Categories
Nevin Manimala Statistics

White matter alterations in pediatric brainstem glioma: An national brain tumor registry of China study

Front Neurosci. 2022 Sep 9;16:986873. doi: 10.3389/fnins.2022.986873. eCollection 2022.

ABSTRACT

BACKGROUND: Previous studies have identified alterations in structural connectivity of patients with glioma. However, white matter (WM) integrity measured by diffusion kurtosis imaging (DKI) in pediatric patients with brainstem glioma (BSG) was lack of study. Here, the alterations in WM of patients with BSG were assessed through DKI analyses.

MATERIALS AND METHODS: This study involved 100 patients with BSG from the National Brain Tumor Registry of China (NBTRC) and 50 age- and sex-matched healthy controls from social recruitment. WM tracts were segmented and reconstructed using U-Net and probabilistic bundle-specific tracking. Next, automatic fiber quantitative (AFQ) analyses of WM tracts were performed using tractometry module embedded in TractSeg.

RESULTS: WM quantitative analysis identified alterations in DKI-derived values in patients with BSG compared with healthy controls. WM abnormalities were detected in the projection fibers involved in the brainstem, including corticospinal tract (CST), superior cerebellar peduncle (SCP), middle cerebellar peduncle (MCP) and inferior cerebellar peduncle (ICP). Significant WM alterations were also identified in commissural fibers and association fibers, which were away from tumor location. Statistical analyses indicated the severity of WM abnormality was statistically correlated with the preoperative Karnofsky Performance Scale (KPS) and symptom duration of patients respectively.

CONCLUSION: The results of this study indicated the widely distributed WM alterations in patients with BSG. DKI-derived quantitative assessment may provide additional information and insight into comprehensively understanding the neuropathological mechanisms of brainstem glioma.

PMID:36161172 | PMC:PMC9500240 | DOI:10.3389/fnins.2022.986873

Categories
Nevin Manimala Statistics

Older Adults’ Biobehavioral Fall Risks Were Affected by the COVID-19 Pandemic: Lessons Learned for Future Fall Prevention Research to Incorporate Multilevel Perspectives

Innov Aging. 2022 Jun 11;6(6):igac033. doi: 10.1093/geroni/igac033. eCollection 2022.

ABSTRACT

BACKGROUND AND OBJECTIVES: Examining the impact of coronavirus disease 2019 (COVID-19) pandemic on fall risks may provide insight into how multilevel factors as described in National Institute of Nursing Research’s (NINR’s) draft strategic plan can guide future fall prevention research. This article describes the affect of COVID-19 on fall risks from the perspective of older adults who live in assisted living facilities (ALFs), and explores the needs and approaches to implement fall prevention interventions at individual, social, community, and policy levels.

RESEARCH DESIGN AND METHODS: Exploratory survey study. Participants from a fall prevention study at 2 ALFs in Oregon were invited to the study. Survey questions asked about COVID experience, and changes in fall risks and day-to-day activities in Spring 2020. Quantitative responses were analyzed using descriptive statistics and Cohen’s d effect sizes. Qualitative responses were analyzed using conventional content analysis.

RESULTS: Thirteen participants (age: M = 87.08, standard deviation = 6.52) responded. More participants reported feeling unsteady compared to pre-COVID data (38% vs. 62%), while the proportion of those worried about falling remained the same at 38%. Participants reported negligible decreases in importance of fall prevention and small decreases in confidence of fall prevention (Cohen’s d = -0.13 and -0.21, respectively). The themes related to the affect of COVID on fall risks were: not to worry about fall risks but be cautious and physical activity is important, but it’s hard during COVID. Impact of COVID on day-to-day activities were: varying degrees of concern for COVID, lack of social and community support, and finding unique ways to cope with COVID.

DISCUSSION AND IMPLICATIONS: These individual-level perspectives suggest that older adults were at increased risk for falling. Results exemplify the influence of broader-level factors (e.g., social, community, and policy) on individual biobehavioral factors (e.g., fall risks and health behaviors), and illustrate the value of examining multilevel factors in future fall prevention research.

PMID:36161144 | PMC:PMC9495495 | DOI:10.1093/geroni/igac033

Categories
Nevin Manimala Statistics

Adherence to secondary prevention measures after acute coronary syndrome in patients associated exclusively with the public and private healthcare systems in Brazil

Prev Med Rep. 2022 Sep 3;29:101973. doi: 10.1016/j.pmedr.2022.101973. eCollection 2022 Oct.

ABSTRACT

Adherence to secondary prevention measures after acute coronary syndrome (ACS) is essential to prevent disease recurrence. In Brazil, the Brazilian Unified Health System (SUS, in Portuguese), and the private healthcare system (PHCS) coexist. We aimed to evaluate the adherence to secondary prevention in patients with ACS who were assisted by either SUS or PHCS. In this longitudinal prospective study, patients with ACS were admitted to the four cardiological reference hospitals of Sergipe, three of which assisted PHCS users, and one, SUS users. We analyzed the two patient care models with multiple logistic regression models for adherence to physical activity, pharmacotherapy, and smoking cessation. We enrolled 581 volunteers in this study: 44.1 % from SUS and 55.9 % from PHCS. PHCS users showed greater adherence to pharmacotherapy at both 30 and 180 (p = 0.001) days after ACS with better results in all classes of medications (p < 0.05) than SUS users did. They also showed better adherence to physical activity (p = 0.047). There was no distinction between the groups regarding smoking cessation. The secondary prevention measures after ACS were more effective in PHCS users than in SUS users due to better adherence, especially to pharmacotherapy and regular physical activity.

PMID:36161134 | PMC:PMC9502285 | DOI:10.1016/j.pmedr.2022.101973

Categories
Nevin Manimala Statistics

Change in physical activity, food choices and hemoglobin A1c among American Indians and Alaska Natives with type 2 diabetes

Prev Med Rep. 2022 Aug 8;29:101945. doi: 10.1016/j.pmedr.2022.101945. eCollection 2022 Oct.

ABSTRACT

The prevalence of diabetes among American Indian and Alaska Native (AI/AN) adults is the highest of all United States racial/ethnic groups. Health behaviors, including regular physical activity and healthy food choices, are important components in the management of diabetes. We estimated the cross-sectional association between physical activity and healthy food scores, separately, and combined (PAHF) with hemoglobin A1c (HbA1c) over three years of the Special Diabetes Program for Indians-Healthy Heart demonstration project (SDPI-HH) intervention. The relationship between physical activity and food choices was also examined. Among 3,039 SDPI-HH participants at baseline, those reporting being physically active and having high healthy food scores had statistically significant lower HbA1c (mean = 7.67 ± 2.01) compared to inactive participants with low healthy food scores (7.90 ± 1.92). Among the 1,150 SDPI-HH participants who attended the three-year follow-up visit, participants who increased physical activity, consumption of healthy foods, or both had a larger decrease in HbA1c (β = -0.29, P = 0.03) over the study period compared to participants with no improvement in physical activity or increase in consuming healthy foods. This association was statistically significant among women (β = -0.35, P = 0.04) but not among men (β = -0.08, P = 0.70). Our findings indicated that an increase in healthier behaviors, including physical activity and healthy food choices, was associated with a small improvement in HbA1c in the subset of women who participated in the SDPI-HH through the three-year follow up. Although the decrease in HbA1c was small, physical activity and healthy food choices are important behaviors to incorporate into everyday life among AI/AN adults, particularly those with diabetes.

PMID:36161132 | PMC:PMC9502664 | DOI:10.1016/j.pmedr.2022.101945

Categories
Nevin Manimala Statistics

Barriers to human papillomavirus (HPV) vaccination among young adults, aged 18-35

Prev Med Rep. 2022 Aug 8;29:101942. doi: 10.1016/j.pmedr.2022.101942. eCollection 2022 Oct.

ABSTRACT

In the United States (US), an estimated 35,900 human papillomavirus (HPV)-related cancers are diagnosed annually. HPV vaccines are projected to eliminate ∼90% of these cancers. Routine vaccination is recommended at age 11-12 with “catch-up” vaccination through age 26 and shared clinical decision making for ages 27-45. However, vaccine uptake has been slow with many young adults remaining unvaccinated. This study examined barriers to HPV vaccination among individuals aged 18-35 years and assessed likelihood of future HPV vaccination. Age-eligible participants (n = 499) recruited through Facebook advertisements, Facebook posts, and clinics (6/2019-3/2020) completed an online survey. Descriptive statistics and bivariate analysis examined HPV vaccine barriers and intent. Logistic regression models examined predictors of HPV vaccine intent. Most (57.1%) reported they were not at all likely to get vaccinated for HPV in the future. Lower intent was associated with belief that the vaccine is not necessary (aOR: 0.134, 95% CI: 0.073, 0.246) and not safe (aOR: 0.312, 95% CI: 0.126, 0.773). Intent was positively associated with the belief that health insurance would not cover vaccination (aOR: 2.226, 95% CI: 1.070, 4.631). Provider recommendation was not significantly associated with vaccine intention. This study highlights challenges to HPV vaccine uptake for young adults. Though several successful interventions exist, most target adolescents and their parents or providers. Future steps should use this evidence to inform development of targeted interventions to increase HPV vaccine intention and uptake in adults, ultimately reducing the burden of HPV-related cancers.

PMID:36161130 | PMC:PMC9502683 | DOI:10.1016/j.pmedr.2022.101942

Categories
Nevin Manimala Statistics

HPV vaccination coverage for pediatric, adolescent and young adult patients receiving care in a childhood cancer survivor program

Prev Med Rep. 2022 Sep 7;29:101972. doi: 10.1016/j.pmedr.2022.101972. eCollection 2022 Oct.

ABSTRACT

Pediatric, adolescent and young adult patients undergoing cancer treatment and/or hematopoietic stem cell transplant are at increased risk for developing a secondary human papillomavirus (HPV)-associated malignancy. The objective of this study was to determine HPV vaccination coverage among individuals participating in a childhood cancer survivor program (CCSP). A retrospective cohort study was conducted among CCSP patients age 11-26 years attending a CCSP visit between 2014 and 2019. Survivors were age-, sex-, and race-matched 1:2 with controls without cancer. Data were abstracted from the electronic health record and state-based vaccination registry. Analysis was limited to Minnesota residents to minimize missing vaccination data. Survivorship care plans (SCPs) were reviewed for vaccine recommendations. 592 patients were included in the analyses (200 CCSP patients; 392 controls). By study design, mean age (18.4 years), race (72 % white), and sex (49 % female) were similar in the two groups. Among CCSP patients 22 % resided in a rural area compared to 3.8 % of controls. Vaccination coverage among CCSP patients was not statistically significantly different from controls [60.0 % vs 66.3 %, OR = 0.82, 95 % CI: (0.55, 1.23), p = 0.35]. Completion of 3 doses was not different between groups even though 3 doses is recommended for all CCSP patients regardless of age at initiation (28.5 % vs 30.1 %, p = 0.09). Only 8.0 % of SCPs recommended HPV vaccination. Although patients participating in a CCSP did not have significantly different HPV vaccination coverage compared to controls, HPV vaccination initiation and 3-dose series completion are still suboptimal in a patient population at high-risk of a secondary HPV-associated cancer.

PMID:36161114 | PMC:PMC9502284 | DOI:10.1016/j.pmedr.2022.101972

Categories
Nevin Manimala Statistics

Exploring differences in adolescent BMI and obesity-related behaviors by urban, suburban, and rural status

Prev Med Rep. 2022 Aug 30;29:101960. doi: 10.1016/j.pmedr.2022.101960. eCollection 2022 Oct.

ABSTRACT

Data from the nationally representative 2014 Family Life, Activity, Sun, Health, and Eating (FLASHE) study was examined to identify differences in adolescent Body Mass Index (BMI) and obesity-related behaviors by rurality status (i.e., urban, suburban, rural) while accounting for relevant demographics (i.e., sex, race/ethnicity, household income). This secondary, cross-sectional analysis included 1,353 adolescents. Analyses included descriptive statistics, one-way analysis of variance, Chi-squared tests, and multiple linear regression models (reported significance level p < 0.05). Rurality was not associated with BMI when controlling for demographics. However, relative to rural adolescents, suburban adolescents had significantly higher junk food, sugar-sweetened beverages (SSB), sugary food (all β=+0.2, p ≤ 0.001), and fruit/vegetable intake (β=+0.1, p ≤ 0.05). Compared to Non-Hispanic White adolescents, Non-Hispanic Black adolescents had significantly higher BMI (β=+4.4, p ≤ 0.05), total sedentary time (β=+4.1, p ≤ 0.001), junk food, SSB, and sugary food intake (all β=+0.2, p ≤ 0.05). Relative to their lower-income household counterparts, adolescents from higher-income households had significantly lower BMI (β = -9.7, p ≤ 0.001), junk food (β = -0.2, p ≤ 0.05), and SSB intake (β = -0.5, p ≤ 0.001). Contrary to literature, rurality was not a significant predictor of adolescent BMI. While suburban status was significantly associated with several diet-related risk factors, it was not in the direction anticipated. Being non-Hispanic Black and from a low-income household had the greatest influence on adolescent BMI. Findings highlight the importance of using a three-category classification for rurality.

PMID:36161111 | PMC:PMC9502040 | DOI:10.1016/j.pmedr.2022.101960

Categories
Nevin Manimala Statistics

Improving health across sectors: Best practices for the implementation of health in all policies approaches

Prev Med Rep. 2022 Aug 31;29:101961. doi: 10.1016/j.pmedr.2022.101961. eCollection 2022 Oct.

ABSTRACT

Health is influenced by a broad range of factors beyond the typical remit of public health. It is therefore increasingly recognized that multiple sectors need to be engaged to improve population health. Health in All Policies (HiAP) is an approach to systematically consider health across policies and programs. This study assessed best practices and gaps in HiAP operationalization to inform practitioners aiming to incorporate HiAP in their work. We used Delaware as a model state to examine operationalization factors in a jurisdiction planning to implement HiAP. Methods included document review, key informant interviews, focus groups, and a questionnaire conducted in Delaware and virtually. Thematic analysis was used to analyze qualitative data to provide information on best practices and gaps in existing HiAP programs and context in Delaware. Descriptive statistics were used to examine collaboration in Delaware and to support or refute qualitative findings. We identified two gaps that can hinder HiAP implementation: 1) HiAP practitioners do not adequately use strategic communications to increase buy-in across sectors; 2) practitioners do not fully recognize the importance of being adaptable throughout HiAP implementation, which hinders sustainability. Qualitative findings from Delaware offer insight to these gaps and opportunities to address them. Refining the essential elements of HiAP to add: 1) strategic communications across sectors and 2) flexibility throughout HiAP implementation may point the way to more successful adoption of HiAP approaches across jurisdictions. This research demonstrated the importance of examining local perspectives on HiAP before implementation based on a jurisdiction’s context.

PMID:36161110 | PMC:PMC9501991 | DOI:10.1016/j.pmedr.2022.101961

Categories
Nevin Manimala Statistics

Social media and use of electronic nicotine delivery systems among school-going adolescents in a rural distressed Appalachian community

Prev Med Rep. 2022 Aug 19;29:101953. doi: 10.1016/j.pmedr.2022.101953. eCollection 2022 Oct.

ABSTRACT

Electronic nicotine delivery systems (ENDS) are the most used tobacco products among middle and high schoolers in the United States (U.S.). Familial relations and access play a major role in uptake among adolescents; yet the role of social media in this phenomenon in the context of communities impacted by tobacco-related health disparities is understudied. In Spring 2019, data were collected from adolescents in 8th and 9th grades in a school located in a rural distressed county in Tennessee to assess social media’s role in ENDS uptake. Descriptive and multivariable statistical analyses were performed to delineate factors associated with ENDS use. Of a total of 399 respondents, 12.5 % reported current ENDS use and 22.1 % indicated having ever discussed ENDS on social media. Closed messaging platforms (Snapchat) and video platforms (Facebook/Instagram/You Tube) were the most reported form of social media used (8.31 % and 8.31 % respectively). Social media use was positively associated with both ever ENDS use (odds ratio [OR] = 2.9) and current ENDS use (OR = 3.98). Parental advice against ENDS use was positively associated with ever ENDS use. In conclusion, social media use was positively associated with both ever and current ENDS use, and Snapchat was the most popular platform among this population of students. The results indicate that youth social media engagement may lead to exposure that can influence ENDS uptake. Future studies are needed to further examine these associations among distressed communities.

PMID:36161107 | PMC:PMC9501989 | DOI:10.1016/j.pmedr.2022.101953

Categories
Nevin Manimala Statistics

Rapid and chronological expression of angiogenetic genes is a major mechanism involved in cell sheet transplantation in a rat gastric ulcer model

Regen Ther. 2022 Sep 11;21:372-379. doi: 10.1016/j.reth.2022.08.008. eCollection 2022 Dec.

ABSTRACT

INTRODUCTION: Cell sheet technology has been applied in the treatment of patients with severe cardiac failure. Although the paracrine effect of cell sheets accelerating angiogenesis is thought to be the intrinsic mechanism for improvement of cardiac function, little is known about how a cell sheet would function in the abdomen.

METHODS: We used acetic acid-induced gastric ulcer rat model to elucidate the mechanisms of myoblast sheet transplantation in the abdomen. Myoblast sheet was implanted onto the serosal side of the gastric ulcer and the effect of sheet transplantation was analyzed. The maximal diameter of the ulcer and the changes in the gene expression of various growth factors in transplanted site was analyzed. The progenitor marker CD34 was also examined by immunohistochemistry.

RESULTS: Cell sheet transplantation accelerated the ulcer healing. qPCR showed that angiogenic growth factors were significantly upregulated around the ulcer in the transplantation group. In addition, at first, HIF-1a and SDF-1 continued to increase from 3 h after transplantation to 72 h, then VEGF increased significantly after 24 h with a slight delay. An immunohistochemical analysis showed a statistically significant increase in CD34 positivity in the tissue around the ulcer in the transplantation group.

CONCLUSION: Myoblast sheet secreted various growth factors and cytokines immediately after transplantation onto the serosal side of artificial ulcer in the abdomen. Autonomous secretion, resulting in the time-dependent and well-orchestrated gene expression of various growth factors, plays a crucial role in the cell sheet function. Cell sheet transplantation is expected to be useful to support angiogenesis of the ischemic area in the abdominal cavity.

PMID:36161102 | PMC:PMC9474311 | DOI:10.1016/j.reth.2022.08.008