some college students as a means of self-harm. Further research is needed to understand this phenomenon and clinicians should consider screening for this in patients who participate in dangerous sexual behaviors or self-injurious behaviors.
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Affiliation(s)
- Julie E Mellin
- Julie E. Mellin, MSN, APRN, PMHNP-BC, PhD Student, School of Nursing, The University of Texas at Austin, Austin, TX, USA
| | - Cara C Young
- Cara C. Young, PhD, APRN, FNP-C, FAANP, Associate Professor, School of Nursing, The University of Texas at Austin, Austin, TX, USA
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28
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Beltsios E, Zubarevich A, Ruemke S, Rubalskii E, Osswald A, Arjomandi Rad A, Heidenau F, Buer J, Hanke J, Schmitto J, Popov AF, Kuehn C, Schmack B, Ruhparwar A, Weymann A. Antibacterial copper-filled TiO 2 coating of cardiovascular implants to prevent infective endocarditis-A pilot study. Artif Organs 2024; 48:356-364. [PMID: 38010063 DOI: 10.1111/aor.14688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 10/15/2023] [Accepted: 11/07/2023] [Indexed: 11/29/2023]
Abstract
BACKGROUND Infective endocarditis (IE) poses a significant health risk, especially in patients with prosthetic heart valves. Despite advances in treatment, mortality rates remain high. This study aims to investigate the antibacterial properties of a copper titanium dioxide (4× Cu-TiO2) coating on cardiovascular implants against Staphylococcus aureus, a common causative agent of IE. METHODS Titanium oxide carriers functionalized with copper ions were employed as an antibacterial coating for heart and vascular prostheses. The coating's antibacterial efficacy was assessed using S. aureus ATCC 29213. Microscopic evaluations were conducted on both biological and artificial materials. Antibacterial activity was qualitatively assessed via a modified disc diffusion method and quantitatively measured through colony counts in NaCl suspensions. RESULTS The coating process was successfully applied to all tested cardiovascular prosthetic materials. Qualitative assessments of antibacterial effectiveness revealed an absence of bacterial growth in the area directly beneath the coated valve. Quantitative evaluations showed a significant reduction in bacterial colonization on coated mechanical valves, with 2.95 × 104 CFU per valve, compared to 1.91 × 105 CFU in control valves. CONCLUSIONS The 4× Cu-TiO2 coating demonstrated promising antibacterial properties against S. aureus, suggesting its potential as an effective strategy for reducing the risk of bacterial colonization of cardiovascular implants. Further studies are needed to assess the longevity of the coating and its efficacy against other pathogens.
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Affiliation(s)
- Eleftherios Beltsios
- Department of Cardiothoracic, Transplant and Vascular Surgery, Hannover Medical School, Hannover, Germany
| | - Alina Zubarevich
- Department of Cardiothoracic, Transplant and Vascular Surgery, Hannover Medical School, Hannover, Germany
| | - Stefan Ruemke
- Department of Cardiothoracic, Transplant and Vascular Surgery, Hannover Medical School, Hannover, Germany
| | - Evgenii Rubalskii
- Department of Cardiothoracic, Transplant and Vascular Surgery, Hannover Medical School, Hannover, Germany
| | - Anja Osswald
- Department of Thoracic and Cardiovascular Surgery, West German Heart and Vascular Center, University of Duisburg-Essen, Essen, Germany
| | | | | | - Jan Buer
- Institute of Medical Microbiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Jasmin Hanke
- Department of Cardiothoracic, Transplant and Vascular Surgery, Hannover Medical School, Hannover, Germany
| | - Jan Schmitto
- Department of Cardiothoracic, Transplant and Vascular Surgery, Hannover Medical School, Hannover, Germany
| | - Aron-Frederik Popov
- Department of Cardiothoracic, Transplant and Vascular Surgery, Hannover Medical School, Hannover, Germany
| | - Christian Kuehn
- Department of Cardiothoracic, Transplant and Vascular Surgery, Hannover Medical School, Hannover, Germany
| | - Bastian Schmack
- Department of Cardiothoracic, Transplant and Vascular Surgery, Hannover Medical School, Hannover, Germany
| | - Arjang Ruhparwar
- Department of Cardiothoracic, Transplant and Vascular Surgery, Hannover Medical School, Hannover, Germany
| | - Alexander Weymann
- Department of Cardiothoracic, Transplant and Vascular Surgery, Hannover Medical School, Hannover, Germany
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Phimister FD, Anderson RC, Thomas DG, Farquhar MJ, Maclean P, Jauregui R, Young W, Butowski CF, Bermingham EN. Using meta-analysis to understand the impacts of dietary protein and fat content on the composition of fecal microbiota of domestic dogs (Canis lupus familiaris): A pilot study. Microbiologyopen 2024; 13:e1404. [PMID: 38515236 PMCID: PMC10958101 DOI: 10.1002/mbo3.1404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Revised: 02/07/2024] [Accepted: 02/29/2024] [Indexed: 03/23/2024] Open
Abstract
The interplay between diet and fecal microbiota composition is garnering increased interest across various host species, including domestic dogs. While the influence of dietary macronutrients and their associated microbial communities have been extensively reviewed, these reviews are descriptive and do not account for differences in microbial community analysis, nor do they standardize macronutrient content across studies. To address this, a meta-analysis was performed to assess the impact of dietary crude protein ("protein") and dietary crude fat ("fat") on the fecal microbiota composition in healthy dogs. Sixteen publications met the eligibility criteria for the meta-analysis, yielding a final data set of 314 dogs. Diets were classed as low, moderate, high, or supra in terms of protein or fat content. Sequence data from each publication were retrieved from public databases and reanalyzed using consistent bioinformatic pipelines. Analysis of community diversity indices and unsupervised clustering of the data with principal coordinate analysis revealed a small effect size and complete overlap between protein and fat levels at the overall community level. Supervised clustering through random forest analysis and partial least squares-discriminant analysis indicated alterations in the fecal microbiota composition at a more individual taxonomic level, corresponding to the levels of protein or fat. The Prevotellaceae Ga6A1 group and Enterococcus were associated with increasing levels of protein, while Allobaculum and Clostridium sensu stricto 13 were associated with increasing levels of fat. Interestingly, the random forest analyses revealed that Sharpea, despite its low relative abundance in the dog's fecal microbiome, was primarily responsible for the separation of the microbiome for both protein and fat. Future research should focus on validating and understanding the functional roles of these relatively low-abundant genera.
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Affiliation(s)
- Francis D. Phimister
- AgResearch LtdManawatu‐WhanganuiNew Zealand
- School of Agricultural and EnvironmentMassey UniversityManawatu‐WhanganuiNew Zealand
| | | | - David G. Thomas
- School of Agricultural and EnvironmentMassey UniversityManawatu‐WhanganuiNew Zealand
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Matheney T, Shore B, Miller P, Barnewolt C, Kim YJ, Paltiel H. Comparison of Contrast-enhanced Ultrasound and Contrast-enhanced Magnetic Resonance Imaging in the Assessment of Infant Hip Perfusion and Prediction of Proximal Femoral Growth Disturbance Following Closed and Open Reduction for Developmental Dysplasia of the Hip: A Preliminary Study. J Pediatr Orthop 2024; 44:e335-e343. [PMID: 38193395 DOI: 10.1097/bpo.0000000000002614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2024]
Abstract
OBJECTIVE Proximal femoral growth disturbance (PFGD) is a significant complication associated with surgical treatment of infant hip dislocation. Contrast-enhanced magnetic resonance imaging (CEMRI) has been utilized to assess perfusion in these hips and avoid PFGD. Contrast-enhanced ultrasound (CEUS) is an imaging technique utilized to evaluate perfusion in other organs. The aims of this study were to compare perfusion of dysplastic infant hips with CEUS and CEMRI after surgical treatment and to determine whether CEUS was as effective as CEMRI at predicting PFGD. METHODS A retrospective analysis of patients undergoing closed or open reduction for infant hip dislocation between 2012 and 2019 was performed. All patients underwent intraoperative CEUS and postoperative CEMRI to assess femoral epiphyseal perfusion using intravenous contrast. Perfusion status was rated as normal, partially decreased, or globally decreased in both modalities. Agreement in perfusion status between CEUS and CEMRI was assessed. Patients were followed for a minimum of 2 years postoperatively and assessed for PFGD. RESULTS Eighteen patients (28% males) underwent closed or open reduction at an average age of 8 months (3 to 16 mo). The agreement in perfusion status between CEUS and CEMRI was substantial (α = 0.74). Patients were followed for a median of 3 years. PFGD developed in 3 hips (17%). For the detection of PFGD, both imaging modalities performed very well and with no difference in the diagnostic utility of CEUS compared with CEMRI. Considering normal perfusion alone the accuracy, sensitivity, and specificity for CEUS were 83%, 100%, and 80%, and for CEMRI were 78%, 100%, and 73%, respectively. Considering global decreased perfusion alone, the accuracy, sensitivity, and specificity for CEUS were 94%, 67%, and 100%, and for CEMRI were 89%, 67%, and 93%, respectively. CONCLUSIONS CEUS is a viable intraoperative method to assess infant hip perfusion. This pilot study appears to be comparable to CEMRI at visualizing perfusion of infant hips and as good or better in predicting PFGD after hip reduction. Prospective studies of this imaging technique should be performed to confirm the findings of this retrospective review. LEVEL OF EVIDENCE Level II-development diagnostic criteria on the basis of consecutive patients (with generally preferred standard).
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Franco FB, Leeman JE, Fedorov A, Vangel M, Fennessy FM. Early change in apparent diffusion coefficient as a predictor of response to neoadjuvant androgen deprivation and external beam radiation therapy for intermediate- to high-risk prostate cancer. Clin Radiol 2024; 79:e607-e615. [PMID: 38302377 DOI: 10.1016/j.crad.2023.12.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 11/15/2023] [Accepted: 12/31/2023] [Indexed: 02/03/2024]
Abstract
AIM To determine the role of serial apparent diffusion coefficient (ADC) as a biomarker for response to neoadjuvant androgen deprivation therapy (nADT) followed by external beam radiation therapy (EBRT) in intermediate- to high-risk prostate cancer (PCa) patients. METHODS This Health Insurance Portability and Accountability Act (HIPAA)-compliant, institutional review board (IRB)-approved prospective study included 12 patients with intermediate- to high-risk PCa patients prior to nADT and EBRT, who underwent serial serum prostate-specific antigen (PSA) and multiparametric prostate magnetic resonance imaging (mpMRI) at baseline (BL), 8-weeks after nADT initiation (time point [TP]1), 6-weeks into EBRT delivery (TP2), and 6-months after nADT initiation (TP3). Tumour volume (tVOL) and tumour and normal tissue ADC (tADC and nlADC) were determined at all TPs. tADC and nlADC dynamics were correlated with post-treatment PSA using Pearson's correlation coefficient. Paired t-tests compared pre/post-treatment ADC. RESULTS There was a sequential decrease in PSA at all TPs, reaching their lowest values at TP3 post-treatment completion. Mean tADC increased significantly from baseline to TP1 (917.8 ± 107.7 × 10-6 versus 1033.8 ± 139.3 × 10-6 mm2/s; p<0.01), with no subsequent change at TP2 or TP3. Both percentage and absolute change in tADC from BL to TP1 correlated with post-treatment PSA (r=-0.666, r=-0.674; p=0.02). Post-treatment PSA in good responders (<0.1 ng/ml) versus poor responders (≥ 0.1 ng/ml) was associated with a greater increase in tADC from BL to TP1 (169.2 ± 122.4 × 10-6 versus 22.9 ± 75.5 × 10-6 mm2/s, p=0.03). CONCLUSION This pilot study demonstrates the potential for early ADC metrics as a biomarker of response to nADT and EBRT in intermediate to high-risk PCA.
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Affiliation(s)
- F B Franco
- Department of Radiology, Harvard Medical School, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA
| | - J E Leeman
- Department of Radiation Oncology, Harvard Medical School, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA
| | - A Fedorov
- Department of Radiology, Harvard Medical School, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA
| | - M Vangel
- Statistician, General Clinical Research Center, Massachusetts Institute of Technology and Massachusetts General Hospital, 55 Fruit St, Boston, MA 02214, USA
| | - F M Fennessy
- Department of Radiology, Harvard Medical School, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA.
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Toriguchi K, Kaihara S, Kitamura K, Ishikawa T, Oshima N, Kondo M, Kobayashi H, Hashida H, Uryuhara K. Efficacy of surgical staple line reinforcement in Glissonean stapling: A single-center pilot study. Asian J Endosc Surg 2024; 17:e13293. [PMID: 38452773 DOI: 10.1111/ases.13293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 01/18/2024] [Accepted: 02/06/2024] [Indexed: 03/09/2024]
Abstract
Vascular staplers are routinely used in laparoscopic liver resection, which has become a standard procedure in advanced medical facilities. Although previous reports have outlined the benefits of staple line reinforcement (SLR), its application in Glissonean pedicle transection during hepatic resection remains poorly studied. This study investigated surgical SLR as a tool to enhance staple line strength and improve perioperative hemostasis. Here, 10 patients who underwent laparoscopic liver resection using the Tri-StapleTM2.0 Reinforced Reload were included. Patient characteristics, surgical details, and outcomes were assessed. The results demonstrated successful outcomes with no complications related to bile leakage or injuries during staple insertion. Overall, our findings suggest that SLR can be safely utilized in Glissonean pedicle transection during laparoscopic liver resections. Further studies are required to comprehensively evaluate its benefits compared with conventional surgical staplers.
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Affiliation(s)
- Kan Toriguchi
- Department of Surgery, Kobe Medical Center General Hospital, Kobe city, Hyogo, Japan
| | - Satoshi Kaihara
- Department of Surgery, Kobe Medical Center General Hospital, Kobe city, Hyogo, Japan
| | - Koji Kitamura
- Department of Surgery, Kobe Medical Center General Hospital, Kobe city, Hyogo, Japan
| | - Tatsuki Ishikawa
- Department of Surgery, Kobe Medical Center General Hospital, Kobe city, Hyogo, Japan
| | - Nobu Oshima
- Department of Surgery, Kobe Medical Center General Hospital, Kobe city, Hyogo, Japan
| | - Masato Kondo
- Department of Surgery, Kobe Medical Center General Hospital, Kobe city, Hyogo, Japan
| | - Hiroyuki Kobayashi
- Department of Surgery, Kobe Medical Center General Hospital, Kobe city, Hyogo, Japan
| | - Hiroki Hashida
- Department of Surgery, Kobe Medical Center General Hospital, Kobe city, Hyogo, Japan
| | - Kenji Uryuhara
- Department of Surgery, Kobe Medical Center General Hospital, Kobe city, Hyogo, Japan
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Carrico C, Skrjanc L, Kanduti D, Deeb G, Deeb JG. Effect of guided implant placement learning experiences on freehand skills: A pilot study. Clin Exp Dent Res 2024; 10:e878. [PMID: 38506282 PMCID: PMC10952114 DOI: 10.1002/cre2.878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 02/14/2024] [Accepted: 02/29/2024] [Indexed: 03/21/2024] Open
Abstract
OBJECTIVES Guided implant systems can be used as a training approach for placing implants. This in vitro prospective randomized pilot study evaluated the learning progression and skill development in freehand placement of two implants supporting a three-unit fixed prosthesis on a simulation model among novice operators. MATERIAL AND METHODS Four senior dental students with no prior implant placement experience participated in the study. As a baseline, each student placed two mandibular and two maxillary implants by freehand technique on a simulation model. Sixteen consecutive guided placements using a static guide, dynamic navigation, and template-based guide followed totaling 32 guided implant placements into maxillary and mandibular models. Freehand implant placements before and after the various guided navigation attempts were compared to assess their impact on freehand skill. Metrics compared included surgical time, horizontal, vertical, and angulation discrepancies between the planned and placed implant positions measured on superimposed CBCT scans and analyzed with repeated measures regression with Tukey's adjusted pairwise comparisons (α = .05). RESULTS Before training with guided techniques, the average baseline freehand implant placement took 10.2 min and decreased to 8.2 after training but this difference was not statistically significant (p = .1670) There was marginal evidence of a significant difference in the 3D apex deviation with an average improvement of 0.89 mm (95% CI: -0.38, 2.16, p = .1120); and marginal evidence of a significant improvement in the overall angle with an average improvement of 3.74° (95% CI: -1.00, 8.48, p = .0869) between baseline and final freehand placement attempts. CONCLUSIONS Within the limitations of this pilot study, guided implant placement experiences did not significantly benefit or hinder freehand placement skills. Dental students should be exposed to various placement techniques to prepare them for clinical practice and allow them to make informed decisions on the best technique based on their skills and a given clinical scenario.
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Affiliation(s)
- Caroline Carrico
- Dental Public Health and Policy, School of DentistryVirginia Commonwealth UniversityRichmondVirginiaUSA
| | | | - Domen Kanduti
- Department for Oral Diseases and Periodontology, Division for Dental Medicine, Faculty of MedicineUniversity of LjubljanaLjubljanaSlovenia
| | - George Deeb
- Department of Oral and Maxillofacial Surgery, School of DentistryVirginia Commonwealth UniversityRichmondVirginiaUSA
| | - Janina Golob Deeb
- Department of Periodontics, School of DentistryVirginia Commonwealth UniversityRichmondVirginiaUSA
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Husk KE, Lewis JM. Higher degree of impostor characteristics relates to lower self-perceived teaching ability and emotional intelligence. Clin Teach 2024; 21:e13647. [PMID: 37665024 DOI: 10.1111/tct.13647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 08/01/2023] [Indexed: 09/05/2023]
Abstract
BACKGROUND Emotional intelligence (EI) has been previously associated with teaching ability and impostor phenomenon (IP) in medical education; however, studies have demonstrated mixed findings and have largely focused on trainees only. Therefore, we sought to explore the potential association between the degree of IP characteristics, EI and teaching ability in obstetrics and gynaecology (Ob/Gyn) faculty physicians. METHODS A cross-sectional, survey-based pilot study was completed at a single academic institution. Ob/Gyn attending (faculty) physicians were queried using surveys related to IP, EI and teaching ability. Resident (trainee) physicians also completed anonymous evaluations of faculty teaching ability. FINDINGS The degree of IP characteristics correlated negatively with self-perceived teaching ability, with no significant differences in resident assessment of faculty teaching. IP also correlated negatively with EI. Although there were no statistically significant differences in resident assessment of teaching ability based on EI, both EI and IP demonstrated inverse relationships to faculty assessment of teaching ability compared with resident assessment. CONCLUSION IP appears to relate to lower perceived teaching ability in Ob/Gyn faculty that does not correspond to resident evaluation of teaching performance. The demonstrated negative correlation between the degree of impostor characteristics and EI suggests that EI could potentially play a protective role in the development of IP and burnout, as well as influence teaching. This relationship may have implications for faculty willingness to continue in academic medicine.
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Affiliation(s)
- Katherine E Husk
- Department of Obstetrics and Gynecology, Albany Medical Center, Albany, New York, USA
| | - James M Lewis
- Department of Surgery, University of Tennessee Graduate School of Medicine, Knoxville, Tennessee, USA
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Viola E, Martorana M, Airoldi C, Caristia S, Ceriotti D, De Vito M, Tucci R, Meini C, Guiot G, Faggiano F. Dedalo Vola project: The effect of choral singing on physiological and psychosocial measures. An Italian pilot study. Acta Psychol (Amst) 2024; 244:104204. [PMID: 38430726 DOI: 10.1016/j.actpsy.2024.104204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 02/27/2024] [Accepted: 02/29/2024] [Indexed: 03/05/2024] Open
Abstract
Several studies have been conducted that show the crucial role of active participation in music in health promotion (e.g. Dingle et al., 2021; Sheppard & Broughton, 2020); however, little research has focused on the biopsychosocial effects of choral singing. The present study aims to evaluate the effectiveness, in terms of improving physiological and psychosocial factors, of a choral program for middle-aged and older individuals. We integrated our study with qualitative observations of the atmosphere and flow state experienced by the choristers. The data were collected before and after 12 weeks of training, with 23 participants took part in the study. They experienced significant improvements in weight, oxygen saturation, heart rate, and satisfaction of psychological needs. A beneficial trend, although not statistically significant, were observed for blood pressure, cholesterol, triglycerides, stress, psychological needs, and mental health. The observations progressively revealed a more cohesive and focused group. Our findings support the potential for cross-disciplinary collaboration between healthcare and arts policy to promote and enhance health and well-being throughout the lifespan.
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Affiliation(s)
- Erica Viola
- Department for Sustainable Development and Ecological Transition, University of Eastern Piedmont, Piazza Sant'Eusebio 5, Vercelli 13100, Italy.
| | - Marco Martorana
- Department for Sustainable Development and Ecological Transition, University of Eastern Piedmont, Piazza Sant'Eusebio 5, Vercelli 13100, Italy
| | - Chiara Airoldi
- Department of Translational Medicine, University of Eastern Piedmont, Via Solaroli, 17, 28100 Novara, Italy
| | - Silvia Caristia
- Department for Sustainable Development and Ecological Transition, University of Eastern Piedmont, Piazza Sant'Eusebio 5, Vercelli 13100, Italy
| | - Daniele Ceriotti
- Department of Translational Medicine, University of Eastern Piedmont, Via Solaroli, 17, 28100 Novara, Italy
| | - Marta De Vito
- Department of Translational Medicine, University of Eastern Piedmont, Via Solaroli, 17, 28100 Novara, Italy
| | - Riccardo Tucci
- Department for Sustainable Development and Ecological Transition, University of Eastern Piedmont, Piazza Sant'Eusebio 5, Vercelli 13100, Italy
| | - Cristina Meini
- Department for Sustainable Development and Ecological Transition, University of Eastern Piedmont, Piazza Sant'Eusebio 5, Vercelli 13100, Italy
| | | | - Fabrizio Faggiano
- Department for Sustainable Development and Ecological Transition, University of Eastern Piedmont, Piazza Sant'Eusebio 5, Vercelli 13100, Italy; Epidemiologic Unit of the Local Health Authority of Vercelli (I) - Osservatorio Epidemiologico, ASL Vercelli, Italy
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Wang AYM, Tang TK, Yau YY, Lo WK. Impact of Parathyroidectomy Versus Oral Cinacalcet on Bone Mineral Density in Patients on Peritoneal Dialysis With Advanced Secondary Hyperparathyroidism: The PROCEED Pilot Randomized Trial. Am J Kidney Dis 2024; 83:456-466.e1. [PMID: 38040277 DOI: 10.1053/j.ajkd.2023.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 10/21/2023] [Accepted: 10/22/2023] [Indexed: 12/03/2023]
Abstract
RATIONALE & OBJECTIVE Parathyroidectomy and calcimimetics have been used to reduce fracture risk in patients with kidney failure and advanced secondary hyperparathyroidism (SHPT), but direct comparisons of these treatment approaches have not been implemented. This pilot study compared their effects on bone mineral density (BMD) in this patient population. STUDY DESIGN A prospective pilot open-label randomized trial. SETTING & PARTICIPANTS 65 patients receiving maintenance peritoneal dialysis with advanced SHPT recruited from 2 university-affiliated hospitals in Hong Kong. INTERVENTIONS Total parathyroidectomy with forearm autografting versus oral cinacalcet treatment for 12 months. OUTCOME Prespecified secondary end points including changes in BMD z and T scores of femoral neck, lumbar spine, and distal radius 12 months after treatment initiation and also categorized as osteopenia or osteoporosis according to the World Health Organization. RESULTS Both total parathyroidectomy and cinacalcet significantly improved BMD of the lumbar spine and femoral neck over 12 months, but the total parathyroidectomy group had a greater increase than the cinacalcet-treated group (P<0.001). The proportion of study participants classified as having osteopenia/osteoporosis by femoral neck T-score fell from 78.2% to 51.7% in the total parathyroidectomy group (P<0.001) and from 65.7% to 52.0% in cinacalcet-treated group after 12 months (P=0.7). The proportion of participants with a T-score at the lumbar spine classified as osteopenia/osteoporosis fell from 53.1% to 31.0% in the total parathyroidectomy group (P=0.01) and from 59.4% to 53.8% with cinacalcet (P=0.3). No significant change was observed in BMD T or z score of the distal radius over 12 months with either intervention. LIMITATIONS Bone histology was not assessed, and the study duration was 12 months. CONCLUSIONS A large proportion of peritoneal dialysis patients with advanced SHPT had low bone densities and osteopenia/osteoporosis. Total parathyroidectomy increased the BMD of the lumbar spine and femoral neck and reduced osteopenia/osteoporosis more than oral cinacalcet. FUNDING Grants from academic (The University of Hong Kong Research) and not-for-profit (Hong Kong Society of Nephrology) entities. REGISTRATION Registered at Clinicaltrials.gov with study number NCT01447368. PLAIN-LANGUAGE SUMMARY It is not known whether oral cinacalcet and surgical parathyroidectomy differ in their effects on bone parameters in patients with advanced secondary hyperparathyroidism (SHPT) receiving peritoneal dialysis. This pilot randomized trial evaluated the effect of medical versus surgical therapy on bone mineral densities (BMD) as prespecified secondary study end points. The findings showed that a large proportion of peritoneal dialysis patients with advanced SHPT had low bone densities and osteopenia/osteoporosis. Parathyroidectomy increased the BMD of the lumbar spine and femoral neck more than cinacalcet over 12 months. Parathyroidectomy reduced the proportion of patients with osteopenia/osteoporosis at the lumbar spine and femoral neck more than cinacalcet after 12 months. Neither intervention led to an increase in the BMD of the distal radius over 12 months.
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Affiliation(s)
- Angela Yee-Moon Wang
- University Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong.
| | - Tak-Ka Tang
- University Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong
| | | | - Wai Kei Lo
- Department of Medicine, Tung Wah Hospital, Hong Kong
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Kaya O, Akif Aydin M, Teymoori M, Kaan Erden O, Sadeghzadeh S, Dedeoglu UO, Demir S, Muhikanci O, Sahin A, Torun H, Dundar G, Yalcinkaya AD. A first-in-human pilot study of a novel electrically-passive metamaterial-inspired resonator-based ocular sensor embedded contact lens monitoring intraocular pressure fluctuations. Cont Lens Anterior Eye 2024; 47:102102. [PMID: 38114379 DOI: 10.1016/j.clae.2023.102102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 11/29/2023] [Accepted: 12/03/2023] [Indexed: 12/21/2023]
Abstract
Glaucoma is a leading cause of blindness with no cure, but early treatment and effective monitoring can often slow the progression of the disease. Monitoring of glaucoma is based on the measurement of intra-ocular pressure (IOP) that is a physiological parameter related to the mechanical state and parameters of the eye. Conventionally, diagnosing and assessing the progression of glaucoma is based on the method of measuring IOP discretely at clinics. Recent studies have demonstrated the importance of continuously monitoring IOP for 24 h to elucidate the effect of circadian rhythm. In this work, a metamaterial-inspired electrically-passive sensor-embedded contact lens is presented to monitor the IOP fluctuations based on a first-in-human pilot study. The sensor inside the contact lens is an electrically passive, metamaterial-based resonator that can be measured using a wearable antenna patch. The system has been tested with six healthy volunteers during an experiment to induce deliberate IOP changes via water-loading and placing the individuals in supine position using a recliner seat. The initial data compared with tonometer measurements suggest that the system can be used to assess the variation of IOP continuously.
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Affiliation(s)
- Ozgur Kaya
- Glakolens, Bogazici Universitesi Teknopark 302, 34470 Istanbul, Turkiye
| | - M Akif Aydin
- Glakolens, Bogazici Universitesi Teknopark 302, 34470 Istanbul, Turkiye
| | - Morteza Teymoori
- Glakolens, Bogazici Universitesi Teknopark 302, 34470 Istanbul, Turkiye
| | - Oguz Kaan Erden
- Glakolens, Bogazici Universitesi Teknopark 302, 34470 Istanbul, Turkiye
| | | | - Ulas O Dedeoglu
- Glakolens, Bogazici Universitesi Teknopark 302, 34470 Istanbul, Turkiye
| | - Saibe Demir
- Glakolens, Bogazici Universitesi Teknopark 302, 34470 Istanbul, Turkiye
| | - Omer Muhikanci
- Glakolens, Bogazici Universitesi Teknopark 302, 34470 Istanbul, Turkiye
| | - Afsun Sahin
- Department of Ophthalmology, Koc University Medical School, Istanbul, Turkiye
| | - Hamdi Torun
- Faculty of Engineering & Environment, University of Northumbria, Newcastle Upon Tyne, NE1 8ST, UK.
| | - Gunhan Dundar
- Department of Electrical and Electronics Engineering, Bogazici University, Bebek 34342 Istanbul, Turkiye
| | - Arda D Yalcinkaya
- Department of Electrical and Electronics Engineering, Bogazici University, Bebek 34342 Istanbul, Turkiye
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Tovoli F, Stefanini B, Mandrioli D, Mattioli S, Vornoli A, Sgargi D, Manservisi F, Piscaglia F, Curti S, Bolondi L. Exploring occupational toxicant exposures in patients with metabolic dysfunction-associated steatotic liver disease: A prospective pilot study. Dig Liver Dis 2024; 56:571-578. [PMID: 38151451 DOI: 10.1016/j.dld.2023.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 11/15/2023] [Accepted: 12/13/2023] [Indexed: 12/29/2023]
Abstract
BACKGROUND Metabolic dysfunction-associated steatotic liver disease (MASLD) has been traditionally associated with insulin resistance and obesity. Recently, pollutants have been shown to contribute to the development of MASLD. Given the global burden of MASLD, understanding whether pollutants are merely associated with steatosis or contribute to its progression to advanced chronic liver disease (ACLD) and hepatocellular carcinoma (HCC) is critical. Workers exposed to occupational toxicants represent an ideal population for assessing the potentially hazardous consequences of professional exposure. Confirming a link between occupational exposure and ACLD/HCC may not only provide further elements in understanding MASLD, but also contribute to preventive strategies for exposed workers. OBJECTIVE This study aimed to assess the prevalence of self-reported occupational exposure to toxicants in patients with MASLD. METHODS This hospital-based prospective pilot study included 201 patients with MASLD. Data on workplace toxicant exposure were collected systematically using a structured questionnaire. Subsequently, patients with ACLD and/or HCC (n = 55) were compared to controls (n = 146). Logistic regression analysis and propensity score models were used to investigate the associations between self-reported occupational exposure and ACLD and/or HCC. RESULTS Patients with ACLD/HCC reported exposure to metals, halogenated refrigerants, pain/resins, and fuel emissions more often than the controls. After controlling for confounders, durations of 21-30 years and >30 years of occupational exposure to toxicants showed odds ratios (ORs) of 2.31 (95 % confidence interval [CI]: 1.09-4.88, p = 0.029) and 4.47 (95 % CI: 2.57-7.78, p<0.001), respectively. CONCLUSIONS In this pilot study, patients with MASLD complications were more likely to report workplace toxicant exposure. Our results warrant future multicentre confirmatory studies, as implementing prevention policies may reduce the risk of life-threatening diseases among exposed populations.
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Affiliation(s)
- Francesco Tovoli
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy; Division of Internal Medicine, Hepatobiliary and Immunoallergic Diseases, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
| | - Bernardo Stefanini
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Daniele Mandrioli
- Cesare Maltoni Cancer Research Center, Ramazzini Institute, Bologna, Italy
| | - Stefano Mattioli
- Department of Environmental and Prevention Sciences, University of Ferrara, Ferrara, Italy
| | - Andrea Vornoli
- Cesare Maltoni Cancer Research Center, Ramazzini Institute, Bologna, Italy
| | - Daria Sgargi
- Cesare Maltoni Cancer Research Center, Ramazzini Institute, Bologna, Italy
| | - Fabiana Manservisi
- Cesare Maltoni Cancer Research Center, Ramazzini Institute, Bologna, Italy
| | - Fabio Piscaglia
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy; Division of Internal Medicine, Hepatobiliary and Immunoallergic Diseases, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Stefania Curti
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Luigi Bolondi
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
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Noureldin A, Alshehri W, Tapias H, Mallonee L, Mancl LM, Milgrom P, Svboda K. Efficacy of 38% silver diamine fluoride in reducing gingival inflammation and plaque accumulation in older adults living in retirement-homes: A randomized controlled pilot trial. J Dent 2024; 143:104890. [PMID: 38387597 DOI: 10.1016/j.jdent.2024.104890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 02/12/2024] [Accepted: 02/13/2024] [Indexed: 02/24/2024] Open
Abstract
OBJECTIVES Emerging from earlier case reports the potential benefits of 38 % silver diamine fluoride (SDF) in addressing pathogenic biofilms and mitigating gingival inflammation and enlargement have sparked interest. Our study aimed to evaluate the efficacy of 38 % SDF in reducing gingival inflammation and plaque accumulation in older adults living in retirement-homes. METHODS This 7-week randomized, controlled, double-blinded pilot trial employed a parallel assignment design. The study enrolled older adults (aged ≥65) residing in retirement homes in Dallas County, ultimately comprising a cohort of 40 participants who were evenly divided into two arms. The experimental group received SDF treatment, whereas the comparator group received a placebo. Over three consecutive weeks, both groups had solutions applied to the facial surfaces of all their teeth once per week. The primary outcomes measured the change in Löe-Silness Gingival Index (GI) and Silness-Löe Plaque Index (PI) at 7 weeks following baseline treatment. Repeated measures ANOVA was utilized to assess changes over time within each group (n = 15 each). Post-hoc paired t-tests were conducted to compare changes between week 1 and each subsequent follow-up time point (weeks 3, 5, 7), supplemented with 95 % confidence intervals for change from week 1. RESULTS In the SDF group, within-group comparisons demonstrated significant reductions (adjusted p < .05) in GI scores within 3 weeks (-.93±.37), as opposed to week 1 (1.90±.39). Between-group comparisons unveiled reductions in both mean GI (p < .05) and PI (p < .05), indicating less gingival inflammation and plaque accumulation in the SDF group at all time points, commencing at week 3. CONCLUSIONS This study showed that 38 % SDF was effective in reducing gingival inflammation and plaque accumulation in older adults living in retirement-homes. CLINICAL SIGNIFICANCE Oral health in older adults is a public health concern, especially for the medically compromised or those without traditional care. Our findings offer hope for enhancing oral health quality of life by introducing a cost-effective, compliance-free, noninvasive, and accessible therapeutic. TRIAL REGISTRATION NCT03445286.(clinicaltrials.gov).
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Affiliation(s)
- Amal Noureldin
- Department of Department Public Health Sciences, Texas A&M University, School of Dentistry, United States
| | - Wedad Alshehri
- Department of Dental Health, College of Applied Medical Science, King Saud University, United States
| | - Helena Tapias
- Department of Comprehensive Dentistry, Texas A&M University, School of Dentistry, United States
| | - Lisa Mallonee
- School of Dental Hygiene, Texas A&M University, School of Dentistry, United States
| | - Lloyd M Mancl
- Department of Oral Health Sciences, University of Washington, Box 357475, Seattle, WA 98195-7475, United States
| | - Peter Milgrom
- Department of Oral Health Sciences, University of Washington, Box 357475, Seattle, WA 98195-7475, United States.
| | - Kathy Svboda
- Department of Biomedical Sciences, School of Dentistry, Texas A&M University, United States
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Aghamohammadi D, Shakouri SK, Jahanpanah N, Dolatkhah N. Effects of adjuvant ozone autohemotherapy combined with routine treatment on clinical and paraclinical features of mechanically ventilated COVID-19 patients in the intensive care unit: a pilot randomized controlled trial. Med Gas Res 2024; 14:67-74. [PMID: 37929510 DOI: 10.4103/2045-9912.385439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2023] Open
Abstract
Until the availability of an effective and practical vaccine, there is a serious need to recognize alternative treatments for coronavirus disease 2019 (COVID-19). This study aimed to determine whether major ozonated autohemotherapy (MOAH) can improve the clinical and paraclinical parameters in critically-ill patients with COVID-19 requiring mechanical ventilation. In this controlled trial, we enrolled 40 critically ill COVID-19 patients receiving invasive mechanical ventilation. The enrolled patients were then randomized into the MOAH and control groups. The patients in the MOAH group received MOAH three times per week (10 times in total) in addition to routine treatment and standard critical supportive care. Patients in the control group were only given regular treatment and standard critical supportive care. The patients in the MOAH group had more days of breathing with no aid than those in the control group. Moreover, the length of stay in the intensive-care unit was significantly lower in the MOAH group than in the control group. MOAH resulted in higher ventilation-free days and less intensive-care unit stay compared with the control treatment. In COVID-19 patients undergoing mechanical ventilation, MOAH with routine treatment resulted in more ventilator-free days and less intensive-care unit stay compared with the standard therapy.
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Affiliation(s)
- Dawood Aghamohammadi
- Palliative Care Medicine Department, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Seyed Kazem Shakouri
- Physical Medicine and Rehabilitation Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Negar Jahanpanah
- Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Neda Dolatkhah
- Physical Medicine and Rehabilitation Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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Montgomery KB, Mellinger JD, Jones A, McLeod MC, Zmijewski P, Sarosi GA, Brasel KJ, Klingensmith ME, Minter RM, Buyske J, Lindeman B. Validity of Entrustable Professional Activities in a National Sample of General Surgery Residency Programs. J Am Coll Surg 2024; 238:376-384. [PMID: 38224150 PMCID: PMC10942265 DOI: 10.1097/xcs.0000000000000967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2024]
Abstract
BACKGROUND The American Board of Surgery has endorsed competency-based education as vital to the assessment of surgical training. From 2018 to 2020, a national pilot study was conducted at 28 general surgery programs to evaluate feasibility of implementing entrustable professional activities (EPAs) for 5 common general surgical conditions. ACGME core competency Milestones were also rated for each resident by program clinical competency committees. This study aimed to evaluate the validity of general surgery EPAs compared with Milestones. STUDY DESIGN Prospectively collected, de-identified EPA Pilot Study data were analyzed. EPAs studied were EPA-1 (gallbladder), EPA-2 (inguinal hernia), EPA-3 (right lower quadrant pain), EPA-4 (trauma), and EPA-5 (consult). Variables abstracted included levels of EPA entrustment (1 to 5) and corresponding ACGME Milestone subcompetency ratings (1 to 5) for the same study cycle. Spearman's correlations were used to evaluate the relationship between summative EPA scores and corresponding Milestone ratings. RESULTS A total of 493 unique residents received a summative entrustment decision. EPA summative entrustment scores had moderate-to-strong positive correlation with mapped Milestone subcompetencies, with median rho value of 0.703. Among operation-focused EPAs, median rho values were similar between EPA-1 (0.688) and EPA-2 (0.661), but higher for EPA-3 (0.833). EPA-4 showed a strong positive correlation with diagnosis and communication competencies (0.724), whereas EPA-5, mapped to the most Milestone subcompetencies, had the lowest median rho value (0.455). CONCLUSIONS Moderate-to-strong positive correlation was noted between EPAs and patient care, medical knowledge, and communication Milestones. These findings support the validity of EPAs in general surgery and suggest that EPA assessments can be used to inform Milestone ratings by clinical competency committees.
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Affiliation(s)
| | - John D Mellinger
- American Board of Surgery, Philadelphia, PA
- Department of Surgery, Southern Illinois University, Springfield, IL
| | | | - M Chandler McLeod
- Department of Surgery, University of Alabama at Birmingham, Birmingham, AL
| | - Polina Zmijewski
- Department of Surgery, University of Alabama at Birmingham, Birmingham, AL
| | - George A Sarosi
- Department of Surgery, University of Florida, Gainesville, FL
| | - Karen J Brasel
- Department of Surgery, Oregon Health & Science University, Portland, OR
| | - Mary E Klingensmith
- Accreditation Council for Graduate Medical Education, Chicago, IL
- Department of Surgery, Washington University in St. Louis, St. Louis, MO
| | | | - Jo Buyske
- American Board of Surgery, Philadelphia, PA
- Department of Surgery, University of Pennsylvania, Philadelphia, PA
| | - Brenessa Lindeman
- Department of Surgery, University of Alabama at Birmingham, Birmingham, AL
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Gell NM, Dittus K, Caefer J, Martin A, Bae M, Patel KV. Remotely delivered exercise to older rural cancer survivors: a randomized controlled pilot trial. J Cancer Surviv 2024; 18:596-605. [PMID: 36374436 PMCID: PMC9662104 DOI: 10.1007/s11764-022-01292-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 11/03/2022] [Indexed: 11/16/2022]
Abstract
PURPOSE The study aimed to determine the feasibility of remotely delivered exercise (tele-exercise) for older, rural cancer survivors and to explore the effects of tele-exercise on physical function, physical activity, and patient-reported outcomes. METHODS Participants were rural cancer survivors age ≥ 60 years (79% female; mean age 70.4 ± 5.7) randomly assigned to the remotely delivered EnhanceFitness (tele-EF) exercise program, inclusive of aerobic, strength, and balance training and led by American Council on Exercise certified instructors for 1 h, 3 days/week for 16 weeks (n = 20) or to a waitlist control group (n = 19). We assessed feasibility, physical function, accelerometer-measured physical activity, and patient-reported outcomes at baseline and post intervention. RESULTS Among those screened as eligible, 44 (64%) consented to participate with 39 randomized after completing baseline measures. Attrition was equivalent between groups (n = 1, each) with 95% completing the study. The median class attendance rate was 86.9% (interquartile range: 79-94%). Compared to controls, tele-EF participants had statistically significant improvement in the five-time sit-to-stand test (- 3.4 vs. - 1.1 s, p = 0.03, effect size = 0.44), mean daily light physical activity (+ 38.5 vs 0.5 min, p = 0.03, effect size = 0.72) and step counts (+ 1977 vs. 33, p = 0.01, effect size = 0.96). There were no changes in self-efficacy for exercise, fatigue, or sleep disturbance between groups. CONCLUSIONS Findings indicate that tele-EF is feasible in older, rural cancer survivors and results in positive changes in physical function and physical activity. IMPLICATIONS FOR CANCER SURVIVORS Tele-EF addresses common barriers to exercise for older, rural cancer survivors, including limited accessible opportunities for professional instruction and supervision.
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Affiliation(s)
- Nancy M Gell
- Department of Rehabilitation and Movement Science, University of Vermont, 306B Rowell 106 Carrigan Drive, Burlington, VT, 05405, USA.
- University of Vermont Cancer Center, Burlington, VT, USA.
| | - Kim Dittus
- University of Vermont Cancer Center, Burlington, VT, USA
- Department of Medicine, University of Vermont Medical Center, Burlington, VT, USA
| | - Jacqueline Caefer
- Department of Physical Therapy Movement and Rehabilitation Sciences, Northeastern University, Boston, MA, USA
| | - Anita Martin
- Department of Rehabilitation and Movement Science, University of Vermont, 306B Rowell 106 Carrigan Drive, Burlington, VT, 05405, USA
| | - Myeongjin Bae
- Department of Rehabilitation and Movement Science, University of Vermont, 306B Rowell 106 Carrigan Drive, Burlington, VT, 05405, USA
| | - Kushang V Patel
- Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, USA
- Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Washington, Seattle, USA
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Xue Y, Dong HY, Feng JY, Bai MS, Li D, Yang H, Jia FY. Parent-child interaction related to brain functional alterations and development outcomes in autism spectrum disorder: A study based on resting state-fMRI. Res Dev Disabil 2024; 147:104701. [PMID: 38402713 DOI: 10.1016/j.ridd.2024.104701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 01/30/2024] [Accepted: 02/15/2024] [Indexed: 02/27/2024]
Abstract
BACKGROUND Limited study has investigated the influence of parent-child interaction on brain functional alterations and development outcomes of autism spectrum disorder (ASD) children. This pilot study aimed to explore the relationship between parent-child interaction, brain functional activities and development outcomes of ASD children. METHODS and Procedures: 653 ASD with an average age of 41.06 ± 10.88 months and 102 typically developmental (TD) children with an average age of 44.35 ± 18.39 months were enrolled in this study, of whom 155 ASD completed brain rs-fMRI scans. The amplitude of low-frequency fluctuations (ALFF) and regional homogeneity (ReHo) measured using resting-state functional magnetic resonance imaging (rs-fMRI) data reflect local brain function. The parent-child interaction was assessed by the Chinese Parent-child Interaction Scale (CPCIS). Childhood Autism Rating Scale (CARS) and developmental quotient (DQ) indicated development outcomes. OUTCOMES AND RESULTS Total CPCIS score was negatively correlated with CARS total score, and positively correlated with DQ. The frequency of parent-child interaction was negatively correlated with ALFF values in the left median cingulate and paracingulate gyri (DCG.L) and ReHo values in the right superior frontal gyrus, medial (SFGmed.R)(P < 0.05, FDR correction). ALFF values in the DCG.L and ReHo values in the SFGmed.R play complete mediating roles in the relationship between parent-child interaction and performance DQ. CONCLUSION AND IMPLICATIONS This study suggest that parent-child interaction has an impact on autistic characteristics and DQ of ASD children. Local brain regions with functional abnormalities in the DCG.L and SFGmed.R may be a crucial factors affecting the performance development of ASD children with reduced parent-child interaction.
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Affiliation(s)
- Yang Xue
- Department of Developmental and Behavioral Pediatrics, Children's Hospital of the First Hospital of Jilin University, The First Hospital of Jilin University, Jilin University, Changchun, China; The Child Health Clinical Research Center of Jilin Province, Changchun, China
| | - Han-Yu Dong
- Department of Developmental and Behavioral Pediatrics, Children's Hospital of the First Hospital of Jilin University, The First Hospital of Jilin University, Jilin University, Changchun, China; The Child Health Clinical Research Center of Jilin Province, Changchun, China
| | - Jun-Yan Feng
- Department of Developmental and Behavioral Pediatrics, Children's Hospital of the First Hospital of Jilin University, The First Hospital of Jilin University, Jilin University, Changchun, China; The Child Health Clinical Research Center of Jilin Province, Changchun, China
| | - Miao-Shui Bai
- Department of Developmental and Behavioral Pediatrics, Children's Hospital of the First Hospital of Jilin University, The First Hospital of Jilin University, Jilin University, Changchun, China; The Child Health Clinical Research Center of Jilin Province, Changchun, China
| | - Dan Li
- Department of Radiology, The First Hospital of Jilin University, Jilin University, Changchun, China
| | - Hong Yang
- Department of Pediatrics, Affiliated Hospital of Beihua University, Beihua University, Jilin, China
| | - Fei-Yong Jia
- Department of Developmental and Behavioral Pediatrics, Children's Hospital of the First Hospital of Jilin University, The First Hospital of Jilin University, Jilin University, Changchun, China; The Child Health Clinical Research Center of Jilin Province, Changchun, China.
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Aksu S, Soyata AZ, Şeker S, Akkaya G, Yılmaz Y, Kafalı T, Evren C, Umut G. Transcranial direct current stimulation combined with cognitive training improves decision making and executive functions in opioid use disorder: a triple-blind sham-controlled pilot study. J Addict Dis 2024; 42:154-165. [PMID: 36861945 DOI: 10.1080/10550887.2023.2168991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
Opioid use disorder (OUD) is a chronic disorder with a considerable amount of morbidity and mortality. Despite remarkable improvement achieved by maintenance programs, an array of treatment goals were still unmet. Mounting evidence suggests that transcranial Direct Current Stimulation (tDCS) improves decision making and cognitive functions in addictive disorders. tDCS paired with a decision making task was depicted to diminish impulsivity as well. The present study aimed to assess the effect of tDCS combined with cognitive training (CT) in OUD for the first time. In this triple-blind randomized sham-controlled pilot study, 38 individuals with OUD from the Buprenorphine-Naloxone Maintenance Therapy program were administered 20-minutes of 2 mA active/sham tDCS over the dorsolateral prefrontal cortex with concomitant cognitive training. A selected test battery evaluating decision making under risk and ambiguity as well as executive functions, verbal fluency and working memory was utilized before and after the intervention. Greater improvements were observed in decision making under ambiguity (p = 0.016), set shifting ability and alternating fluency while no improvements were observed in decision making under risk in the active group, compared to sham. Deficits of decision making and executive functions have a pivotal role in the perpetuation and the relapse of the OUD. Alleviation of these impairments brought tDCS/CT forth as an expedient neuroscientifically-grounded treatment option that merits further exploration in OUD, Trial registration: NCT05568251.
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Affiliation(s)
- Serkan Aksu
- Department of Physiology, Faculty of Medicine, Muğla Sıtkı Koçman University, Muğla, Turkey
- Department of Physiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Ahmet Zihni Soyata
- Psychiatry Outpatient Clinic, Başakşehir State Hospital, İstanbul, Turkey
| | - Sercan Şeker
- Department of Physiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Gözde Akkaya
- Department of Child Development, Istanbul Topkapı University, Istanbul, Turkey
| | - Yasemin Yılmaz
- Department of Psychology, İstanbul University, Istanbul, Turkey
| | - Tuğba Kafalı
- Department of Psychology, Akdeniz University, Antalya, Turkey
| | - Cüneyt Evren
- Department of Psychology, Istanbul Gelisim University, Istanbul, Turkey
| | - Gökhan Umut
- Research, Treatment and Training Center for Alcohol and Substance Dependence (AMATEM), Bakirkoy Training and Research Hospital for Psychiatry Neurology and Neurosurgery, Turkey, Istanbul
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Chander DS, Tomezzoli A, Cavatorta MP, Gréau M, Marie S, Pontonnier C. Biomechanical requirements of meat cutting tasks: A pilot study quantifying tasks sustainability and assistance required at the wrist. Appl Ergon 2024; 116:104186. [PMID: 38052153 DOI: 10.1016/j.apergo.2023.104186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 11/14/2023] [Accepted: 11/27/2023] [Indexed: 12/07/2023]
Abstract
The meat processing industry is particularly affected by distal upper limb musculoskeletal disorders. This pilot study aims at proposing a methodology able to quantify biomechanical requirements of meat cutting tasks at butchers' dominant wrist and, when necessary, at estimating the assistance needed to reach sustainability. Six professional butchers repeatedly cut pieces of pork. Joint angles were recorded using a motion capture system, cutting forces using an instrumented knife. Sustainability was computed by the maximal acceptable effort method. Assistance requirements were computed for isolated stressful exertions and for overall work cycle sustainability. Five butchers exceeded the sustainability threshold for wrist flexion. Ulnar or radial deviation torques were excessive for 2 and 3 of them, respectively. Extension torques were sustainable. The peak assistive torque for isolated exertions was at most 1.1Nm, 1.6Nm and 1.1Nm, and the percentage of assistance for overall sustainability was at most 60%, 56% and 56% for wrist flexion, ulnar and radial deviation, respectively.
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Switzer T, Metzler Sawin E, Lam C, Robinson J. Creation of an Enhanced Primary Care Registered Nurse Preceptor Role: A Pilot Project. J Community Health Nurs 2024; 41:75-81. [PMID: 37919268 DOI: 10.1080/07370016.2023.2277840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2023]
Abstract
Historically, community health nursing education has not encompassed clinical sites in primary care. Primary care can be an important domain of community health nursing education. However, student practicum opportunities are limited by the number of and underutilization of RNs practicing at the full scope of their licensure (including assessment, client education, care planning and evaluation of care interventions) who can serve as student preceptors, especially in rural areas. This article describes the creation and implementation of the Enhanced Primary Care Registered Nurse (EPCRN) role in rural primary care clinics, as well as evaluates student perceptions of the EPCRN-precepted clinical experience. One nursing school used a federal training award to create the role of Enhanced Primary Care Registered Nurses (EPCRNs) to practice in federally-designated Rural Health Clinics. The EPCRNs worked in the Rural Health Clinics performing patient care and also functioned as student preceptors. Student experiences were evaluated through quantitative and qualitative methods, namely the Clinical Learning Experience, Supervision, and Nurse Teacher (CLES+T) scale and focus groups. This pilot project demonstrated positive pre-licensure student experience feedback as well as role value and sustainability for the health system. This pilot served as an example of a process for EPCRN role design within a primary care clinic site. It also demonstrated the importance of innovative, sustainable academic-practice partnerships.
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Affiliation(s)
- Tina Switzer
- School of Nursing, James Madison University, Harrisonburg, USA
| | | | - Christina Lam
- School of Nursing, James Madison University, Harrisonburg, USA
| | - Jamie Robinson
- School of Nursing, James Madison University, Harrisonburg, USA
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Shai D, Boris N, Brandtzaeg I, Torsteinson S, Spencer R, Haugaard K, Smith-Nielsen J. I'm with you, baby: Using parental embodied mentalizing in a pilot study to capture change following the circle of security parenting intervention. Scand J Psychol 2024; 65:321-330. [PMID: 37901937 DOI: 10.1111/sjop.12978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 10/04/2023] [Accepted: 10/11/2023] [Indexed: 10/31/2023]
Abstract
Supported by a large body of work demonstrating the impact of infant attachment representations on subsequent development, numerous therapeutic programs have been developed to promote secure attachment, with increasing focus on parental mentalizing. Nonetheless, empirical evidence supporting their effectiveness has yet to be fully established. The current pilot study (N = 24) was designed to evaluate whether and to what extent parents' shifts in parental mentalizing following a brief attachment-based group intervention, namely circle of security parenting (COSP; Cooper, Hoffman & Powell, 2009) can be captured using the parental embodied mentalizing instrument (PEM; Shai & Belsky, 2017). Compared to a waiting list-control group, this small-scale study examined whether community-based low-risk mothers of infants aged 5-48 months show an increase in their observed PEM capacities following the intervention. Secondary self-reported outcome variables parental stress, feeling of competence, and self-compassion. Findings show that PEM ratings improved significantly over time in the COSP group, but not in the control group. Intervention group mother-infant dyads also presented significantly longer embodied interactions communication post intervention compared to the control group. No effects of the COSP on parental stress, competence, or self-compassion were found. Despite the small sample size, these results tentatively suggest that COSP can improve embodied mentalizing abilities.
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Affiliation(s)
- Dana Shai
- SEED Center, Academic College Tel Aviv-Yaffo, Tel Aviv, Israel
| | - Neil Boris
- Circle of Security International, Spokane, Washington, USA
| | | | | | - Rose Spencer
- Anna Freud National Centre for Children and Families, London, UK
| | | | - Johanne Smith-Nielsen
- Center for Early Intervention and Family Studies, Department of Psychology, University of Copenhagen, Copenhagen, Denmark
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Hui T, Wang J, Yu Y, Dong H, Lin W. External fixator versus Ilizarov external fixator for pediatric tibial shaft fractures: A retrospective comparative study. Injury 2024; 55:111376. [PMID: 38307778 DOI: 10.1016/j.injury.2024.111376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 01/19/2024] [Accepted: 01/20/2024] [Indexed: 02/04/2024]
Abstract
INTRODUCTION External fixators (EF) are widely employed for pediatric tibial shaft fractures, being a prevalent choice in clinical practice. However, they are associated with numerous complications, such as loss of reduction, delayed union, and nonunion. An alternative approach involves the use of Ilizarov external fixators (IEF), which have been documented in the treatment of tibial shaft fractures in various studies. This study endeavors to retrospectively compare the clinical outcomes of EF and IEF in the treatment of pediatric tibial shaft fractures. METHODS The study retrospectively examined patients aged 5-14 years who underwent treatment for tibial shaft fractures at our institute between January 2017 and January 2023. These individuals were subsequently classified into EF and IEF groups. Exclusions comprised patients presenting with pathological fracture, neuromuscular disorder, metabolic disease, prior tibial fracture or instrumentation, and polytrauma. Additionally, individuals with a follow-up duration of more than 12 months or incomplete medical records were excluded. RESULTS A total of 45 patients were divided into two groups: the EF group, comprising 24 patients (18 males, 6 females), and the IEF group, consisting of 21 patients (17 males, 4 females). The two groups exhibited no statistically significant differences in terms of sex, age, body weight, time from injury to surgery, AO classification, or concomitant injuries. There were two cases of nonunion in the EF group. Radiological union occurred more rapidly in the IEF group (7.8 ± 0.4 weeks) than in the EF group (9.3 ± 1.1 weeks) (P < 0.05). The mean hospitalization duration differed significantly between the EF group (6.7 ± 3.4 days) and the IEF group (7.5 ± 1.1 days) (P > 0.05). The mean duration of the operative procedure significantly differed between the IEF group (147.8 ± 24.5 min) and the EF group (77.2 ± 43.9 min) (P < 0.001). A significant difference (P < 0.001) in weight-bearing time was observed between the IEF group (2.6 ± 0.7 weeks) and the EF group (9.9 ± 1.4 weeks). According to the Johner-Wruhs criteria, no significant differences were found between the two groups. A significant difference (P < 0.001) in hospitalization costs was observed between the IEF group (7848.0 ± 262.4 $) and the EF group (5403.0 ± 233.3 $). CONCLUSION EF is cheaper, quicker and simpler and we need more randomized controlled studies and that this is a pilot study only. Both types of surgery are good choices for children. Nevertheless, the IEF group demonstrates advantages such as early weight-bearing capability and faster fracture healing.
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Affiliation(s)
- Taotao Hui
- Department of Pediatric Orthopedics, Wuxi No.9 People's Hospital Affiliated to Soochow University, Wuxi, 214000, Jiangsu Province, China
| | - Jun Wang
- Department of Pediatric Orthopedics, Wuxi No.9 People's Hospital Affiliated to Soochow University, Wuxi, 214000, Jiangsu Province, China
| | - Yinghao Yu
- Department of Pediatric Orthopedics, Wuxi No.9 People's Hospital Affiliated to Soochow University, Wuxi, 214000, Jiangsu Province, China
| | - Haojuan Dong
- Department of Pediatric Orthopedics, Wuxi No.9 People's Hospital Affiliated to Soochow University, Wuxi, 214000, Jiangsu Province, China
| | - Weifeng Lin
- Department of Pediatric Orthopedics, Wuxi No.9 People's Hospital Affiliated to Soochow University, Wuxi, 214000, Jiangsu Province, China.
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Sinai D, Lassri D, Spira C, Lipsitz JD. Telephone interpersonal counseling treatment for frequent attenders to primary care: Development and piloting. Psychother Res 2024; 34:555-569. [PMID: 37079921 DOI: 10.1080/10503307.2023.2200982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 04/01/2023] [Indexed: 04/22/2023] Open
Abstract
BACKGROUND Frequent attenders in primary care (FAs) consume a disproportionate amount of healthcare resources and often have depression, anxiety, chronic health issues, and interpersonal problems. Despite extensive medical care, they remain dissatisfied with the care and report no improvement in quality of life. OBJECTIVE To pilot a Telephone-based Interpersonal Counseling intervention for Frequent Attenders (TIPC-FA) and assess its feasibility and efficacy in reducing symptoms and healthcare utilization. METHOD Top 10% of primary care visitors were randomly assigned to TIPC-FA, Telephone Supportive Contact (Support), or Treatment as Usual (TAU). TIPC-FA and Support groups received six telephone sessions over twelve weeks, while the TAU group was interviewed twice. Multilevel regression tested for changes over time, considering patient and counselor variance. RESULTS TIPC-FA and Support groups demonstrated reduced depressive symptoms, and the TIPC-FA group showed decreased somatization and anxiety. The TIPC-FA group demonstrated a trend towards less healthcare utilization than the TAU group. CONCLUSION This pilot study suggests that IPC via telephone outreach is a feasible approach to treating FAs, achieving a reduction in symptoms not seen in other groups. Promising reduction in healthcare utilization in the TIPC-FA group warrants further exploration in larger-scale trials.
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Affiliation(s)
- Dana Sinai
- Department of Psychology, Ben-Gurion University of the Negev., Beer-Sheva, Israel
| | - Dana Lassri
- The Paul Baerwald School of Social Work and Social Welfare, The Hebrew University of Jerusalem, Jerusalem, Israel
- Research Department of Clinical, Educational and Health Psychology, UCL (University College London), London, UK
| | | | - Joshua D Lipsitz
- Department of Psychology, Ben-Gurion University of the Negev., Beer-Sheva, Israel
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Rodriguez-Arguello J, Lienhard K, De Grood J, Geransar R, Somayaji R, Khan D, Conly J, Ho C, Parsons L. The Use of Silver Oxynitrate Wound Dressings in the Treatment of Chronic Wounds: A Feasibility Pilot Study. Adv Skin Wound Care 2024; 37:197-202. [PMID: 38353651 DOI: 10.1097/asw.0000000000000085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2024]
Abstract
OBJECTIVE To evaluate the feasibility and effectiveness of a silver oxynitrate (Ag 7 NO 11 ) dressing on wound healing in patients with stalled chronic wounds. METHODS A prospective pilot study was conducted to determine the feasibility and effect of using silver oxynitrate dressings within an outpatient setting in Alberta, Canada. A total of 23 patients (12 women and 11 men; mean age, 66.1 ± 13.8 years) with a chronic wound that failed to heal with conventional treatment were included in the study. Wound assessments including the Bates-Jensen Wound Assessment Tool, wound-related pain, wound size, and patient quality of life (QoL) were conducted at baseline, after dressing application for 1 and 2 weeks, and during 4- and 12-week follow-ups. RESULTS Dressing application at 1 and 2 weeks improved patients' wound healing progression as measured through significantly decreased Bates-Jensen Wound Assessment Tool scores with a more than 10% decrease at 4- and 12-week follow-up ( P < .001). Pain ( P = .004), and QoL psyche subscore ( P = .008) significantly improved at 4-week follow-ups, although wound area, perimeter, and QoL body and everyday subscores were not significantly affected. Wound size was not significantly affected. CONCLUSIONS The silver oxynitrate dressing may improve healing progression in patients with chronic wounds, enhance patient experience by reducing wound-related pain, and improve patients' mental well-being. Further studies are warranted to elucidate the effect of silver oxynitrate dressings on wound area, perimeter, and volume measurements.
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Affiliation(s)
- Jimena Rodriguez-Arguello
- At the Ward of the 21st Century (W21C) Research and Innovation Centre, Calgary, Alberta, Canada, Jimena Rodriguez-Arguello, BHSc, is Research Assistant; Karin Lienhard, PhD, CCRP, is Research Associate; and Rose Geransar, PhD, is Research Manager. Ranjani Somayaji, MD, is Assistant Professor, University of Calgary. John Conly, MD, is Medical Director, W21C Research and Innovation Centre and Infectious Disease Physician and Professor, Cumming School of Medicine, University of Calgary. Chester Ho, MD, is Professor and Division Director, Division of Physical Medicine and Rehabilitation, University of Alberta. Laurie Parsons, MD, is Dermatologist and Medical Director, Southern Alberta Sheldon Chumir Wound Clinic, and Clinical Associate Professor, University of Calgary
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