Tag: nevin manimala

J Nutr Educ Behav. 2025 Jan 14:S1499-4046(24)00527-X. doi: 10.1016/j.jneb.2024.11.006. Online ahead of print.

ABSTRACT

OBJECTIVE: Assess if a virtual culinary medicine program improves healthy eating, glycosylated hemoglobin (HbA1c), and associated variables among adults with type 2 diabetes.

DESIGN: Mixed-methods, intervention-only pilot study.

SETTING: Classes via video conferencing from the teaching kitchen, with participants cooking from their homes.

PARTICIPANTS: One hundred and four patients from a Texas primary care system.

INTERVENTIONS: Five-session program (Spanish and English) led by a dietitian.

MAIN OUTCOME MEASURES: HbA1c. Secondary outcomes included MyPlate knowledge, self-efficacy, healthy eating and cooking behaviors, diabetes self-management, perceived health, and blood pressure.

ANALYSIS: Multilevel mixed-effects regression to analyze changes at pretreatment, posttreatment, and 6-month follow-up. Framework analysis to analyze postintervention interviews.

RESULTS: Participants with complete posttest data (n = 61) demonstrated statistically significant (P <0.05) improvements in MyPlate knowledge, cooking self-efficacy, servings of fruits and vegetables, frequency of healthy food intake, shopping, cooking and eating behaviors, diabetes self-management, and perceived health, compared with pretest. HbA1c levels showed statistically significant reductions from pretest to posttest (P = 0.02) and at 6-month follow-up (P <0.001). Participants reported high satisfaction and sustained new habits.

CONCLUSIONS AND IMPLICATIONS: We saw improvements in healthy eating and cooking behaviors and HbA1c. While further rigorous testing is needed, this program could be incorporated into clinical practices as a brief intervention for patients with type 2 diabetes.

PMID:39818659 | DOI:10.1016/j.jneb.2024.11.006

J Nutr Educ Behav. 2025 Jan 16:S1499-4046(24)00528-1. doi: 10.1016/j.jneb.2024.11.007. Online ahead of print.

ABSTRACT

OBJECTIVE: To assess the mean differences in outcomes of 3 delivery modalities of a nutrition education program targeting older adults.

METHODS: A natural experiment was conducted from March 2020 to September 2021, with presurveys and postsurveys used to assess dietary and physical activity behaviors. Results were analyzed using descriptive statistics, t tests, and ANOVA, with a Bonferroni-corrected significance threshold at P < 0.001.

RESULTS: There were 3 groups: in-person (n = 212), Zoom (n = 61), and phone (n = 104). Respondents aged > 70 years and in rural areas were more likely to be enrolled in person (P < 0.001). Across all modalities, there were significant improvements from before to after for most outcomes. The phone group reported significantly larger mean differences than the in-person group for fruit, vegetable, and whole grain consumption (P < 0.001).

CONCLUSIONS AND IMPLICATIONS: Healthy Eating, Staying Active as We Age can be delivered across all modalities. Future practitioners can use the findings to consider alternative modalities that may better meet the needs of their audience.

PMID:39818658 | DOI:10.1016/j.jneb.2024.11.007

J Adolesc Health. 2025 Jan 16:S1054-139X(24)00527-5. doi: 10.1016/j.jadohealth.2024.10.028. Online ahead of print.

ABSTRACT

PURPOSE: We aimed to analyze adolescent and young adults’ (AYAs) perspectives on using sexually transmitted infection (STI) self-collection kits to help guide the provision and implementation of accessible and confidential reproductive health-care services for those who experience the burden of STIs and STI-related morbidity.

METHODS: We utilized MyVoice, a nationwide text message survey of AYAs, to pose 6 open-ended questions on their perceptions and use of STI self-collection kits. Two independent reviewers used inductive content analysis to develop a codebook and analyze responses, and a third settled any coding discrepancies through discussion to reach consensus. Code frequencies and demographic data were summarized using descriptive statistics.

RESULTS: We collected responses from 763 participants. Individuals who answered at least one question were included in the sample. Responses indicated that most (n = 695, 91.1%) participants would use free STI self-collection kits. Participants who would not use an STI self-collection kit (n = 45, 5.9%) cited concerns about test result accuracy and discomfort with specimen collection.

DISCUSSION: Survey respondents were amenable to using free, STI self-collection kits; however, some were concerned about accuracy. There is an urgent need to prioritize and increase the accessibility of STI testing among youth. STI self-collection kits are an effective and accessible option that addresses barriers to reproductive health-care services-stigma, inconvenience, and lack of privacy. A social media campaign focusing on AYAs may increase knowledge and use of STI self-collection kits through dissemination of accurate information, stigma reduction, and provision of accessible resources that empower AYAs to prioritize their sexual health.

PMID:39818656 | DOI:10.1016/j.jadohealth.2024.10.028

J Emerg Nurs. 2025 Jan 15:S0099-1767(24)00364-7. doi: 10.1016/j.jen.2024.12.007. Online ahead of print.

ABSTRACT

INTRODUCTION: In hospital-based emergency departments, the national average of left before treatment complete was 2%. In addition, patients may leave without being seen or against medical advice and elope after arriving to the emergency department. When events occurred, they were associated with an increased length of stay for patients who were admitted to the hospital and decreased patient satisfaction.

METHODS: In a 24-bed emergency department within a small rural hospital that is part of a large quaternary care health care system, a multidisciplinary team used a continuous improvement model and nursing and medical caregivers to implement a clustered intervention to decrease the frequency of patients leaving before treatment was completed. After completing summary statistics, logistic regression was performed to assess left before treatment complete rates in 2021 and 2022. Sensitivity analysis was performed using Poisson log-linear regression.

RESULTS: Of 45,814 emergency visits (July to December 2021, 15,600; January to December 2022, 30,214), 3097 patients (6.76%) left before treatment complete, left before being seen, left against medical advice, or eloped. When comparing rates before and after countermeasures were introduced, the odds of leaving before a final disposition was made was 354% higher pre- vs postcountermeasure implementation (odds ratio [95% confidence interval], 4.54 [4.2-4.91], P < .001). In sensitivity analyses that regressed the rate of left before treatment complete over the 2 years, the odds ratio was similar (4.07 [2.92-5.67], P < .001).

DISCUSSION: Using a continuous improvement framework and nursing caregiver-based countermeasures, the rate of leaving before final disposition was dramatically reduced. Team involvement in action planning and change processes was critical to successful outcomes.

PMID:39818632 | DOI:10.1016/j.jen.2024.12.007

Ann Coloproctol. 2025 Jan 17. doi: 10.3393/ac.2024.00024.0003. Online ahead of print.

ABSTRACT

PURPOSE: This study aimed to evaluate the long-term efficacy of the ligation of the intersphincteric fistula tract (LIFT) procedure in treating high transsphincteric fistulas.

METHODS: We conducted a retrospective study to evaluate the success rate of LIFT treatment in 82 patients with high transsphincteric fistulas involving at least 1/3 of the external sphincter. This study was carried out across 2 centers from November 2009 to February 2023.

RESULTS: All patients underwent successful surgery with a median operative time of 48.9 minutes (range, 20-80 minutes), and no intraoperative or postoperative complications were reported. The median follow-up duration was 85.5 months (range, 4-120 months), with 5 patients (6.1%) lost to follow-up. Treatment was successful in 62 patients, whose symptoms disappeared and both the external opening and the intersphincteric incision completely healed, yielding an overall efficiency rate of 80.5%. There were 15 cases (19.5%) of treatment failure, including 6 (7.8%) that converted to intersphincteric anal fistula and 9 (11.7%) that experienced persistent or recurrent fistulas. Only 1 patient reported minor overflow during the postoperative follow-up, but no other patients reported any significant discomfort. There were no statistically significant differences between patients with surgical success and those with treatment failure in terms of fistula length, history of previous abscess or anal fistula surgery, number of external orifices or fistulas, and location of fistulas (all P>0.05).

CONCLUSION: LIFT is a safe and effective sphincter-preserving procedure that yields satisfactory healing outcomes and has minimal impact on anal function.

PMID:39818537 | DOI:10.3393/ac.2024.00024.0003

Int Dent J. 2025 Jan 15:S0020-6539(24)01617-4. doi: 10.1016/j.identj.2024.11.023. Online ahead of print.

ABSTRACT

INTRODUCTION AND AIMS: Marginal sealing by enamel bonding is important to enhance the durability of the restoration and prevent secondary caries after operative procedure. This study aimed to evaluate the enamel acid resistance and bond strength of an experimental calcium-containing adhesive system.

METHODS: All materials were provided by Kuraray Noritake Dental, Inc. (Tokyo, Japan). A calcium-containing primer (CaP) was formulated by blending 10% CaCl₂ into Clearfil SE Bond2 primer. The original primer (SEP) served as a control. Clearfil SE Bond2 Bond and Clearfil Protect Bond (PBB) were used as bonding agents. Human molar enamel was used for acid-resistance evaluation. After the adhesive was applied, a resin composite was built and light-cured. The samples were then subjected to an acid-base challenge and observed under scanning electron microscopy after 1 day and 3 months of storage. Mechanical strength was evaluated using microshear bond strength (μSBS) testing on bovine incisor enamel, with tests conducted 1 day after bonding (TC0) and after 5000 thermal cycles (TC5000). Statistical analysis was performed using two-way ANOVA and t tests (α = 0.05).

RESULTS: Acid-base resistant zones (ABRZs) formed in all groups, with thicker ABRZ formation in the CaP groups than in the SEP groups. A slope formation at the bottom of the outer lesion was noted in the PBB group. No morphological differences were found between the immediate and 3-month storage groups. The thermal cycling mode did not significantly affect the μSBS between the CaP and SEP groups.

CONCLUSION: The experimental calcium-containing adhesive system formed a thicker ABRZ on enamel without affecting the μSBS.

CLINICAL RELEVANCE: The study suggests that the experimental adhesive system enhances enamel acid resistance, forming a thicker ABRZ while maintaining bond strength, offering improved long-term protection against caries for clinical use.

PMID:39818536 | DOI:10.1016/j.identj.2024.11.023

Acad Radiol. 2025 Jan 15:S1076-6332(24)01040-7. doi: 10.1016/j.acra.2024.12.052. Online ahead of print.

ABSTRACT

RATIONALE AND OBJECTIVES: Photon Counting CT (PCCT) offers advanced imaging capabilities with potential for substantial radiation dose reduction; however, achieving this without compromising image quality remains a challenge due to increased noise at lower doses. This study aims to evaluate the effectiveness of a deep learning (DL)-based denoising algorithm in maintaining diagnostic image quality in whole-body PCCT imaging at reduced radiation levels, using real intraindividual cadaveric scans.

MATERIALS AND METHODS: Twenty-four cadaveric human bodies underwent whole-body CT scans on a PCCT scanner (NAEOTOM Alpha, Siemens Healthineers) at four different dose levels (100%, 50%, 25%, and 10% mAs). Each scan was reconstructed using both ADMIRE level 2 and a DL algorithm (ClariCT.AI, ClariPi Inc.), resulting in 192 datasets. Objective image quality was assessed by measuring CT value stability, image noise, and contrast-to-noise ratio (CNR) across consistent regions of interest (ROIs) in the liver parenchyma. Two radiologists independently evaluated subjective image quality based on overall image clarity, sharpness, and contrast. Inter-rater agreement was determined using Spearman’s correlation coefficient, and statistical analysis included mixed-effects modeling to assess objective and subjective image quality.

RESULTS: Objective analysis showed that the DL denoising algorithm did not significantly alter CT values (p ≥ 0.9975). Noise levels were consistently lower in denoised datasets compared to the Original (p < 0.0001). No significant differences were observed between the 25% mAs denoised and the 100% mAs original datasets in terms of noise and CNR (p ≥ 0.7870). Subjective analysis revealed strong inter-rater agreement (r ≥ 0.78), with the 50% mAs denoised datasets rated superior to the 100% mAs original datasets (p < 0.0001) and no significant differences detected between the 25% mAs denoised and 100% mAs original datasets (p ≥ 0.9436).

CONCLUSION: The DL denoising algorithm maintains image quality in PCCT imaging while enabling up to a 75% reduction in radiation dose. This approach offers a promising method for reducing radiation exposure in clinical PCCT without compromising diagnostic quality.

PMID:39818525 | DOI:10.1016/j.acra.2024.12.052

Vet Anaesth Analg. 2024 Dec 30:S1467-2987(24)00420-3. doi: 10.1016/j.vaa.2024.12.008. Online ahead of print.

ABSTRACT

OBJECTIVE: To develop an ultrasound-guided technique for intercostal nerve blocks in rabbit cadavers and to compare the success rate and potential complications of this technique to blind injection.

STUDY DESIGN: Prospective, randomized, blinded, descriptive experimental cadaveric study.

ANIMALS: A group of nine adult domestic rabbit cadavers (body mass 1.8-2.4 kg).

METHODS: Anatomic landmarks were identified by dissection of one cadaver and used to develop the ultrasound-guided technique. Eight cadavers were administered blind injections on one hemithorax and ultrasound-guided injections on the opposite hemithorax. The side used for each treatment was randomly assigned. For both techniques, the third to ninth intercostal nerves were targeted and 0.1 mL of yellow dye solution was injected per site. Medial displacement of the parietal pleura was assessed during ultrasound-guided injections. Rabbits were dissected following injection, and injections were considered successful if the circumference of the intercostal nerve was stained with dye. Additionally, the internal aspect of the parietal pleura was assessed for the presence of free dye to determine whether perforation of the parietal pleura had occurred. The number of stained nerves and incidence of pleural perforations were compared between injection techniques using Fisher’s exact test. Data were considered statistically different if p < 0.05.

RESULTS: A total of 56 blind and 56 ultrasound-guided intercostal injections were performed. Success rates of the blind and ultrasound-guided techniques were 35.7 % and 66.0 %, respectively (p = 0.002). The internal aspect of the pleura was stained in 23.2 % of blind and 21.4 % of ultrasound-guided injections, with no significant difference between groups (p > 0.999).

CONCLUSIONS AND CLINICAL RELEVANCE: Ultrasound guidance improves the accuracy of intercostal nerve injections when compared with a blind technique; however, pleural puncture is a common complication when performing intercostal injections with both techniques studied.

PMID:39818484 | DOI:10.1016/j.vaa.2024.12.008

Clin Colorectal Cancer. 2024 Dec 11:S1533-0028(24)00116-6. doi: 10.1016/j.clcc.2024.12.002. Online ahead of print.

ABSTRACT

BACKGROUND: The efficacy of trifluridine/tipiracil (FTD/TPI) + bevacizumab compared to FTD/TPI for treatment of refractory metastatic colorectal cancer (mCRC) was demonstrated in the SUNLIGHT trial. This analysis of SUNLIGHT investigated the impact of treatment with FTD/TPI + bevacizumab on patient quality of life (QoL) and Eastern Cooperative Oncology Group performance status (ECOG PS).

METHODS: Questionnaires (EORTC QLQ-C30 and EQ-5D-5L) and ECOG PS assessments were conducted at baseline and on Day 1 of each treatment cycle. Time to definitive deterioration (TTDD) of QoL and time to ECOG PS worsening between treatment arms was assessed. A repeated-measures mixed-effects model was used to compare changes in QoL and ECOG PS from baseline. Kaplan-Meier and Cox regression methods were used to assess TTDD of QoL, time to ECOG PS worsening to ≥ 2, and overall survival (OS) and progression-free survival (PFS) in patients maintaining an ECOG PS of 0-1.

RESULTS: Both treatment arms showed similar QoL scores from baseline to cycle 6, with no clinically relevant change over time. Patients receiving FTD/TPI + bevacizumab had a longer TTDD of QoL than patients receiving FTD/TPI, as well as longer time to ECOG PS worsening. In patients with maintained ECOG PS, median OS and PFS was prolonged in the FTD/TPI + bevacizumab arm compared to the FTD/TPI arm.

CONCLUSION: This analysis of SUNLIGHT showed that patients treated with FTD/TPI + bevacizumab had no clinically relevant changes in QoL, and prolonged TTDD and time to ECOG PS worsening, compared to patients treated with FTD/TPI.

PMID:39818468 | DOI:10.1016/j.clcc.2024.12.002

Urol Oncol. 2025 Jan 15:S1078-1439(24)01058-5. doi: 10.1016/j.urolonc.2024.12.277. Online ahead of print.

ABSTRACT

BACKGROUND: Prostate cancer treatment involves hormonal therapies that may carry cardiovascular risks, particularly for long-term use. Gonadotropin-releasing hormone (GnRH) antagonists, such as degarelix, may offer advantages over agonists, but comprehensive comparative cardiovascular outcomes are not well established. This study aimed to systematically review and analyze the cardiovascular safety profiles of degarelix compared to those of traditional GnRH agonists, providing critical insights for optimizing treatment strategies.

METHODS: We used Medline (PubMed), Scopus, Embase, Cochrane, and Web of Science databases to identify included studies using a preferred search strategy. All studies assessed the cardiovascular events profile between degarelix versus GnRH agonists were included in our study. We used the review manager version 5.4 to perform the analysis.

RESULTS: 13 studies (160,214 participants) were included in this meta-analysis. Degarelix was associated with a significantly lower incidence of major adverse cardiovascular events [RR: 0.60, 95%CI (0.41, 0.88), P value = .008]. Incidence of stroke [RR: 0.92, 95%CI (0.56, 1.50), P value= .74], hypertension [RR: 0.85, 95%CI (0.37, 1.93), P value= .69], myocardial infarction [RR: 0.82, 95%CI (0.55, 1.21), P value= .31], heart failure [RR: 0.88, 95%CI (0.63, 1.23), P value= .46] and arrhythmia [RR: 0.61, 95%CI (0.24, 1.54), P value= .30] did not reach a statistically significant difference between groups.

CONCLUSION: Degarelix demonstrates a lower incidence of major adverse cardiovascular events compared to GnRH agonists, suggesting a potential cardiovascular safety advantage in prostate cancer treatment. Further studies are required to prove the results of our systematic review and meta-analysis.

PMID:39818461 | DOI:10.1016/j.urolonc.2024.12.277