Tag: pubmed

Eur J Contracept Reprod Health Care. 2024 Oct 15:1-7. doi: 10.1080/13625187.2024.2410838. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate the efficacy and acceptability of virtual reality (VR) as a distraction technique in the management of acute pain and anxiety during outpatient uterine aspiration using a manual vacuum aspirator (MVA).

MATERIALS AND METHODS: This mixed methods study included a prospective multi-centre randomised controlled trial and structured individual interviews. Of the 72 patients approached, 50 consenting, eligible participants were randomised to VR intervention (immersive video content ‘The Forest of Serenity’) or standard care during MVA for the management of miscarriage or incomplete abortion from July 2021-July 2022 across two university hospitals in London, UK. Expected and actual pain scores, and anxiety before and after the procedure were measured as numeric rating scores (0-10). Structured interviews were undertaken after the procedure in women randomised to VR. Statistical analysis of pain and anxiety scores were by intention-to-treat including all randomised participants, using Stata-12 software. Qualitative analysis was achieved by thematic analysis of transcribed interviews.

RESULTS: There was no significant difference in pain or anxiety scores reported by participants randomised to VR compared with standard care. Mean worst pain scores were 5.98 and 6.88 in the standard care and VR groups respectively (p-value 0.13), with corresponding anxiety scores at the end of the procedure 3.94 and 3.3 (p-value 0.57). Qualitative analysis from interviews was highly favourable from women randomised to VR with all participants reporting a positive experience. 90% (18/20) of participants reported that VR reduced their anxiety and 71% (15/21) stated that it helped to reduce or distract from their pain.

CONCLUSION: While virtual reality did not decrease pain or anxiety scores during MVA, it is a feasible and acceptable option that may improve patient experience.

SHORT CONDENSATION: Randomisation to VR during MVA did not reduce pain or anxiety scores. However, at structured interview most participants reported that VR reduced their anxiety and reduced or distracted them from their pain. VR is a feasible and acceptable option that may improve patient experience during MVA.

PMID:39405045 | DOI:10.1080/13625187.2024.2410838

Phys Eng Sci Med. 2024 Oct 15. doi: 10.1007/s13246-024-01469-y. Online ahead of print.

ABSTRACT

The treatment, planning, simulation, and setup of radiotherapy patients contain many processes subject to errors involving both staff and equipment. Cone-beam-CT (CBCT) provides a final check of patient positioning and corrections based on this can be made prior to treatment delivery. Statistical Process Control (SPC) techniques are used in various industries for quality management and error mitigation. The utility of SPC techniques to monitor process and equipment changes in our Head and Neck patient treatments was assessed by application to CBCT results from a quality-focused longitudinal study. Individuals and moving range (XmR) as well as exponentially-weighted moving average (EWMA) techniques were explored. The SPC techniques were sensitive to process changes and trends over the 12 years of data collected. A reduction in the random component of patient setup errors needing correction was observed. Systematic components of error remained more stable. An uptick in both datasets was observed correlating with the COVID-19 pandemic. Process control limits for use in prospective process monitoring were established. Challenges that arose from using SPC techniques in a retrospective study are outlined.

PMID:39405028 | DOI:10.1007/s13246-024-01469-y

Sports Med. 2024 Oct 15. doi: 10.1007/s40279-024-02123-z. Online ahead of print.

ABSTRACT

BACKGROUND: The optimal prescription and precise recommendations of resistance training volume for older adults is unclear in the current literature. In addition, the interactions between resistance training volume and program duration as well as physical health status remain to be determined when assessing physical function, muscle size and hypertrophy and muscle strength adaptations in older adults.

OBJECTIVES: This study aimed to determine which resistance training volume is the most effective in improving physical function, lean body mass, lower-limb muscle hypertrophy and strength in older adults. Additionally, we examined whether effects were moderated by intervention duration (i.e. short term, < 20 weeks; medium-to-long term, ≥ 20 weeks) and physical health status (i.e. physically healthy, physically impaired, mixed physically healthy and physically impaired; PROSPERO identifier: CRD42023413209).

METHODS: CINAHL, Embase, LILACS, PubMed, Scielo, SPORTDiscus and Web of Science databases were searched up to April 2023. Eligible randomised trials examined the effects of supervised resistance training in older adults (i.e. ≥ 60 years). Resistance training programs were categorised as low (LVRT), moderate (MVRT) and high volume (HVRT) on the basis of terciles of prescribed weekly resistance training volume (i.e. product of frequency, number of exercises and number of sets) for full- and lower-body training. The primary outcomes for this review were physical function measured by fast walking speed, timed up and go and 6-min walking tests; lean body mass and lower-body muscle hypertrophy; and lower-body muscle strength measured by knee extension and leg press one-repetition maximum (1-RM), isometric muscle strength and isokinetic torque. A random-effects network meta-analysis was undertaken to examine the effects of different resistance training volumes on the outcomes of interest.

RESULTS: We included a total of 161 articles describing 151 trials (n = 6306). LVRT was the most effective for improving timed up and go [- 1.20 standardised mean difference (SMD), 95% confidence interval (95% CI): – 1.57 to – 0.82], 6-min walk test (1.03 SMD, 95% CI: 0.33-1.73), lean body mass (0.25 SMD, 95% CI: 0.10-0.40) and muscle hypertrophy (0.40 SMD, 95% CI: 0.25-0.54). Both MVRT and HVRT were the most effective for improving lower-limb strength, while only HVRT was effective in increasing fast walking speed (0.40 SMD, 95% CI: – 0.57 to 0.14). Regarding the moderators, our results were independent of program duration and mainly observed for healthy older adults, while evidence was limited for those who were physically impaired.

CONCLUSIONS: A low resistance training volume can substantially improve healthy older adults’ physical function and benefits lean mass and muscle size independently of program duration, while a higher volume seems to be necessary for achieving greater improvements in muscle strength. A low volume of resistance training should be recommended in future exercise guidelines, particularly for physically healthy older adults targeting healthy ageing.

PMID:39405023 | DOI:10.1007/s40279-024-02123-z

Trop Anim Health Prod. 2024 Oct 15;56(8):345. doi: 10.1007/s11250-024-04189-3.

ABSTRACT

Fodder scarcity and low quality affect the productivity of dairy cattle in Kenya yet only few smallholder dairy farmers show positive deviance in fodder conservation. Information on the strategies of such positive deviant (PD) farmers is scanty. The objective of this study was to determine strategies that distinguish PDs from peers (non-PDs) in fodder conservation among smallholder dairy farmers in highlands and midlands of Kenya. A cross-sectional survey was conducted among farms producing and conserving fodder in Tharaka Nithi County. Multistage sampling procedures was used; purposive sampling of the Sub-counties and locations, random selection of villages and proportional selection of 246 farms through snowball chain referral. Data were collected on demographic, socio-economic, farm characteristics and fodder conservation. Farms were categorized as PDs (n = 24) or non-PDs (n = 97). The PDs conserved fodder adequate to last dry season (about 3 months) and had milk yield 15 kg/cow/day and above, while non-PDs do not qualify for both criteria. Chi-square and T-test were used to analyze categorical and continuous variables respectively. Logit regression was used to examine independent variables that influence probability of PDs. Farmers with high school and tertiary education who accessed extension services were PDs while non-PDs had non-formal and primary education and access extension less. Farms conserving hay and silage dominated PDs. Land in hectare (ha) and herd sizes in Tropical Livestock Unit (TLU) distinguished PDs (1.7 ha and 9.0 TLU) from non-PDs (0.7 ha and 3.3 TLU). The strategies that distinguished PDs from non-PDs were allocating land to fodder production, high milk yield kg/cow/day, large herd size and access to extension services. Increasing access to extension and resources (land) raised chances of PDs in fodder conservation. Knowledge of PDs strategies is important for fodder conservation, improve productivity and inform direction of future research.

PMID:39405002 | DOI:10.1007/s11250-024-04189-3

J Community Health. 2024 Oct 15. doi: 10.1007/s10900-024-01411-z. Online ahead of print.

ABSTRACT

American Indians and Alaska Natives (AI/AN) have consistently exhibited suicide rates that surpass all other racial and ethnic groups in the United States. However, not much has been published regarding the epidemiology of AI/AN youth suicides. The objectives of this study on AI/AN adolescents were to assess the prevalence of suicidal thoughts and behaviors by age and gender, assess the number of years of life lost to suicide before the age of 80, and assess the most common methods used to commit suicide by AI/AN adolescents. Data utilized for this study were from the national Youth Risk Behavior Surveys and the Web-Based Injury Statistics Query and Reporting System. We conducted a cross-sectional descriptive analysis of the suicide-related data from years 2015, 2017, 2019, and 2021. We found AI/AN adolescents averaged one in four contemplated suicides, one in five planned suicides, and one in six attempted suicides. A total of 257 adolescents committed suicide during the study period where the majority (62.5%) were observed in males and suicides were more common in older adolescents. AI/AN adolescents had the highest crude suicide death rate of any racial or ethnic group and the most common methods used to commit suicide were suffocation (57.5%) and firearms (35.5%). AI/ AN adolescents lost almost 16,000 years of potential life during the four years of the study and the majority were lost by males. Professionals and policymakers desiring to reduce suicidal thoughts and behaviors among AI/AN adolescents need to focus more of their efforts on providing youths with resilience factors to establish sufficient ego strength in them to deal with all types of stressors. Concurrently, federal, state, and tribal leaders need to work together to improve the social and economic circumstances faced by many AI/AN families and children.

PMID:39404991 | DOI:10.1007/s10900-024-01411-z

Head Neck Pathol. 2024 Oct 15;18(1):100. doi: 10.1007/s12105-024-01705-7.

ABSTRACT

AIM: To characterize the immunohistochemical expression of MDM2, Bcl-2, SATB2 and Ki-67 in histological variants of unicystic ameloblastoma (UA).

METHODOLOGY: Following the ethical approval, forty (40) patients with unicystic ameloblastoma were retrieved from the archives and subjected to immunohistochemistry (IHC). Sociodemographic and clinical data were also retrieved. The results were entered into a Microsoft Excel spreadsheet and analyzed using SPSS software.

RESULTS: Human tooth germs, which served as the control, showed moderate expression of Bcl-2 and MDM2 with slight proliferative activity in ameloblasts and moderate expression of SATB2 in ectomesenchyme and odontoblasts. Luminal UA (Type 1) showed low Ki-67 index and negative to mild Bcl-2 and MDM2 expression, whilst Type 1.2 (luminal and intraluminal), Type 1.2.3 (luminal, intraluminal and mural), and Type 1.3 (luminal and mural), including the recurrent cases, showed moderate to intense expression with high mean Ki-67 index. The difference between the study groups was statistically significant (p value < 0.001). No expression of SATB2 was noted in any histological variant of UA. Furthermore, no significant differences were noted in age, gender, site and location between the groups.

CONCLUSION: In contrast to luminal variant of UA, mural±intraluminal variants and recurrent cases demonstrate higher expression of Bcl-2 and MDM2 with higher mean Ki-67 index. It may thus be prudent to provide aggressive treatment for cases, not just with mural follicles but also for the patients with intraluminal plexiform proliferation, to prevent recurrence and improve patient outcomes.

PMID:39404986 | DOI:10.1007/s12105-024-01705-7

Cardiovasc Toxicol. 2024 Oct 15. doi: 10.1007/s12012-024-09929-3. Online ahead of print.

ABSTRACT

Cardiac magnetic resonance (CMR) enables the assessment of tissue characteristics of the myocardium. Changes in the extracellular volume (ECV) and fibrosis volume (FV) of the myocardium are sensitive and early pathogenetic markers and have prognostic significance. The aim of the study was to assess ECV and FV of left ventricular myocardium in T1 mapping sequence in patients with a history of SARS-CoV-2 infection, considering vaccination status against COVID-19. The study group consisted of 97 patients (52.54 ± 8.31 years, 53% women and 47% men). The participants were divided into three subgroups: A) patients with a history of symptomatic SARS-CoV-2 infection, unvaccinated against COVID-19 (n = 39), B) patients with a history of symptomatic SARS-CoV-2 infection, with a full vaccination schedule against COVID-19 (n = 22), and C) persons without a history of SARS-CoV-2 infection constituting the control subgroup (C, n = 36). All patients underwent 1.5 T cardiac magnetic resonance. In subgroup A compared to subgroups B and C, both the ECV whole myocardium and ECV segments 2, 5-6, 8, and 10-11 were statistically significantly higher. In addition, the ECV segment 16 was statistically significantly higher in subgroup A than in subgroup C. Also, the FV whole myocardium was statistically significantly higher in subgroup A in comparison to subgroups B and C. There were no significant differences in ECV and FV between subgroups B and C. In summary, unvaccinated against COVID-19 patients with a history of symptomatic SARS-CoV-2 infection have higher myocardial ECV and FV values in the T1 mapping sequence, compared to those without COVID-19 and those suffering from COVID-19, previously vaccinated with the full vaccination schedule.

PMID:39404974 | DOI:10.1007/s12012-024-09929-3

JA Clin Rep. 2024 Oct 15;10(1):66. doi: 10.1186/s40981-024-00749-6.

ABSTRACT

BACKGROUND: Prehabilitation, which includes nutritional and exercise therapies, is recommended for patients before surgery to improve physical and cognitive functions. This study aimed to identify the awareness, understanding, and issues among surgeons and anesthesiologists regarding the implementation of prehabilitation.

METHODS: We conducted a survey on prehabilitation targeting surgeons and anesthesiologists working at a university hospital and two private hospitals. The survey collection period was set for 1 month, commencing on February 5, 2024. Descriptive statistics were employed to summarize the characteristics of the participants.

RESULTS: A total of 254 surgeons and 49 anesthesiologists from three hospitals participated, with a response rate of 61.7%. Regarding the understanding of prehabilitation, 16.7% of anesthesiologists and only 2% of surgeons had a good grasp of its content. When enquired about the necessity of prehabilitation, 100% of anesthesiologists indicated it as necessary or somewhat necessary, whereas 98.7% of surgeons responded similarly. Several barriers to the implementation of prehabilitation were identified, with the most common reason being the busy schedule of outpatient services.

CONCLUSION: This study highlights that while both surgeons and anesthesiologists recognize the importance of prehabilitation, significant challenges exist in its practical implementation. This underscores the need for simple explanatory tools for patients, the introduction of remote care options, and simple orders to relevant departments, which are essential and require multidisciplinary collaboration.

PMID:39404964 | DOI:10.1186/s40981-024-00749-6

Neurol Sci. 2024 Oct 15. doi: 10.1007/s10072-024-07791-3. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate mortality for Alzheimer’s Disease (AD) in Italy over more than three decades (1980-2015) and discuss the possible role of general and specific contributing factors.

METHODS: Mortality data were extracted by the Italian National Institute of Statistics: crude mortality rates were computed for sex and age, considering the whole country and its five main geographical sub-areas. Rates were standardized in two ways: directly (annual mortality rates AMRs) and indirectly (standardized mortality rates, SMRs). SMRs were then used to evaluate geographical differences; to study mortality trend, AMRs and joinpoint linear regression analysis were used.

RESULTS: Considering the entire period and the whole country, mortality rates were similar for females and males and for geographical regions, with the exception of the older age groups where mortality for AD in females slightly prevailed. In these older patients, a steep increase of mortality was seen starting from the current century. The increase in male mortality mirrored the national trend in North-West and Central Italy, but not in North-East, South, and the Islands, where it did not surge until the mid to late 1990s.

CONCLUSIONS: the general increase of mortality is in line with international data and it reflects the increasing prevalence of the disease, likely due to increasing longevity, and to improvements in diagnostic accuracy. In addition, the accuracy of death certificate compilation could account for both geographical and temporal differences. Currently available drugs for AD do not seem to have an impact on mortality rates.

PMID:39404919 | DOI:10.1007/s10072-024-07791-3

Neurol Sci. 2024 Oct 15. doi: 10.1007/s10072-024-07794-0. Online ahead of print.

ABSTRACT

BACKGROUND: The existing evidence on the effect of dietary supplements for preventing migraines has generated conflicting results.

METHODS: We assessed alterations in migraine clinical features corresponding to the intake of dietary supplements. Our main outcomes included the frequency (number of attacks), duration (in hours), the severity (intensity) and the monthly migraine days. Using a dose-response meta-analysis, we estimated the dose-dependent impact. The certainty of evidence was evaluated using the GRADE tool.

RESULTS: Finally, twenty-two trials were included in the systematic review and meta-analysis. Magnesium supplementation reduced migraine attacks (mean difference (MD) = -2.51), severity (MD = -0.88), and the monthly migraine days (MD = -1.66) compared with the control group. CoQ10 decreased the frequency (MD = -1.73), severity (MD = -1.35), and duration of migraine (MD = -1.72). Riboflavin decreased attack frequency (MD = -1.34). Alpha-lipoic acid decreased attack frequency (MD = -1.24) and severity (MD = -0.38). Probiotics decreased the frequency (MD = -1.16), severity (MD = -1.07) and the monthly migraine days (MD = -3.02). Vitamin D reduced migraine frequency (MD = -1.69) and the monthly migraine days (MD = -2.41). In adults, compared with placebo, these supplements did not significantly affect other outcomes, and omega-3 supplementation did not yield a statistically significant reduction in any of these outcomes.

CONCLUSION: The use of certain dietary supplements has resulted in a significant decrease in migraine prophylaxis. Further clinical trials of high quality appear to be beneficial.

PMID:39404918 | DOI:10.1007/s10072-024-07794-0