Category: Nevin Manimala

Behav Modif. 2022 Feb 3:1454455211073738. doi: 10.1177/01454455211073738. Online ahead of print.

ABSTRACT

Mindfulness-based programs are a promising intervention modality for reducing disruptive behavior, and Soles of the Feet (SOF) is one program that teaches internal awareness of personal events (e.g., unpleasant emotions) and a self-regulation strategy to decrease disruptive behaviors. This study conducted a meta-analysis of single-case research design (SCRD) studies that implemented SOF to decrease disruptive behaviors. Existing SOF studies were evaluated using high-quality SCRD standards, resulting in 15 studies included in the analysis (49 participants; mean age 23.12 years (SD = 15.87); highly heterogeneous backgrounds). Studies were analyzed to calculate effect sizes using Tau-U, an innovative non-parametric statistical approach for estimating effect sizes in SCRD studies. The aggregated weighted Tau-U effect size of SOF across all studies was -0.87. Moderator analyses indicated SOF’s effectiveness was robust across participant characteristics and delivery formats. This meta-analysis suggests that SOF is a moderately effective evidence-based practice for reducing disruptive behavior.

PMID:35112575 | DOI:10.1177/01454455211073738

Ideggyogy Sz. 2022 Jan 30;75(1-02):51-59. doi: 10.18071/isz.75.0051.

ABSTRACT

BACKGROUND AND PURPOSE: Oxidative stress has been associated as an essential contributor to the development of neurodegenerative diseases. Recent developments in the field of Parkinson’s Disease (PD) pathophysiology have led to a renewed interest in this field. As an antioxidant, uric acid (UA) has arisen as a potential neuroprotectant. Higher concentrations of UA are linked to reducing the risk of the development of the disease and preventing its progression. However, the expositions are unsatisfactory because the outcomes of these reports have not been consistent. This study is set out to assess the association of whether lower UA concentrations increased the PD risk by investigating its relationship with patients’ demographic and clinical data, and to determine whether previous studies are compatible with the Turkish-sampled population. Furthermore, we aimed to determine UA’s probability of being an early-stage diagnostic marker.

METHODS: A total of 305 patients and 100 healthy controls were included. Serum UA levels of patients and controls were compared with clinical features. We classified the patients into three motor subtypes and determined the disease severity by modified Hoehn&Yahr Staging Scale (mH&Y) and Unified Parkinson’s Disease Rating Scale (UPDRS). Standardized Mini-Mental State Examination (MMSE-TR) was assessed for cognition.

RESULTS: There were not any significant differences of age and sex between patients and controls (p=0.030, p=0.132). The mean UA was 5.06±1.33 mg/dL in patients and 5.46±1.44 in controls, and a statistical significance was detected (p=0.022). The mean MMSE-TR were 24.83±4.35 in patients and 27.09±2.13 in controls, and statictical significance was revealed (p=0.001). The mean duration of the disease was 6.31±4.16 years, mean UPDRS scores were 59.74±22.33, and mH&Y scores were 2.29±0.91. In binary comparisons, patients with tremor-dominant motor subtype had lower UA concentrations than controls (p=0.014). ROC curve analysis revealed UA’s cut-off as ≤9.15, the specificity was 99.3, the sensitivity was 10.0, and the area under the curve was 0.576 (p<0.005). Regression analysis revealed age as an independent risk factor on UA values. Oxidative stress might be a factor in the development of PD, and UA may be a possible prospective protecting factor in the clinical course of the disease. However, it does not affect the severity.

CONCLUSION: Our results support that lower uric acid concentrations are associated with PD; however, it is not a powerful indicator for predicting PD risk. As we reveal more about UA and its effect in further investigations, its significant role will become well-defined.

PMID:35112521 | DOI:10.18071/isz.75.0051

Natl Med J India. 2022 Jul-Aug;34(4):232-234. doi: 10.25259/NMJI_119_19.

ABSTRACT

Background Nursing and allied health professionals are helping hands for healthcare and are important in the training cascade. We aimed to develop and validate the effectiveness of a web-based learning module on oral health promotion among nursing and allied health professionals. Methods We developed and validated an oral health module focused on prevention and promotion for a web-based intervention among nurses and allied health professionals. Pre- and post-test assessment was conducted to evaluate the effectiveness of the programme. Results Of a total of 347 participants, 170 (48.9%) had a good knowledge score in the pre-test, and after attending the oral health module their number increased to 267 (76.9%). The mean difference between the pre-test and post-test scores was statistically significant (p<0.005). Conclusions Training of nurses and allied health professionals on oral health through a web-based module showed improvement in oral health literacy.

PMID:35112551 | DOI:10.25259/NMJI_119_19

ESC Heart Fail. 2022 Feb 2. doi: 10.1002/ehf2.13805. Online ahead of print.

ABSTRACT

AIMS: Sodium-glucose cotransporter 2 (SGLT2) inhibitors have been shown to be an effective therapy in improving heart failure outcomes. We conducted a meta-analysis of randomized controlled trials to evaluate the efficacy of SGLT2 inhibitors in heart failure patients with either a reduced or preserved ejection fraction.

METHODS AND RESULTS: We searched MEDLINE and EMBASE for large (≥1000 patients) randomized controlled trials evaluating the effects of SGLT2 inhibitors compared with placebo in the setting of heart failure until September 2021. Our primary outcome was the composite of heart failure hospitalization and cardiovascular death, and secondary outcomes included all-cause mortality and total heart failure hospitalizations. We pooled hazard ratios and risk ratios and evaluated risk of bias with the Cochrane Collaboration tool. Four randomized controlled trials (DAPA HF, EMPEROR-Preserved, EMPEROR-Reduced, and SOLOIST-WHF) were included (n = 15 684); two of which evaluated patients with a reduced LVEF, one of which evaluated patients with a preserved LVEF, and one of which included both. Treatment with SGLT2 inhibitors resulted in a significant reduction in the composite of CV death and heart failure hospitalization (HR: 0.76, 95% CI: 0.70, 0.82, I² : 0%, P < 0.00001). This was consistent in sub-groups of patients with LVEF ≤40% (n = 9199, HR: 0.74, 95% CI: 0.68, 0.81, I² : 0%) and LVEF >40% (n = 6482, HR: 0.78, 95% CI: 0.68, 0.89, I² : 0%, P-for-interaction: 0.57), as well as in sub-groups of patients with and without diabetes mellitus at baseline (P-for-interaction: 0.81). SGLT2 inhibitors were associated with a significant reduction in cardiovascular death (HR: 0.87, 95% CI: 0.79, 0.97, I² : 0%, P < 0.00001) and total heart failure hospitalization (RR: 0.71, 95% CI: 0.67, 0.76, I² : 0%, P < 0.00001); although a potential trend towards reduced all-cause mortality was noted with SGLT2 inhibitors, no statistically significant difference was observed (HR: 0.91, 95% CI: 0.83, 1.00, I² : 14%, P = 0.05).

CONCLUSIONS: Sodium-glucose cotransporter 2 inhibitors reduce cardiovascular death and heart failure hospitalization among patients with heart failure, regardless of LVEF status.

PMID:35112512 | DOI:10.1002/ehf2.13805

Hemodial Int. 2022 Feb 3. doi: 10.1111/hdi.13007. Online ahead of print.

ABSTRACT

INTRODUCTION: Chronic kidney disease-associated pruritus is a common complication in patients with end-stage renal disease. In this study, we have explored the outcome of omega-3 supplementary intake for the treatment of this symptom.

METHODS: This double-blinded, randomized, crossover study was conducted in two dialysis centers in which 40 hemodialysis patients suffering from pruritus were randomly assigned into two groups (Group A and Group B). Patients in Group A consumed omega-3 capsules for 4 weeks and after a washout period (6 weeks), they took placebo for another 4 weeks. The same was performed in Group B but in the reverse order. Pruritus score was determined at the baseline, Week 4, 10, and 14. Serum levels of prostaglandin E2 were also recorded at the baseline and Week 4.

RESULTS: There was a statistically significant reduction of pruritus score in patients who took the omega-3 fatty acid supplement. The mean pruritus score decreased significantly in both first (-3.41 ± 2.62, p < 0.001) and second (-1.00 ± 1.84, p = 0.04) treatment period after omega-3 treatment; but no significant mean pruritus score difference in placebo group after both intervention periods was observed. The decrease in prostaglandin E2 amount was not statistically significant in the intervention (omega-3) group compared to the placebo group (p = 0.204).

DISCUSSION: Our observations indicate that omega-3 fatty acids (3 grams per day) have decreasing effects on pruritus. Also, reduction in prostaglandin E2 levels in the omega-3 group did not differ from the changes in the placebo group.

PMID:35112475 | DOI:10.1111/hdi.13007

J Diabetes Investig. 2022 Feb 3. doi: 10.1111/jdi.13764. Online ahead of print.

ABSTRACT

AIMS: To assess the impact of baseline characteristics on the efficacy and safety of oral semaglutide in Japanese patients with type 2 diabetes.

MATERIALS AND METHODS: In PIONEER 9 and 10, Japanese patients were randomized to once-daily oral semaglutide (3, 7, or 14 mg) or a comparator (placebo or once-daily subcutaneous liraglutide 0.9 mg in PIONEER 9; once-weekly subcutaneous dulaglutide 0.75 mg in PIONEER 10) for 52 weeks, with 5 weeks of follow up. An exploratory analysis grouped patients in each trial according to baseline glycated hemoglobin (HbA_1c ; ≤8.0, >8.0-≤9.0, or >9.0%), body mass index (<25, ≥25-<30, or ≥30 kg/m² ), and, for PIONEER 10 only, by background medication (sulfonylurea, glinide, thiazolidinedione, α-glucosidase inhibitor, sodium-glucose cotransporter-2 inhibitor). Efficacy (changes from baseline to week 26 in HbA_1c and body weight) and safety were assessed.

RESULTS: 701 patients were included (PIONEER 9: N = 243; PIONEER 10: N = 458). In both trials, HbA_1c reductions increased as baseline HbA_1c increased; there were no other apparent patterns between the variables investigated and HbA_1c or body weight changes. There was one statistically significant subgroup interaction between baseline HbA_1c and estimated treatment differences in body weight change for oral semaglutide 14 mg versus placebo in PIONEER 9 (P = 0.0286). Baseline HbA_1c , baseline body mass index and background medication did not appear to affect the proportions of patients reporting adverse events.

CONCLUSIONS: Oral semaglutide is effective across a range of baseline subgroups of Japanese patients with type 2 diabetes, with no unexpected safety findings.

PMID:35112504 | DOI:10.1111/jdi.13764

Diabetes Obes Metab. 2022 Feb 2. doi: 10.1111/dom.14656. Online ahead of print.

NO ABSTRACT

PMID:35112456 | DOI:10.1111/dom.14656

J Appl Clin Med Phys. 2022 Feb 2:e13541. doi: 10.1002/acm2.13541. Online ahead of print.

ABSTRACT

Despite breast cancer prevalence and widespread adoption of deep inspiration breath-hold (DIBH) radiation techniques, few data exist on the error risks related to using surface-guided (SG) DIBH during breast radiation therapy (RT). Due to the increasingly technical nature of these methods and being a paradigm shift from traditional breast setups/treatments, the associated risk for error is high. Failure modes and effects analysis (FMEA) has been used in identifying risky RT processes yet is time-consuming to perform. A subset of RT staff and a hospital patient-safety representative performed FMEA to study SG-DIBH RT processes. After this group (cohort 1) analyzed these processes, additional scoring data were acquired from RT staff uninvolved in the original FMEA (cohort 2). Cohort 2 received abbreviated FMEA training while using the same process maps that cohort 1 had created, which was done with the goal of validating our results and exploring the feasibility of expedited FMEA training and efficient implementation elsewhere. An extensive review of the SG-DIBH RT process revealed 57 failure modes in 16 distinct steps. Risks deemed to have the highest priority, large risk priority number (RPN), and severity were addressed with policy changes, checklists, and standardization; of these, most were linked with operator error via manual inputs and verification. Reproducibility results showed that 5% of the average RPN between cohorts 1 and 2 was statistically different. Unexpected associations were noted between RPN and RT staff role; 12% of the physicist and therapist average scores were statistically different. Different levels of FMEA training yielded similar scoring within one RT department, suggesting a time-savings can be achieved with abbreviated training. Scores between professions, however, yielded significant differences suggesting the importance of involving staff across disciplines.

PMID:35112445 | DOI:10.1002/acm2.13541

Angew Chem Int Ed Engl. 2022 Feb 2. doi: 10.1002/anie.202117596. Online ahead of print.

ABSTRACT

Quantitative measurements of sex difference in vesicle chemistry (i.e., chemical storage and release) at a single vesicle level are very essential to understand sex differences in cognitive behaviors; however, such measurements are very challenging to conventional analytical methods. By using single-vesicle electrochemistry, we find the duration of single exocytotic events of chromaffin cells prepared from male rats is statistically longer than that from female rats, leading to more neurotransmitter released in male group. Further analysis reveals that a higher percentage of vesicles in female group release part of neurotransmitter, i.e., partial release, during exocytosis than that in male group. This sex dimorphism in neurotransmitter release in exocytosis might relate to the sex difference in the expression of voltage-dependent calcium channels and membrane lipid composition. Our finding offers the first experimental evidence that sex dimorphism even exists in vesicle chemistry, providing a brand new viewpoint for understanding the sex dimorphism in cognitive behaviors.

PMID:35112448 | DOI:10.1002/anie.202117596

Appl Psychol Health Well Being. 2022 Feb 2. doi: 10.1111/aphw.12346. Online ahead of print.

ABSTRACT

Theory-based, user-informed interventions are needed to increase the low participation rates of population-based faecal occult blood test (FOBT) bowel cancer screening. This study investigated the theoretical fit of the health action process approach (HAPA) for home FOBT screening and measured screening invitees’ attitudes towards different intervention strategies. A cross-sectional sample (n = 377), aged 50-74 years, participated in this study. Two scales were created for this study. The process approach to mail-out screening (PAMS) scale measured HAPA constructs, and the user ratings of mail-out screening interventions (UR-MSI) scale measured attitudes towards different intervention strategies. Structural equation modelling was used to assess the fit of PAMS scale responses to the HAPA model, and descriptive statistics were calculated for UR-MSI responses. PAMS results showed acceptable model fit, CFI = .968, RMSEA = .050 and explained 49.9% of the variation in FOBT screening participation. Positive ratings of interventions ranged from 20.47%, an intervention prompting planning to complete the FOBT kit, to 72.25%, an intervention promoting the positive health outcome associated with FOBT screening. Intervention strategies should be combined such that they target all factors specified within the HAPA model. User-informed intervention design should be used to effectively facilitate FOBT uptake in the community.

PMID:35107867 | DOI:10.1111/aphw.12346