Tag: pubmed

Braz J Cardiovasc Surg. 2024 Nov 28;e20230241(e20230241). doi: 10.21470/1678-9741-2023-0241.

ABSTRACT

INTRODUCTION: Various cannulation strategies for venoarterial extracorporeal membrane oxygenation (V-A ECMO) support are currently in use according to the clinical urgency and experience of the rescuing team. Although central V-A ECMO is considered more effective than a peripheral approach, the superiority of one cannulation configuration instead of another remains a controversial subject. This study mainly aims to compare the contribution of V-A ECMO circulatory support modalities to patients’ improvement according to various cannulation site strategies and additional usage of intra-aortic balloon pump (IABP).

METHODS: The study design involved the categorization of all patients into two groups: isolated V-A ECMO support and V-A ECMO plus IABP support. Secondly, we divided the patients into four groups considering V-A ECMO cannulation sites, such as central (aorto-atrial), axillo-femoral, femoro-femoral, and jugulo-femoral. We analyzed the parameters regarding the outcome for each group.

RESULTS: When comparing cannulation sites in relation to laboratory parameters for assessing organ perfusion, no statistically significant differences were observed among the groups. We found no statistically significant result within the groups affecting organ perfusion. The complication rates were higher in patients with concomitant IABP support, but the difference was not statistically significant likewise.

CONCLUSION: V-A ECMO provides effective perfusion, no matter which cannulation site is preferred during the decision-making process, and the utilization of IABP support has no additional contribution to the outcomes. We believe that the most suitable strategy should be a tailor-made decision according to the clinical status of patients, the pathology, urgency, and cost-effectiveness.

PMID:39607957 | DOI:10.21470/1678-9741-2023-0241

Diabet Med. 2024 Nov 28:e15489. doi: 10.1111/dme.15489. Online ahead of print.

ABSTRACT

AIM: Gestational diabetes (GDM) poses risks of short- and long-term complications for mother and infant, emphasising the importance of antenatal and postpartum education and support. We aimed to understand the experiences and views of women with GDM in the Republic of Ireland.

METHODS: Women with current or previous GDM were invited to complete an online cross-sectional survey (April-June 2022). Recruitment utilised social media, local media and personal networks. The survey addressed demographics, GDM knowledge and experiences, breastfeeding and weight management during pregnancy and post-pregnancy GDM support needs. Descriptive statistics were conducted, and between-group comparisons were undertaken using the chi-square test. Content analysis was applied to free text data.

RESULTS: Amongst 231 respondents, most were aged 35-39 (42%); 70% experienced a single GDM pregnancy. Only 6% correctly identified their increased level of risk for developing type 2 diabetes. Under half (44.5%) of respondents reported sufficient time with health professionals to address GDM-related questions. Just over half (54.3%) reported attending for diabetes screening at 6-12 weeks postpartum. The majority (66%) expressed a desire for postpartum information, particularly on healthy eating and physical activity. Having a more recent GDM experience was associated with a stronger preference for weaning (p ≤ 0.001) and weight management information (p = 0.025). Qualitative analysis identified inconsistencies in healthcare messaging, significant concerns about a GDM diagnosis’ impact on the pregnancy experience, and financial costs of diagnosis.

CONCLUSIONS: The findings underscore women’s desire for appropriate information and support during and after pregnancy with GDM. Future interventions should address these needs to effectively promote chronic disease prevention after GDM.

PMID:39607953 | DOI:10.1111/dme.15489

Science. 2024 Nov 29;386(6725):1055-1060. doi: 10.1126/science.adi3252. Epub 2024 Nov 28.

ABSTRACT

Low-dimensional quantum systems can host anyons, particles with exchange statistics that are neither bosonic nor fermionic. However, the physics of anyons in one dimension remains largely unexplored. In this work, we realize Abelian anyons in one dimension with arbitrary exchange statistics using ultracold atoms in an optical lattice, where we engineer the statistical phase through a density-dependent Peierls phase. We explore the dynamical behavior of two anyons undergoing quantum walks and observe the anyonic Hanbury Brown-Twiss effect as well as the formation of bound states without on-site interactions. Once interactions are introduced, we observe spatially asymmetric transport in contrast to the symmetric dynamics of bosons and fermions. Our work forms the foundation for exploring the many-body behavior of one-dimensional anyons.

PMID:39607918 | DOI:10.1126/science.adi3252

Endocrinol Diabetes Metab. 2025 Jan;8(1):e70014. doi: 10.1002/edm2.70014.

ABSTRACT

AIMS: Diabetes mellitus is the most common endocrine disease in childhood which significantly impacts quality of life, morbidity and mortality. This study aimed to investigate the socioeconomic background of children with diabetes and their families and to assess its association with diabetes control.

METHODS: This cross-sectional study was conducted in Khartoum State, Sudan, in 2018, at three outpatient diabetes clinics, using standardised questionnaires. We included 138 diabetic children (T1D and T2D) aged 2-18 years using systematic random sampling. Descriptive statistics, economic indicator and inferential statistics were applied using SPSS version 20. An HbA1C level of > 7.0% was set as the cut-point for uncontrolled diabetes. A p-value of < 0.05 was considered statistically significant.

RESULTS: The mean age of the children was 11.1 (3.64) years. Over half of the respondents were not covered by any insurance scheme and 73% lived in urban areas. Mothers had a mean age of 37.3 (7.8), with one-fourth being illiterate, while fathers had a mean age of 45.4 (9.3). Twenty per cent of parents had higher education. Two-thirds of the participants had their HbA1C levels checked within the last 3 months. The prevalence of uncontrolled diabetes was 78.0%. No statistically significant association was found between HbA1C levels and families’ socioeconomic, demographic or clinical characteristics (p > 0.05).

CONCLUSION: Neither children’ nor parents’ characteristics influenced HbA1C level. The high rate of uncontrolled diabetes (78.0%), and other countries showing better profiles of control, suggests the need for exploring other contributing factors. Insulin availability and lack of home glucose monitoring need to be considered. We recommend future prospective studies to consider these factors and use multiple HbA1C measures’ average as a better indicator of diabetic control.

PMID:39607902 | DOI:10.1002/edm2.70014

Eur J Gen Pract. 2024 Dec;30(1):2430507. doi: 10.1080/13814788.2024.2430507. Epub 2024 Nov 28.

ABSTRACT

BACKGROUND: National Action Plans (NAPs) aim to address antimicrobial resistance (AMR) understanding and awareness but struggle to translate targets into clinically relevant guidance for general practice.

OBJECTIVE: To identify and map antibiotic use targets in European general practice and explore if and how these targets are linked to NAPs.

METHODS: A systematic search was carried out in MEDLINE (OVID), EMBASE and SCOPUS, with additional manual searches. The research questions were: What are existing targets for antibiotic use in general practice in the 31 European countries? and How are these targets linked to the NAPs on AMR?. The results are presented narratively.

RESULTS: 77 reports were included, of which 33 focused on national targets and general practice or linking national and local targets. Reports describe local strategies to achieve targets, such as prescriber feedback, benchmarking systems and financial incentives. However, these reports provide aggregated targets for general practice, such as a percentage reduction of antibiotics prescribed. These targets are set in general, for a specific type of antibiotic, for an amount per number of patients, in defined daily doses or items. None of the reports translate national targets into clinically relevant or practical targets for general practitioners.

CONCLUSION: Most European countries have an NAP with established targets, but the type and implementation of these targets vary between nations. Translating national targets into daily clinical practice is challenging and often lacks the involvement of prescribers. Aligning national and local targets would enhance coherence and more effectively contribute to improvements in antibiotic use.

PMID:39607900 | DOI:10.1080/13814788.2024.2430507

Dentomaxillofac Radiol. 2024 Nov 28:twae064. doi: 10.1093/dmfr/twae064. Online ahead of print.

ABSTRACT

OBJECTIVES: Cysts in jaws may have similar radiographic features. However, it is important to clarify the diagnosis prior to surgery. The aim of this study was to compare the radiomic features of radicular cysts (RCs), dentigerous cysts (DCs) and odontogenic keratocysts (OKCs) as a non-invasive diagnostic alternative to biopsy.

METHODS: In total, 161 odontogenic cysts diagnosed histopathologically (55 RCs, 53 DCs and 53 OKCs) were included in the present study. Each cyst was semi-automatically segmented on CBCT images, and radiomic features were extracted by an observer. A second observer repeated 20% of the evaluations and the radiomic features. Those achieving an inter-observer agreement level above 0.850 were included in the study. Consequently, 5 shape-based and 22 textural features were investigated in the study. Statistical analysis was performed comparing both three cyst features and making pairwise comparisons.

RESULTS: All features included in the study showed statistical differences between cysts, with the exception of one textural feature (NGTDM coarseness) (p < 0.05). However, only one shape-based feature (shericity) and one textural feature (GLSZM large area emphasis) were statistically different in pairwise comparisons of all three cysts (p < 0.05).

CONCLUSION: Radiomics features of the RCs, DCs and OKCs showed significant differences, and may have the potential to be used as a non-invasive method in the differential diagnosis of cysts.

PMID:39607768 | DOI:10.1093/dmfr/twae064

Pediatr Allergy Immunol Pulmonol. 2024 Nov 28. doi: 10.1089/ped.2024.0082. Online ahead of print.

ABSTRACT

Background: This study aims to evaluate systemic immune inflammation index, systemic inflammatory response index (SIRI), aggregate index of systemic inflammation (AISI), and follistatin-like protein-1 (FSTL-1) levels in children with pneumonia and healthy controls. Methods: The study was carried out at the Seydisehir State Hospital between February 1, 2024 and June 1, 2024. The patient group included 44 children diagnosed with pneumonia and the control group included 45 healthy children without any disease. Index values obtained from hemogram data. Enzyme-linked immunosorbent assay was used to measure FSTL-1 levels. Results: A total of 89 participants, 44 in the patient group and 45 in the healthy control group, were included in the study. White blood cells, monocyte, eosinophil, neutrophil, c-reactive protein, SIRI, and AISI levels were significantly higher in the patient group than in the control group. FSTL-1 levels were higher in the patient group, but did not differ statistically significant. The patient and control groups were compared in the receiver operating characteristics analysis, we found the highest area under curve (AUC) in the SIRI (AUC: 0.754) and AISI (AUC: 0.713) parameters. Conclusion: In conclusion, compared to healthy controls, SIRI and AISI levels were significantly higher in the patient group, and the highest AUC values belonged to these indices. Therefore, we believe that SIRI and AISI indices, which are inexpensive and simple tests, are useful for early diagnosis and treatment of pneumonia.

PMID:39607763 | DOI:10.1089/ped.2024.0082

Arch Clin Neuropsychol. 2024 Nov 28:acae110. doi: 10.1093/arclin/acae110. Online ahead of print.

ABSTRACT

OBJECTIVE: Previous studies have reported that patients with Multiple Sclerosis (MS) face cognitive difficulties. Much less, however, is known about their language abilities. The present study aims to provide a clear view of the language abilities of adults with MS, considering their cognitive skills and the type of the disorder.

METHOD: Specifically, 20 patients with Relapsing-Remitting MS, 17 patients with Secondary Progressive MS, and two healthy control groups demographically matched with the clinical groups, took part in the study. Their language abilities were examined using the Adult Language Abilities Test, which explores morpho-syntactic and semantic phenomena of the Greek language in both comprehension and production modes.

RESULTS: Our results did not reveal statistically significant differences between the two clinical groups on any cognitive or language subtest. Both groups, however, performed poorer than the control groups in producing the correct form of verbs, possessive and weak personal pronouns, and in comprehending relative and passive clauses. Participants’ performance in morphosyntax was found to be related to their processing speed.

CONCLUSION: Mapping the cognitive and language abilities of patients with MS is crucial for designing effective targeted interventions, which can help them adopt strategies to manage their specific cognitive and language symptoms.

PMID:39607750 | DOI:10.1093/arclin/acae110

ACS Appl Mater Interfaces. 2024 Nov 28. doi: 10.1021/acsami.4c17912. Online ahead of print.

ABSTRACT

Objective: To compare the diagnostic value of [¹⁸F]AlF-LNC1007, [¹⁸F]FDG, and [¹⁸F]AlF-NOTA-FAPI-04 PET/CT in breast cancer. Methods: 33 patients with highly suspected or already diagnosed but untreated breast cancer were enrolled in the study and underwent [¹⁸F]AlF-LNC1007 (30 patients), [¹⁸F]FDG (22 patients), and [¹⁸F]AlF-NOTA-FAPI-04 (8 patients) PET/CT. Quantitative measurements included the SUV_max and tumor-to-background ratio (TBR) for all lesions and background tissues. The Chi-square test was used for intergroup diagnostic efficacy, and the Wilcoxon test was used for intergroup SUV_max or TBR. Diagnostic efficacy for lymph node metastasis was evaluated using receiver operating characteristic (ROC) analysis. Results: Compared to [¹⁸F]FDG, [¹⁸F]AlF-LNC1007 had a higher positive predictive value (100% vs 91%, P = 0.0004) in lymph node metastases (42 vs 46) and higher sensitivity (100 vs 76%, P = 0.0003) in bone metastases (33 vs 25) but lower sensitivity (93 vs 100%, P = 0.001) in liver metastases. Apart from liver metastases, [¹⁸F]AlF-LNC1007 PET/CT had higher SUV_max in primary tumor and other metastases, with no statistical difference in TBR. Compared to [¹⁸F]AlF-NOTA-FAPI-04 PET/CT, [¹⁸F]AlF-LNC1007 had less false-positive and a higher positive predictive value in bone metastases (99 vs 95%, P = 0.0003) but had lower SUV_max(P < 0.01) in all primary and metastases lesions. The TBR difference between [¹⁸F]AlF-LNC1007 and [¹⁸F]AlF-NOTA-FAPI-04 was statistically significant only in bone metastases (5.97 vs 5.02, P = 0.001). The comparison of lymph node detection efficacy between [¹⁸F]AlF-LNC1007 and [¹⁸F]FDG PET/CT showed significant differences in SUV_max cutoff values for diagnosing lymph node metastases (2.62 vs 3.90), sensitivity (95.2% vs 66.67), and specificity (100% vs 85.00) (all P < 0.001). Conclusion: [¹⁸F]AlF-LNC1007 demonstrated superior efficacy compared to [¹⁸F]FDG and [¹⁸F]AlF-NOTA-FAPI-04 and higher uptake than [¹⁸F]FDG in primary tumor, lymph node and bone metastases, and higher TBR than [¹⁸F]AlF-NOTA-FAPI-04, especially in bone metastases. [¹⁸F]AlF-LNC1007 also showed high specificity in differentiating inflammatory and metastatic lymph nodes.

PMID:39607746 | DOI:10.1021/acsami.4c17912

J Integr Complement Med. 2024 Nov 28. doi: 10.1089/jicm.2024.0681. Online ahead of print.

ABSTRACT

Objective: Federally Qualified Health Centers (FQHCs) provide comprehensive primary care to underserved populations. While the presence of chiropractic services in these multidisciplinary systems is of growing interest, little is known. The purpose of this study is to identify and map where Doctors of Chiropractic (DCs) are employed or providing care within FQHCs and describe their employment characteristics. Methods: Websites for FQHC clinics identified by the Health Resources and Services Administration were reviewed to determine whether chiropractic services are offered and/or a DC is employed at that clinic. Identified DCs were invited to participate in a cross-sectional survey, which included questions about their employment. Analysis of survey data utilized descriptive statistics and content analysis of open-ended questions. Results: We identified 233 DCs working full- or part-time in 146 of 1537 (9.5%) FQHC systems, with two thirds of those employing more than one DC. Chiropractic services are delivered at FQHCs in 28/50 U.S. states, 75.0% of which offer a chiropractic benefit in their state Medicaid program. California had the largest concentration of FQHCs offering chiropractic services (65/146, 44.5%). Of surveys sent to 206 viable DC e-mail addresses, 101 were completed (49.0% response rate). Most DCs responded to personal (39.0%) or advertised (26.0%) solicitation for employment by the FQHC, while some DCs (14.0%) initiated the opportunity. Average employment at the FQHC was 5.1 years. Credentialing levels and compensation structures were inconsistent. DCs predominantly spend their time on clinical care (mean 88.0%) compared with administrative tasks (mean 10.4%). Conclusion: This study provides important baseline information about the presence of chiropractic within FQHCs and DCs employment characteristics. Future research should include exploring the roles DCs fulfill within FQHCs, skills necessary for successful collaboration, and barriers to incorporating chiropractic services within these systems.

PMID:39607742 | DOI:10.1089/jicm.2024.0681