Tag: pubmed

Appl Physiol Nutr Metab. 2022 Jun 1. doi: 10.1139/apnm-2021-0618. Online ahead of print.

ABSTRACT

This study investigated intakes of total, n-3, and n-6 polyunsaturated fatty acids (PUFA) in 109 preschool-aged children who participated in the Guelph Family Health Study pilot. Intakes of total, n-3, and n-6 PUFA did not meet recommendations. This study highlights the need for additional monitoring and potential interventions to improve PUFA intake in preschool-aged children. Clinical trial #NCT02223234. Novelty: Canadian preschool-aged children are not consuming enough n-3 and n-6 polyunsaturated fatty acids.

PMID:35649282 | DOI:10.1139/apnm-2021-0618

J Phys Chem Lett. 2022 Jun 1:5009-5016. doi: 10.1021/acs.jpclett.2c00685. Online ahead of print.

ABSTRACT

Atomic descriptions of peptide aggregation nucleation remain lacking due to the difficulty of exploring complex configurational spaces on long time scales. To elucidate this process, we develop a multiscale approach combining a metadynamics-based method with cluster statistical mechanics to derive concentration-dependent free energy surfaces of nucleation at near-atomic resolution. A kinetic transition network of nucleation is then constructed and employed to systematically explore nucleation pathways and kinetics through stochastic simulations. This approach is applied to describe Aβ_16-21 amyloid nucleation, revealing a two-step mechanism involving disordered aggregates at millimolar concentration, and an unexpected mechanism at submillimolar concentrations that exhibits kinetics reminiscent of classical nucleation but atypical pathways involving growing clusters with structured cores wrapped by disordered surface. When this atypical mechanism is operative, critical nucleus size can be reflected by the nucleation reaction order. Collectively, our approach paves the way for a more quantitative and detailed understanding of peptide aggregation nucleation.

PMID:35649244 | DOI:10.1021/acs.jpclett.2c00685

Int J Prosthodont. 2022 May 25. doi: 10.11607/ijp.7457. Online ahead of print.

ABSTRACT

PURPOSE: To investigate the risk factors related to failure of removable partial dentures (RPDs) and to compare the survival of RPDs when abutment teeth have good vs reduced bone support.

MATERIALS AND METHODS: In this longitudinal patient record-based cohort study with a mean follow-up of 44.9 months, Cox regression models were used to evaluate the associations between clinical covariates and abutment tooth failure, as well as prosthesis failure.

RESULTS: A total of 142 patients and 172 RPDs were included. Of the 172 prostheses, 64 (nearly 40%) failed after a mean time of about 4 years. Loss of abutment teeth was the main reason leading to RPD failure, followed closely by poor fit and adaptation. No factor was shown to be statistically significant at the prosthesis level. Women (Hazard Ratio [HR] = 0.542), endodontic treatment (HR = 3.460), presence of post and core (HR = 0.302), presence of a prosthetic crown (HR = 3.403), and abutment tooth type (in relation to incisor: canine HR = 0.196, premolar HR = 0.449) were the risk factors statistically significantly associated with the loss of abutment teeth. The pre-prosthesis amount of bone support of the teeth did not affect their prognosis as abutments for RPDs.

CONCLUSION: RPD treatment modality presented a high failure rate after a mean follow-up of 4 years. Vital abutment teeth had a better survival rate than the ones treated endodontically (whether restored with or without a post and core); nevertheless, the amount of bone support did not affect their survival.

PMID:35649280 | DOI:10.11607/ijp.7457

Ann Am Thorac Soc. 2022 Jun 1. doi: 10.1513/AnnalsATS.202106-651OC. Online ahead of print.

ABSTRACT

RATIONALE: There has been a paradigm shift to partner with family caregivers by actively involving them in the direct care of the patient throughout the critical illness trajectory. Before effectively engaging family members in patient care, clinicians must assess characteristics and circumstances that may affect caregiver readiness to assume a caregiving role in the ICU.

OBJECTIVE: To determine how demographic, clinical, and psychological factors are related to characteristics of family caregiver readiness to engage in ICU patient care.

METHODS: A convenience sample of ICU family caregivers of both adult and pediatric ICU patients was recruited for this cross-sectional study. Participants completed the following measures: PROMIS-29; Hospital Anxiety and Depression Scale; Caregiver Self-Efficacy Scale; Preparedness for Caregiving Scale; Patient Activation Measure for Caregivers; and Family Caregiver’s Motives for Helping Scale. Data were collected via self-report at a single time point while the caregiver was visiting the critically ill patient in the ICU. Data analysis consisted of descriptive statistics and bivariate correlations.

RESULTS: Caregivers (N=127) were primarily White (82.7%), females (77.2%), with a mean age of 51.8 (SD=15.6). Most were either spouses (37.8%) or parents (32.3%) of the ICU patient. Patients were primarily adult (76.4%) with a mean APACHE III of 45.9 (SD=22.5). There were significant (p<0.05) negative correlations between: depression, anxiety, and fatigue and all subscales of self-efficacy (Resilience r = -.18 to -.30; Self-Maintenance r = -.44 to -.63; Emotional Connectivity r = -.27 to -.41; Instrumental Giving r = -.34 to -.46) Caregiver depression was negatively correlated with caregiver activation (r = -.199) and caregiver preparedness (r = -.300). Social satisfaction was positively correlated (p<.05) with caregiving preparedness, motivation, and all subscales of self-efficacy (Preparedness r = .19; Motivation = .24; Resilience r = .21; Self-Maintenance r = .49; Emotional Connectivity r = .29; Instrumental Giving r = .36).

CONCLUSIONS: We found that caregiver symptoms of depression, anxiety and fatigue are inversely related to caregiver preparation, motivation, and self-efficacy. In order to develop effective interventions for ICU family caregivers, further research is needed to understand the relationship between caregiver well-being, caregiving readiness, and caregiver involvement in patient care.

PMID:35649201 | DOI:10.1513/AnnalsATS.202106-651OC

Child Obes. 2022 Jun 1. doi: 10.1089/chi.2021.0313. Online ahead of print.

ABSTRACT

Background: There are limited evidence-based programs for children living in Queensland, Australia, who are at risk of overweight or obesity. Despite the known importance of prevention initiatives, an online, locally relevant program supporting sustainable health behaviors does not exist. This study aimed to understand the perspectives of parents/guardians and health professionals regarding important aspects of an online childhood obesity prevention program. Methods: This pragmatic, mixed-methods study was conducted from March to December 2020. Recruitment included participants from two groups involved with children aged 2-17 years, health professionals, and parents/guardians. Phase 1 involved dissemination of an online survey. Questions addressed program structure, content delivery (including nutrition, physical activity, and parenting practices), program evaluation, and information dissemination. Descriptive statistics were used to describe survey data to inform the delivery of Phase 2, where two focus groups further explored the topics. Thematic analysis was used to investigate the qualitative data. Results: Twenty-eight health professionals and 11 parents/guardians completed the survey, and 14 health professionals and 6 parents/guardians participated in the focus groups. Participants believed that the most beneficial approach would target younger children with family-based interventions, via a nontraditional structure. There was a strong preference for interactive content, gamification, and practical resources to translate knowledge into practice. Parents emphasized that there should be no assumption of basic knowledge, and that decision fatigue is a barrier to engagement. Conclusion: Participants provided clear direction regarding key aspects for future development of an online prevention program, highlighting the importance of codesign to tailor the program to identified needs.

PMID:35649200 | DOI:10.1089/chi.2021.0313

J Integr Complement Med. 2022 Jun 1. doi: 10.1089/jicm.2022.0476. Online ahead of print.

ABSTRACT

Highlights Home-based hydrotherapy leads to fewer missed kindergarten-days in total. In the application group, more fever days could be registered. Hydrotherapy, according to the hormesis principle by Sebastian Kneipp, aims to reduce infections of the lower respiratory tract. Parents participation motivated by increase in applicable health knowledge for their children. Objectives: This study investigates the effect of cold-water hydrotherapy stimulation according to the hormesis principle by Sebastian Kneipp on the number of missing kindergarten-days, fever days, and respiratory tract infections in children aged 3-6 years. Study design: A nonrandomized, controlled, explorative, mixed-methods clinical study. Intervention: The hydrotherapeutic intervention treated children aged 3-6 years with Kneipp arm affusions over 6 weeks. The control group received no intervention. Number of missed kindergarten-days, fever days, and respiratory tract infections were assessed by means of a digital diary. Through a self-developed structured questionnaire, sociodemographic data of both groups were compared and reason for participation in the study was recorded and qualitatively evaluated. Results: Twenty children participants and their parents in the intervention group and 18 in the control group were evaluated. The intervention was conducted at home by the parents. Statistical analysis revealed no significant differences between the groups but still showed intermediate effect sizes (indicating an underpowered study). These effect sizes point to a potentially lower proportion of children in the application group versus the control group with missed kindergarten-days in total (d = 0.67), days missed due to fever (d = 0.29), and infections of the lower respiratory tract (d = 0.60). In a future study, these parameters will thus serve as promising factors for evaluation. Parent’s stated reasons for participation interest were to improve health, increase their own health knowledge, and because of their interest in alternative therapies and to support research. Conclusions: Cold-water hydrotherapy stimulation, according to the hormesis principle by Sebastian Kneipp, did reduce the number of days absent in kindergarten in total in the intervention group and lower respiratory tract infections occurred less frequently. Parent’ participation interest demonstrated a desire to increase health literacy and implement this with their own children. Due to the small sample size, the results should be interpreted cautiously. Trial registration: German Register of Clinical Trials (DRKS): ID 00017562.

PMID:35649190 | DOI:10.1089/jicm.2022.0476

J Clin Psychiatry. 2022 May 30;83(3):22f14529. doi: 10.4088/JCP.22f14529.

ABSTRACT

Between 0.3%-4.6% of women use antipsychotic (AP) drugs during pregnancy. Two large, retrospective, population-based cohort studies, conducted in Nordic countries and in the US, examined the risk of neurodevelopmental disorders (NDDs) following gestational exposure to APs. The Nordic study found that, in unadjusted analyses, exposure to APs during pregnancy was associated with increased risk of attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) in offspring; that the risk all but disappeared after adjusting for covariates; and that the risk appeared to be related to maternal major mental illness rather than to gestational exposure to APs. The US study also found that, in unadjusted analyses, gestational exposure to APs was associated with an increased risk of almost all of the study-specified NDDs in offspring; however, after adjusting for covariates, the risks were no longer meaningfully increased and, importantly, were no longer statistically significant for ADHD and ASD. Thus, these 2 studies suggest that gestational exposure to APs is a marker of NDD risk in offspring rather than a potential cause. Whereas a small but significantly increased risk was identified for aripiprazole in the US study, the signal was inconsistent across analyses, and confounding due to maternal mental illness was not ruled out. Previous studies have suggested that the use of APs during pregnancy is not associated with an increased risk of major congenital malformations and other adverse gestational outcomes. Considering the potential harm and suffering associated with major mental illness and the very low risks associated with AP use during pregnancy, initiation or continuation of APs appears to carry a favorable risk-benefit ratio in pregnant women who need these drugs; however, decision-making should be shared between patients, their caregivers, and the treating team.

PMID:35649168 | DOI:10.4088/JCP.22f14529

Med Phys. 2022 Jun 1. doi: 10.1002/mp.15714. Online ahead of print.

ABSTRACT

PURPOSE: Anatomical changes occurred during the treatment course of radiation therapy for lung cancer patients may introduce clinically unacceptable dosimetric deviations from the planned dose. Adaptive radiotherapy (ART) can compensate these dosimetric deviations in subsequent treatments via plan adaption. Determining whether and when to trigger plan adaption during the treatment course is essential to the effectiveness and efficiency of ART. In this study, we aimed to develop a prediction model as an auxiliary decision-making tool for lung ART to identify the patients with intrathoracic anatomical changes that would potentially benefit from the plan adaptions during the treatment course.

METHODS: Seventy-one pairs of weekly cone-beam computer tomography (CBCT) and planning CT (pCT) from 17 advanced non-small cell lung cancer patients were enrolled in this study. To assess the dosimetric impacts brought by anatomical changes observed on each CBCT, dose distribution of the original treatment plan on the CBCT anatomy was calculated on a virtual CT generated by deforming the corresponding pCT to the CBCT, and compared to that of the original plan. A replan was deemed needed for the CBCT anatomy once the recalculated dose distribution violated our dosimetric-based trigger criteria. A three-dimensional region of significant anatomical changes (region of interest, ROI) between each CBCT and the corresponding pCT was identified and 16 morphological features of the ROI were extracted. Additionally, eight features from the overlapped volume histograms (OVHs) of patient anatomy were extracted for each patient to characterize the patient specific anatomy. Based on the 24 extracted features and the evaluated replanning needs of the pCT-CBCT pairs, a nonlinear supporting vector machine was used to build a prediction model to identify the anatomical changes on CBCTs that would trigger plan adaptions. The most relevant features were selected using the sequential backward selection (SBS) algorithm and a shuffling-and-splitting validation scheme was used for model evaluation.

RESULTS: Fifty-Five CBCT-pCT pairs were identified of having a ROI, among which 21 CBCT anatomies required plan adaptions. For these 21 positive cases, statistically significant improvements in the sparing of lung, esophagus and spinal cord were achieved by plan adaptions. A high model performance of 0.929 AUC and 0.851 accuracy was achieved with six selected features including five ROI shape features and one OVH feature. Without involving the OVH features in the feature selection process, the mean AUC and accuracy of the model significantly decreased to 0.826 and 0.779, respectively. Further investigation showed that poor prediction performance with AUC of 0.76 was achieved by the univariate model in solving this binary classification task.

CONCLUSION: We built a prediction model based on the features of patient anatomy and the anatomical changes captured by on-treatment CBCT imaging to trigger plan adaption for lung cancer patients. This model effectively associated the anatomical changes with the dosimetric impacts for lung ART. This model can be a promising tool to assist the clinicians in making decisions for plan adaptions during the treatment courses. This article is protected by copyright. All rights reserved.

PMID:35649103 | DOI:10.1002/mp.15714

J Food Drug Anal. 2021 Dec 15;29(4):717-725. doi: 10.38212/2224-6614.3383.

ABSTRACT

The Rare Disease and Orphan Drug Act (the Act) was enacted in 2000 in Taiwan for the facilitation of the research, development, and accessibility of orphan drugs and special nutritional foods; for the prevention and early diagnosis of rare diseases; and for providing intensive care for patients with rare diseases. The aim was to investigate the impact of the Act on the availability and use of orphan drugs in Taiwan in the hope of identifying the remaining challenges and possible solutions to assist future policy making, which may be applicable in other countries as well. The information and statistics for rare diseases and orphan drugs retrieved from the official annual reports and documents were analyzed. There were 225 diseases recognized as rare diseases, and one-third (75/225) of them were congenital metabolic disorders. Among the 110 designated orphan drugs that could apply for listing in the National Health Insurance (NHI) Pharmaceutical Benefits and Reimbursement Scheme, approximately half (62/110) of them were granted marketing authorization. While the NHI program compulsory for all citizens increased patient accessibility to orphan drugs, the rapidly increasing economic burden became an urgent issue for the government. Emerging gene therapies may be the solution to unmet medical needs and also a financial obstacle to tackle. The Act increased the availability of orphan drugs while the NHI system facilitated patient access, which benefited many patients with rare diseases in Taiwan. However, the soaring economic burden was noticed and was anticipated to aggravate. More communication and cooperation between stakeholders is critical in finding solutions for the long-term sustainability of the NHI system.

PMID:35649145 | DOI:10.38212/2224-6614.3383

Rev Lat Am Enfermagem. 2022;30:e3595. doi: 10.1590/1518-8345.5798.3595.

ABSTRACT

OBJECTIVE: to analyze the effect of an app on Nursing students’ knowledge about diabetes during the COVID-19 pandemic, as well as their self-assessment and satisfaction level.

METHOD: a quasi-experimental study carried out with 40 Nursing students from the Brazilian Northeast region. The E-MunDiabetes® app was used to assess the participants’ knowledge at the pre-test, immediate post-test and after 15 days, as well as their self-assessment and satisfaction level in relation to using the app. The analysis was performed by means of descriptive and inferential statistics (binomial test, Intraclass Correlation Coefficient and Wilcoxon’s test).

RESULTS: the comparison of the medians of correct answers in the three periods revealed a significant increase in the post-test. The self-assessment and satisfaction items presented an Agreement Index > 80%, with a total Agreement Index of 96.3% and an Intraclass Correlation Coefficient of 0.91.

CONCLUSION: the app was considered satisfactory and promoted a significant increase in the students’ knowledge, therefore being suitable for its intended use.

PMID:35649093 | DOI:10.1590/1518-8345.5798.3595