Tag: pubmed

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

J Foot Ankle Res. 2024 Sep;17(3):e70004. doi: 10.1002/jfa2.70004.

ABSTRACT

BACKGROUND: Podiatry enrolments at Australian and New Zealand universities have decreased by 17.3% since 2015, which threatens the profession’s sustainability and the health and wellbeing of Australian and New Zealand people and communities. Reasons for this decline remain unclear due to insufficient evidence on factors influencing career choices. The overarching aim of this study was to identify motivators and barriers for studying podiatry in Australia and New Zealand.

METHODS: This study used a convergent mixed methods design. Students enrolled in (i) podiatry and (ii) relevant non-podiatry health, sport or science programs at nine Australian and one New Zealand university, were invited to participate in an online survey. First-year podiatry students were also invited to participate in an online workshop. Quantitative data were analysed using descriptive statistics and linear/logistic regression models. Three independent assessors used inductive thematic analysis for the qualitative data.

RESULTS: Overall, 278 podiatry students (mean age 24.9 ± 8.5 years, 65.1% female) and 553 non-podiatry students (mean age 24.8 ± 8.2 years, 75.4% female; 32.2% from physiotherapy and 29.1% from occupational therapy) responded to the survey. Interest in a health-related career, wanting to make a difference to people’s health, and opportunity to care for people from different backgrounds/age groups were key motivating factors among podiatry students. Barriers to studying podiatry were encountered by 28.1% of podiatry students. Thematic analysis identified seven themes concerning career choice, which are as follows: (i) awareness of profession and scope of practice; (ii) stereotypes and negative perceptions of the profession; (iii) awareness of career pathways; (iv) job prospects and earning potential; (v) working with people and building relationships; (vi) podiatry is not the first preference; and (vii) barriers which limit student enrolment.

CONCLUSIONS: There are a variety of factors that motivate and influence students to study podiatry, however, altruistic reasons are most highly rated. Allied health students have limited understanding of the scope of practice and career opportunities in podiatry. Additionally, the podiatry profession often faces negative stereotypes. Further work is required to reverse the negative stereotypes and perceptions of podiatry and build knowledge of the profession’s scope of practice, career pathways/opportunities, job prospects and earning potential.

PMID:39229789 | DOI:10.1002/jfa2.70004

Infect Control Hosp Epidemiol. 2024 Sep 4:1-9. doi: 10.1017/ice.2024.105. Online ahead of print.

ABSTRACT

OBJECTIVE: To assess the impact of a diagnostic test stewardship intervention focused on tracheal aspirate cultures.

DESIGN: Quality improvement intervention.

SETTING: Tertiary care pediatric intensive care unit (PICU).

PATIENTS: Mechanically ventilated children admitted between 9/2018 and 8/2022.

METHODS: We developed and implemented a consensus guideline for obtaining tracheal aspirate cultures through a series of Plan-Do-Study-Act cycles. Change in culture rates and broad-spectrum antibiotic days of therapy (DOT) per 100 ventilator days were analyzed using statistical process control charts. A secondary analysis comparing the preintervention baseline (9/2018-8/2020) to the postintervention period (9/2020-8/2021) was performed using Poisson regression.

RESULTS: The monthly tracheal aspirate culture rate prior to the COVID-19 pandemic (9/2018-3/2020) was 4.6 per 100 ventilator days. A centerline shift to 3.1 cultures per 100 ventilator days occurred in 4/2020, followed by a second shift to 2.0 cultures per 100 ventilator days in 12/2020 after guideline implementation. In our secondary analysis, the monthly tracheal aspirate culture rate decreased from 4.3 cultures preintervention (9/2018-8/2020) to 2.3 cultures per 100 ventilator days postintervention (9/2020-8/2021) (IRR 0.52, 95% CI 0.47-0.59, P < 0.01). Decreases in tracheal aspirate culture use were driven by decreases in inappropriate cultures. Treatment of ventilator-associated infections decreased from 1.0 to 0.7 antibiotic courses per 100 ventilator days (P = 0.03). There was no increase in mortality, length of stay, readmissions, or ventilator-associated pneumonia postintervention.

CONCLUSION: A diagnostic test stewardship intervention was both safe and effective in reducing the rate of tracheal aspirate cultures and treatment of ventilator-associated infections in a tertiary PICU.

PMID:39229740 | DOI:10.1017/ice.2024.105

Photobiomodul Photomed Laser Surg. 2024 Sep 4. doi: 10.1089/photob.2024.0005. Online ahead of print.

ABSTRACT

Objective: The purpose of this study was to demonstrate heat transfer within oral soft tissues using different lasers under the effect of local anesthetics (LA). Methods: Bovine tongue slices were placed in between two glass slides and at a distance from a thermographic camera. In total, 2-cm-long 240 incisions were made along the surface of the tissue parallel to glass slides and the camera capture field. Incisions were performed using 445-nm and infrared (IR) lasers (970 nm and 980 nm on a continuous wave at 2 W) with 320 µm-initiated (concentrated energy at the tip provided by a blue articulated paper and laser irradiation) and noninitiated (defused energy) fiber (30-sec irradiation period). LA was injected into the specimens before irradiation. The temperature changes in °C (ΔT) and vertical and lateral heat transfer (in mm) were recorded at 10-sec intervals for 30 sec, using thermographic images. The amount of lateral and vertical heat transfer was measured. A repeated analysis of variance statistical comparison test was used to analyze differences between the lateral (width) and the vertical (height) heat transfer for initiated and noninitiated lasers and different lasers. Results: The maximum ΔT in °C utilizing initiated tips of 970, 980, or 445 nm were 11.82 ± 3.46, 7.66 ± 3.24, and 18.94 ± 7.01 and using noninitiated tips were 8.27 ± 1.69, 8.87 ± 2.40, and 12.31 ± 8.65, respectively. Heat transfers (height/width) for initiated were 40.65 ± 10.40/90.65 ± 10.77 mm, 41.50 ± 11.83/83.95 ± 11.20 mm, and 33.70 ± 9.10/95.10 ± 11.17 mm and for noninitiated lasers were 52.95 ± 6.89/96.10 ± 11.17 mm, 47.75 ± 7.41/93.75 ± 14.96 mm, and 31.35 ± 11.40/75.20 ± 19.68 mm, respectively. A statistically significant difference was found between all lasers (p < 0.05) for initiated and noninitiated lasers (except for 970/980 nm for noninitiated lasers). Lower penetration depth (p < 0.05) at 445-nm diode and greater lateral heat spreading (p < 0.05) were identified under LA especially utilizing noninitiated tips without significant difference in IR lasers. Conclusions: LA might negatively influence soft tissues creating scattering when noninitiated tips are used and IR diode laser technology.

PMID:39229735 | DOI:10.1089/photob.2024.0005