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Patel A, Rosenke K, Parzych EM, Feldmann F, Bharti S, Griffin AJ, Schouest B, Lewis M, Choi J, Chokkalingam N, Machado V, Smith BJ, Frase D, Ali AR, Lovaglio J, Nguyen B, Hanley PW, Walker SN, Gary EN, Kulkarni A, Generotti A, Francica JR, Rosenthal K, Kulp DW, Esser MT, Smith TRF, Shaia C, Weiner DB, Feldmann H. In vivo delivery of engineered synthetic DNA-encoded SARS-CoV-2 monoclonal antibodies for pre-exposure prophylaxis in non-human primates. Emerg Microbes Infect 2024; 13:2294860. [PMID: 38165394 PMCID: PMC10903752 DOI: 10.1080/22221751.2023.2294860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 12/11/2023] [Indexed: 01/03/2024]
Abstract
COVID-19 remains a major public health concern. Monoclonal antibodies have received emergency use authorization (EUA) for pre-exposure prophylaxis against COVID-19 among high-risk groups for treatment of mild to moderate COVID-19. In addition to recombinant biologics, engineered synthetic DNA-encoded antibodies (DMAb) are an important strategy for direct in vivo delivery of protective mAb. A DMAb cocktail was synthetically engineered to encode the immunoglobulin heavy and light chains of two different two different Fc-engineered anti-SARS-CoV-2 antibodies. The DMAbs were designed to enhance in vivo expression and delivered intramuscularly to cynomolgus and rhesus macaques with a modified in vivo delivery regimen. Serum levels were detected in macaques, along with specific binding to SARS-CoV-2 spike receptor binding domain protein and neutralization of multiple SARS-CoV-2 variants of concern in pseudovirus and authentic live virus assays. Prophylactic administration was protective in rhesus macaques against signs of SARS-CoV-2 (USA-WA1/2020) associated disease in the lungs. Overall, the data support further study of DNA-encoded antibodies as an additional delivery mode for prevention of COVID-19 severe disease. These data have implications for human translation of gene-encoded mAbs for emerging infectious diseases and low dose mAb delivery against COVID-19.
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Affiliation(s)
- Ami Patel
- Vaccine and Immunotherapy Center, The Wistar Institute of Anatomy and Biology, Philadelphia, PA, USA
| | - Kyle Rosenke
- Rocky Mountain Laboratories, National Institutes of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT, USA
| | - Elizabeth M. Parzych
- Vaccine and Immunotherapy Center, The Wistar Institute of Anatomy and Biology, Philadelphia, PA, USA
| | - Friederike Feldmann
- Rocky Mountain Laboratories, National Institutes of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT, USA
| | - Suman Bharti
- Vaccine and Immunotherapy Center, The Wistar Institute of Anatomy and Biology, Philadelphia, PA, USA
| | - Amanda J. Griffin
- Rocky Mountain Laboratories, National Institutes of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT, USA
| | | | - Matt Lewis
- Rocky Mountain Laboratories, National Institutes of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT, USA
| | - Jihae Choi
- Vaccine and Immunotherapy Center, The Wistar Institute of Anatomy and Biology, Philadelphia, PA, USA
| | - Neethu Chokkalingam
- Vaccine and Immunotherapy Center, The Wistar Institute of Anatomy and Biology, Philadelphia, PA, USA
| | | | - Brian J. Smith
- Rocky Mountain Laboratories, National Institutes of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT, USA
| | - Drew Frase
- Vaccine and Immunotherapy Center, The Wistar Institute of Anatomy and Biology, Philadelphia, PA, USA
| | - Ali R. Ali
- Vaccine and Immunotherapy Center, The Wistar Institute of Anatomy and Biology, Philadelphia, PA, USA
| | - Jamie Lovaglio
- Rocky Mountain Laboratories, National Institutes of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT, USA
| | - Brian Nguyen
- Inovio Pharmaceuticals, Plymouth Meeting, PA, USA
| | - Patrick W. Hanley
- Rocky Mountain Laboratories, National Institutes of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT, USA
| | - Susanne N. Walker
- Vaccine and Immunotherapy Center, The Wistar Institute of Anatomy and Biology, Philadelphia, PA, USA
| | - Ebony N. Gary
- Vaccine and Immunotherapy Center, The Wistar Institute of Anatomy and Biology, Philadelphia, PA, USA
| | - Abhijeet Kulkarni
- Vaccine and Immunotherapy Center, The Wistar Institute of Anatomy and Biology, Philadelphia, PA, USA
| | | | - Joseph R. Francica
- Vaccines & Immune Therapies, BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, MD, USA
| | - Kim Rosenthal
- Vaccines & Immune Therapies, BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, MD, USA
| | - Daniel W. Kulp
- Vaccine and Immunotherapy Center, The Wistar Institute of Anatomy and Biology, Philadelphia, PA, USA
| | - Mark T. Esser
- Vaccines & Immune Therapies, BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, MD, USA
| | | | - Carl Shaia
- Rocky Mountain Laboratories, National Institutes of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT, USA
| | - David B. Weiner
- Vaccine and Immunotherapy Center, The Wistar Institute of Anatomy and Biology, Philadelphia, PA, USA
| | - Heinz Feldmann
- Rocky Mountain Laboratories, National Institutes of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT, USA
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Xiong Y, Luan Y, Yuan L, Hong W, Wang B, Zhao H, Zhang B. Aerobic exercise attenuates high-fat diet-induced renal injury through kidney metabolite modulation in mice. Ren Fail 2024; 46:2286330. [PMID: 38390733 PMCID: PMC10896126 DOI: 10.1080/0886022x.2023.2286330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 11/16/2023] [Indexed: 02/24/2024] Open
Abstract
PURPOSE To investigate the preventive effect of aerobic exercise on renal damage caused by obesity. METHODS The mice in the Control (Con) and Control + Exercise (Con + Ex) groups received a standard chow diet for the 21-week duration of the study, while the High-fat diet (HFD) group and High-fat diet + Exercise (HFD + Ex) group were fed an HFD. Mice were acclimated to the laboratory for 1 week, given 12 weeks of being on their respective diets, and then the Con + Ex and HFD + Ex groups were subjected to moderate intensity aerobic treadmill running 45 min/day, 5 days/week for 8 weeks. RESULTS We found that HFD-induced obesity mainly impacts kidney glycerin phospholipids, glycerides, and fatty acyls, and aerobic exercise mainly impacts kidney glycerides, amino acids and organic acids as well as their derivatives. We identified 18 metabolites with significantly altered levels that appear to be involved in aerobic exercise mediated prevention of HFD-induced obesity and renal damage, half of which were amino acids and organic acids and their derivatives. CONCLUSION Aerobic exercise rewires kidney metabolites to reduce high-fat diet-induced obesity and renal injury.
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Affiliation(s)
- Yingzhe Xiong
- School of Physical Education and Sports, Central China Normal University, Wuhan, China
- Division of Sports Science and Physical Education, Tsinghua University, Beijing, China
| | - Yisheng Luan
- Division of Sports Science and Physical Education, Tsinghua University, Beijing, China
| | - Lingfeng Yuan
- Division of Sports Science and Physical Education, Tsinghua University, Beijing, China
| | - Weihao Hong
- Division of Sports Science and Physical Education, Tsinghua University, Beijing, China
| | - Bin Wang
- School of Physical Education and Sports, Central China Normal University, Wuhan, China
| | - Hua Zhao
- School of Physical Education and Sports, Central China Normal University, Wuhan, China
| | - Bing Zhang
- Division of Sports Science and Physical Education, Tsinghua University, Beijing, China
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Kuptarak A, Phupong V. Oral dydrogesterone for prevention of miscarriage in threatened miscarriage: a randomized, double-blind, placebo-controlled trial. J Matern Fetal Neonatal Med 2024; 37:2333929. [PMID: 38570191 DOI: 10.1080/14767058.2024.2333929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2024]
Abstract
OBJECTIVE To determine the effectiveness of oral dydrogesterone in preventing miscarriage in threatened miscarriage. METHODS A randomized, controlled trial study was conducted among pregnant Thai women at the gestational age of six to less than 20 weeks who visited King Chulalongkorn Memorial Hospital, Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand with threatened miscarriage from August 2021 to August 2022. These pregnant women were randomized to receive oral dydrogesterone 20 mg per day or placebo twice a day until one week after vaginal bleeding stopped or otherwise for a maximum of six weeks. RESULTS A total of 100 pregnancies were recruited. Fifty of them were assigned to receive oral dydrogesterone and 50 were assigned to receive placebo. The rate of continuing pregnancy beyond 20 weeks of gestational age was 90.0% (45 out of 50 women) in the dydrogesterone group and 86.0% (43 out of 50 women) in the placebo group (p = 0.538). The incidence of adverse events did not differ significantly between the groups. CONCLUSION Oral dydrogesterone 20 mg/day could not prevent miscarriages in women with threatened miscarriage.
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Affiliation(s)
- Arissara Kuptarak
- Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Pathumwan, Bangkok, Thailand
| | - Vorapong Phupong
- Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Pathumwan, Bangkok, Thailand
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Chansaeng S, Boonchieng W, Naksen W. Secondhand smoke prevention through the perceptions of pregnant women with smoking family members: a Thailand study. Int J Qual Stud Health Well-being 2024; 19:2326109. [PMID: 38498815 PMCID: PMC10949832 DOI: 10.1080/17482631.2024.2326109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 02/28/2024] [Indexed: 03/20/2024] Open
Abstract
PURPOSE Pregnant women with smoking family members are at risk of exposure to second-hand smoke, which leads to adverse pregnancy outcomes. Second-hand smoke prevention is thus important but remains less understood based on pregnant women's perceptions. This study aimed to describe the perceptions of pregnant women on second-hand smoke prevention. METHODS This study employed a qualitative descriptive approach. Data collection was performed between July and August 2023 through in-depth interviews with 17 pregnant women purposively selected from a province in central Thailand. The verbatim transcribed data were analysed using thematic analysis. RESULTS Five themes emerged: unclear understanding of second-hand smoke; influences shaping perceptions related to second-hand smoke; attempt to prevent second-hand smoke exposure; barriers to prevention of second-hand smoke exposure; and needs related to prevention of second-hand smoke exposure. CONCLUSION The findings provide insights into second-hand smoke prevention from the perception of pregnant women with smoking family members. Healthcare professionals need to design interventions tailored to pregnant women's needs and involve smoking family members. It is necessary to develop and incorporate clinical guidelines into standard prenatal care to support healthcare personnel in identifying, assessing, educating, and mitigating the issue of second-hand smoking exposure.
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Affiliation(s)
- Sunisa Chansaeng
- Faculty of Public Health, Chiang Mai University, Chiang Mai, Thailand
| | | | - Warangkana Naksen
- Faculty of Public Health, Chiang Mai University, Chiang Mai, Thailand
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Yang X, Zhu L, Pan H, Yang Y. Cardiopulmonary bypass associated acute kidney injury: better understanding and better prevention. Ren Fail 2024; 46:2331062. [PMID: 38515271 PMCID: PMC10962309 DOI: 10.1080/0886022x.2024.2331062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 03/11/2024] [Indexed: 03/23/2024] Open
Abstract
Cardiopulmonary bypass (CPB) is a common technique in cardiac surgery but is associated with acute kidney injury (AKI), which carries considerable morbidity and mortality. In this review, we explore the range and definition of CPB-associated AKI and discuss the possible impact of different disease recognition methods on research outcomes. Furthermore, we introduce the specialized equipment and procedural intricacies associated with CPB surgeries. Based on recent research, we discuss the potential pathogenesis of AKI that may result from CPB, including compromised perfusion and oxygenation, inflammatory activation, oxidative stress, coagulopathy, hemolysis, and endothelial damage. Finally, we explore current interventions aimed at preventing and attenuating renal impairment related to CPB, and presenting these measures from three perspectives: (1) avoiding CPB to eliminate the fundamental impact on renal function; (2) optimizing CPB by adjusting equipment parameters, optimizing surgical procedures, or using improved materials to mitigate kidney damage; (3) employing pharmacological or interventional measures targeting pathogenic factors.
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Affiliation(s)
- Xutao Yang
- The Fourth Affiliated Hospital of School of Medicine, and International School of Medicine, International Institutes of Medicine, Zhejiang University, Yiwu, China
| | - Li Zhu
- The Fourth Affiliated Hospital of School of Medicine, and International School of Medicine, International Institutes of Medicine, Zhejiang University, Yiwu, China
- The Jinhua Affiliated Hospital of Zhejiang University School of Medicine, Yiwu, China
| | - Hong Pan
- The Fourth Affiliated Hospital of School of Medicine, and International School of Medicine, International Institutes of Medicine, Zhejiang University, Yiwu, China
| | - Yi Yang
- The Fourth Affiliated Hospital of School of Medicine, and International School of Medicine, International Institutes of Medicine, Zhejiang University, Yiwu, China
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Udoh K, Wessel C, Branch R, Mahler J, Holland J, Coleman B, Alluri S, Jordan S, Ahmed A, Polzin B, Dye C, Smith K, Brown A, Gully Z, Sawning S, Ziegler C, Ruther M, Jones C, Miller K. Evaluating the Feasibility of a Novel Firearm Injury Prevention Program for Pre-adolescent Children Through Health Care and Community-Based Partnerships: The Future Healers Program Pilot Study. Am Surg 2024; 90:1050-1058. [PMID: 38093402 DOI: 10.1177/00031348231220595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2023]
Abstract
BACKGROUND Firearm violence is an American public health crisis that negatively impacts children and disproportionately affects Black youth. Few firearm injury prevention programs have been described in pre-adolescent children. The Future Healers Program is a novel collaboration constructed via partnership between the medical school, trauma center, academic surgery department, and local non-profit community organization. Our study sought to evaluate if (1) partnering with community organizations facilitated recruitment of children with prior exposure to firearm violence and (2) the health care community was a potential trusted partner appropriate for program delivery. METHODS Children aged 4-13 were recruited to join the program via news outlets and social media and in partnership with a local non-profit organization. Of the children and parents participating in the program, 48% (44/92) and 59% (38/64), respectively, completed an IRB-approved survey study. Pearson's chi-square, percentages, and 95% confidence intervals evaluated differences between children and caregivers on sociodemographic characteristics, firearm exposure (FE), firearm violence exposure (FVE), and perception of health care. Participant's residence was geocoded in relationship to incidents of firearm injury (2008-2021) in the same region. RESULTS Caregivers (95%) and children (84%) reported substantial exposure to firearm violence and resided in areas with frequent firearm injury incidents. Notably, 82% of caregivers and 66% of children reported having a family member injured by gunfire. A high percentage of caregivers (79%) and children (91%) self-reported trust in the health care system. CONCLUSION Partnerships between community organizations and health care systems can develop prevention programs that effectively recruit and engage pre-adolescent children impacted by firearm violence.
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Affiliation(s)
- Karen Udoh
- University of Louisville School of Medicine, Louisville, KY, USA
| | - Caitlin Wessel
- University of Louisville School of Medicine, Louisville, KY, USA
| | - Rheyana Branch
- University of Louisville School of Medicine, Louisville, KY, USA
| | - Jessica Mahler
- University of Louisville School of Medicine, Louisville, KY, USA
| | - Joseph Holland
- University of Louisville School of Medicine, Louisville, KY, USA
| | - Briana Coleman
- University of Louisville School of Medicine, Louisville, KY, USA
| | - Satya Alluri
- University of Louisville School of Medicine, Louisville, KY, USA
| | - Symone Jordan
- University of Louisville School of Medicine, Louisville, KY, USA
| | - Anam Ahmed
- University of Louisville School of Medicine, Louisville, KY, USA
| | - Baylee Polzin
- University of Louisville School of Medicine, Louisville, KY, USA
| | - Crystal Dye
- University of Louisville School of Medicine, Louisville, KY, USA
| | - Kiara Smith
- University of Louisville School of Medicine, Louisville, KY, USA
| | - Alyssa Brown
- Department of Surgery, Northwestern University, Chicago, IL, USA
| | - Zahara Gully
- Jefferson Community and Technical College, Louisville, KY, USA
| | - Susan Sawning
- University of Louisville School of Medicine, Louisville, KY, USA
| | - Craig Ziegler
- University of Louisville School of Medicine, Louisville, KY, USA
| | - Matthew Ruther
- University of Louisville School of Urban and Public Affairs, Louisville, KY, USA
| | - Christopher Jones
- University of Louisville School of Medicine, Louisville, KY, USA
- Department of Surgery, Division of Transplant, University of Louisville School of Medicine, Louisville, KY, USA
| | - Keith Miller
- University of Louisville School of Medicine, Louisville, KY, USA
- Department of Surgery, Division of Trauma and Surgery Critical Care, University of Louisville School of Medicine, Louisville, KY, USA
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Labhardt D, Brown S, Holdsworth E, McKillop N, Howat DJ, Jones C. UK and Australian University Students' Perceptions of the Nature of Sexual Assault and Intervening Behavior. J Interpers Violence 2024; 39:1952-1975. [PMID: 37961902 PMCID: PMC10993633 DOI: 10.1177/08862605231212171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
Sexual assault is a global problem, with the risk highest among university students. Bystander intervention preventing sexual assaults has primarily been researched using quantitative methods to understand what factors influence it. However, both sexual assault and bystander intervention are complex with many subtle and overlapping issues that, when analyzed qualitatively, can offer new insights. The current study aimed to explore and develop a nuanced and comprehensive understanding of students' perceptions of sexual assault and bystander intervention across two universities, one in the United Kingdom and one in Australia. Thirty-nine university students (19 in the United Kingdom; 20 in Australia) took part in one-to-one semistructured interviews. Using inductive thematic analysis, two overarching themes were identified: (a) navigating the complex dynamics of sexual assault; and (b) decisions to intervene or not to intervene. Findings suggest that the complexity and ambiguity around sexual assault can forestall bystander intervention. As such, increasing education, awareness, and discussions around sexual assault and bystander intervention is vital to increase awareness of the problem and mobilize action from bystanders to prevent sexual assault.
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Affiliation(s)
| | - Sarah Brown
- University of the Sunshine Coast, Sippy Downs, QLD, Australia
| | | | - Nadine McKillop
- University of the Sunshine Coast, Sippy Downs, QLD, Australia
| | | | - Christian Jones
- University of the Sunshine Coast, Sippy Downs, QLD, Australia
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Starnberg J, Renström L. Scoping review showed that obesity prevention in Nordic countries had limited effects on children from birth to 7 years of age. Acta Paediatr 2024; 113:912-922. [PMID: 37988200 DOI: 10.1111/apa.17043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 10/27/2023] [Accepted: 11/10/2023] [Indexed: 11/23/2023]
Abstract
AIM The aim of this scoping review was to map and summarise clinical trials that attempted to prevent obesity in children from birth to 7 years of age in any of the Nordic countries. METHODS PubMed, CINAHL Plus and clinicaltrials.gov were searched for peer-reviewed papers and registered trials published in English or Swedish. The overall search period was from 1 January 2002 to 13 December 2022. We included randomised and non-randomised trials initiated from birth to 7 years of age that aimed to prevent obesity in Denmark, Finland, Iceland, Norway and Sweden. RESULTS The search resulted in 414 papers and 14 were included. Despite having diverse settings and designs, none of them reported consistently favourable results for anthropometric outcomes, apart from beneficial trends in subgroups with a high body mass index at baseline. Most studies reported temporarily improved dietary patterns. CONCLUSION There is a gap in the current research about how to best prevent obesity in children. We suggest that researchers should focus on risk groups and that interventions that last a number of years are needed.
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Affiliation(s)
- Josefine Starnberg
- Centre for Research and Development, Region Gävleborg, Gävle, Sweden
- Centre for Clinical Research, Region Gävleborg and Uppsala University, Gävle, Sweden
| | - Lina Renström
- Centre for Research and Development, Region Gävleborg, Gävle, Sweden
- Centre for Clinical Research, Region Gävleborg and Uppsala University, Gävle, Sweden
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McCall D, Luu X, Krogh C, Phelan L, Dempsey A, Acosta C, Marshall F, Svejkar D, Pruscino C, Beres MA. A Comparative Account of Institutional Approaches to Addressing Campus-Based Sexual Violence in Australia and Aotearoa New Zealand. Violence Against Women 2024; 30:1586-1613. [PMID: 37461389 PMCID: PMC10998435 DOI: 10.1177/10778012231183654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2023]
Abstract
Sexual violence is prevalent on university campuses globally. In this article, we report a qualitative insider research study examining practices for addressing sexual violence at four universities across Australia and Aotearoa New Zealand. We collected, analysed, and synthesised descriptive information about the practices at each institution. We found unique institutional approaches that nonetheless share some commonalities, yieldingseveral themes that are central to practice. In reflecting on our findings, we conclude with an outline of critical considerations and a call to action for future efforts to address campus-based sexual violence, particularly as this field remains underdeveloped across Australia and Aotearoa New Zealand.
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Affiliation(s)
- Deanna McCall
- Student Central, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Xuan Luu
- School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Chris Krogh
- School of Humanities, Creative Industries and Social Sciences, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Liam Phelan
- School of Environmental and Life Sciences, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Amy Dempsey
- Campus Community Division, Monash University, Clayton, Victoria, Australia
| | - Carmen Acosta
- Campus Community Division, Monash University, Clayton, Victoria, Australia
| | - Fiona Marshall
- Campus Community Division, Monash University, Clayton, Victoria, Australia
| | - Domenic Svejkar
- Design Innovation Research Centre, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Catharine Pruscino
- Office of the Provost, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Melanie A. Beres
- Te Whare Tāwharau, University of Otago, Dunedin, Otago, New Zealand
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Deane KD. Rheumatoid arthritis: prediction of future clinically-apparent disease, and prevention. Curr Opin Rheumatol 2024; 36:225-234. [PMID: 38441488 PMCID: PMC10959682 DOI: 10.1097/bor.0000000000001013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Abstract
PURPOSE OF REVIEW This review discusses updates in the prediction and prevention of future rheumatoid arthritis (RA). RECENT FINDINGS In individuals with musculoskeletal symptoms and elevated antibodies to citrullinated proteins (ACPA) without clinical inflammatory arthritis (IA), a 'simple' score has a positive predictive value (PPV) of ∼28% for clinical IA/RA within 1 year, and a comprehensive score (including ultrasound) has a PPV of ∼71% for clinical RA within 5 years. Controlled clinical trials in individuals at-risk for future RA have been performed using corticosteroids, rituximab, atorvastatin, methotrexate, hydroxychloroquine and abatacept. Abatacept modestly reduced rates of incident clinical RA and imaging inflammation within the trials, rituximab delayed clinical IA, and methotrexate improved function, symptoms and imaging inflammation. Vitamin D with or without omega 3 fatty acids reduced incidence of autoimmune diseases, including RA. While not proven in controlled clinical trials, observational studies suggest exercise, weight loss and smoking cessation may reduce progression to clinical RA. SUMMARY Prediction and prevention of RA is advancing although there are no currently approved interventions for prevention. Future studies should include deeper evaluation of the pathophysiology of RA development to improve prediction and identify key pathways to target in future clinical trials, as well as develop infrastructure to support prevention-related research.
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Affiliation(s)
- Kevin D Deane
- University of Colorado Anschutz Medical Campus, 1775 Aurora Court, Mail Stop B-115, Aurora, Colorado USA
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Mukwege D, Conry JA. A call to action: Drawing a red line to end conflict-related sexual violence. Int J Gynaecol Obstet 2024; 165:526-528. [PMID: 37332138 DOI: 10.1002/ijgo.14963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/20/2023]
Abstract
SynopsisThis article calls on health professionals to speak out and join the campaign to end the use of sexual violence as a weapon of war.
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Affiliation(s)
- Denis Mukwege
- Department of Obstetrics and Gynecology, Panzi General Referral Hospital, Bukavu, The Democratic Republic of Congo
- Université Evangélique en Afrique (UEA), Bukavu, The Democratic Republic of Congo
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Shepard LD, Campbell KA, Byrne KA, Thorn B, Keeshin BR. Screening for and Responding to Suicidality Among Youth Presenting to a Children's Advocacy Center (CAC). Child Maltreat 2024; 29:272-282. [PMID: 36927222 DOI: 10.1177/10775595231163592] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Youth presenting to a Children's Advocacy Center (CAC) for a forensic interview are at increased risk for suicidality, but no data exist for suicidality or suicide screening and response at the time of the forensic interview. The current study applied a suicide and traumatic stress screening and response protocol, the Care Process Model for Pediatric Traumatic Stress (CPM-PTS), with youth (11-18 years) presenting for a forensic interview to one of 16 participating CAC locations, 2018-2020.46.2% of youth screened for traumatic stress and suicidality (N = 1651) endorsed thoughts of suicide or self-harm in the past two weeks, and 13.6% were assessed as high risk for suicide. High symptoms of traumatic stress increased the risk of suicidal thinking as well as of high risk suicidality. CAC workers, both clinicians and non-clinicians, facilitated screening and provided prevention response. Suicide screening and response at the CAC at the time of the forensic interview appears important and feasible.
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Affiliation(s)
- Lindsay D Shepard
- School of Medicine, Department of Pediatrics, University of Utah, Salt Lake City, UT, USA
| | - Kristine A Campbell
- School of Medicine, Department of Pediatrics, University of Utah, Salt Lake City, UT, USA
| | - Kara A Byrne
- School of Medicine, Department of Pediatrics, University of Utah, Salt Lake City, UT, USA
| | - Brian Thorn
- School of Medicine, Department of Pediatrics, University of Utah, Salt Lake City, UT, USA
| | - Brooks R Keeshin
- School of Medicine, Department of Pediatrics, University of Utah, Salt Lake City, UT, USA
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Guastaferro K, Linden-Carmichael AN, Chiang SC. Association Between Child Maltreatment and Substance Use Disorder Across Emerging Adulthood. Child Maltreat 2024; 29:340-349. [PMID: 36715445 PMCID: PMC10981177 DOI: 10.1177/10775595231154545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Child maltreatment is associated with substance use beginning in adolescence and throughout early adulthood. Substance use disorders (SUD) are most likely to develop during emerging adulthood (18-25 years old). Thus, to develop effective substance use prevention strategies, it is useful to know the ages at which associations between maltreatment exposure (prior to age 18) and SUD are most strongly tied. This study examined the age-varying association between child maltreatment and past-year SUD in emerging adulthood by sex and by maltreatment type using time-varying effect models (TVEM). Data were from the National Epidemiological Survey on Alcohol and Related Conditions (NESARC-III). The analytic sample consisted of 5194 emerging adults. The association was strongest at younger ages, with individuals who experienced child maltreatment having three times greater odds of reporting SUD in the past-year. Differential associations were found by sex, racial-ethnic group, and maltreatment type across age. Prevention efforts may be more effective if their development is informed by these important differences and targeted at emerging adults rather than adolescents.
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Affiliation(s)
- Kate Guastaferro
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, USA
- Department of Social and Behavioral Sciences, New York University, New York, NY, USA
| | - Ashley N. Linden-Carmichael
- The Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University, University Park, PA, USA
| | - Shou-Chun Chiang
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, USA
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14
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Bright MA, Huq MS, Miller MD, Patel S, Li Z, Finkelhor D. Randomized Control Trial of a School-Based Curriculum that Teaches About Multiple Forms of Abuse. Child Maltreat 2024; 29:364-374. [PMID: 36639370 DOI: 10.1177/10775595231152623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Most school-based prevention curricula for young children fail to address multiple types of abuse and limit instruction to a single day, despite evidence that polyvictimization is common and children learn better when allowed to practice material repeatedly. This study utilized a cluster randomized control trial design to evaluate a multi-abuse prevention program, the Monique Burr Foundation for Children (MBF) Child Safety Matters®, based on varying lesson structure. Participants included nine Florida schools consisting of 843 children in grades K-2. Schools were randomized within cluster to implement in two lessons, four lessons, or after study data collection (i.e., control group). Lessons averaged 34 minutes (SD = 8.8 minutes) in length for 2-lesson group and 23.6 minutes (SD = 6.9 minutes) for the 4-lesson condition. Knowledge was assessed before implementation and on average 11 weeks after implementation. There were no statistical differences between clusters. Controlling for pre-test scores, schools in the four-lesson group scored highest on a measure of knowledge of potentially risky and unsafe situations (M = 69.68, SE = .80) on post-test, followed by schools in the two-lesson group (M = 67.31, SE = .77), followed by schools in the control group (M = 62.92, SE = .76). Results support use of more frequent, shorter lessons for prevention programs and the promise of addressing multiple forms of child victimization.
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Affiliation(s)
| | - Mona Sayedul Huq
- Department of Pediatrics, University of Florida, Gainesville, FL, USA
| | - M David Miller
- School of Human Development and Organizational Studies in Education, University of Florida, Gainesville, FL, USA
| | - Shivam Patel
- Cooper Medical School of Rowan University, Camden, NJ, USA
| | - Ziying Li
- School of Human Development and Organizational Studies in Education, University of Florida, Gainesville, FL, USA
| | - David Finkelhor
- Crimes Against Children Research Center, Family Research Laboratory, and Department of Sociology, University of New Hampshire, Durham, NH, USA
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Klich S, Smoter M, Michalik K, Bogdański B, Valera Calero JA, Manuel Clemente F, Makar P, Mroczek D. Foam rolling and tissue flossing of the triceps surae muscle: an acute effect on Achilles tendon stiffness, jump height and sprint performance - a randomized controlled trial. Res Sports Med 2024; 32:443-456. [PMID: 36134907 DOI: 10.1080/15438627.2022.2125317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 09/13/2022] [Indexed: 10/14/2022]
Abstract
This study aimed to investigate an acute effect of foam rolling and tissue flossing of the Triceps Surae muscle on Achilles tendon stiffness, jump height and sprint performance at different time points. The participants were academic athletes (n = 32) aged between 22 and 24 years; randomly allocated into two groups: foam rolling (ROLL) and tissue flossing (FLOSS). The participants were tested at baseline and 5-min, 15-min, 30-min, 45-min, and 60-min after ROLL and FLOSS for Achilles tendon stiffness (ATstiffeness) at three reference locations: (1) tendon's origin, (2) ankle joint height and (3) intermuscular septum of the gastronomies muscle; countermovement jump (CMJ); and sprint performance at 15-m (SPRINT15 m). The analysis of stiffness revealed a significant decrease in ATstiffness from baseline to Post-60 (p ≤ 0.001) for three locations in the FLOSS group (p ≤ 0.001). In FLOSS, a significant increase was observed from Post-15 to Post-60 (all p≤0.001) in CMJ. We found also a significant decrease in SPRINT15 m in FLOSS in all-time points (p ≤ 0.001), however, SPRINT15 m decreased in Post-5 min, Post-15 min, and Post-30 min (p ≤ 0.001 for all) in ROLL. The current study suggested that both groups enhanced performance up to 60 min after the intervention, caused by mitigating excessive stiffness.
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Affiliation(s)
- Sebastian Klich
- Department of Paralympic Sport, Wrocław University of Health and Sport Sciences, Wrocław, Poland
| | - Małgorzata Smoter
- Department of Basics of Physiotherapy, Gdansk University of Physical Education and Sport, Gdańsk, Poland
| | - Kamil Michalik
- Department of Human Motor Skills, Wrocław University of Health and Sport Sciences, Wrocław, Poland
| | | | - Juan Antonio Valera Calero
- Department of Physiotherapy, Universidad Camilo José Cela, Madrid, Spain
- VALTRADOFI Research Group, Department of Physiotherapy, Universidad Camilo José Cela, Madrid, Spain
| | - Filipe Manuel Clemente
- Escola Superior Desporto e Lazer, Instituto Politécnico de Viana do Castelo, Rua Escola Industrial e Comercial de Nun'Álvares, Viana do Castelo, Portugal
- Research Center in Sports Performance, Innovation and Technology (SPRINT) Recreation, Melgaço, Portugal
- Instituto de Telecomunicações Delegação da Covilhã, Lisboa, Portugal
| | - Piotr Makar
- Department of Swimming, Gdansk University of Physical Education and Sport, Gdańsk, Poland
| | - Dariusz Mroczek
- Department of Human Motor Skills, Wrocław University of Health and Sport Sciences, Wrocław, Poland
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16
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Cenčič A, Bajec S, Žvanut B. Effects of web-based diabetes education on knowledge retention in adult general population: An experiment. Public Health Nurs 2024; 41:555-561. [PMID: 38506318 DOI: 10.1111/phn.13304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 11/23/2023] [Accepted: 02/22/2024] [Indexed: 03/21/2024]
Abstract
OBJECTIVE To conduct a study to improve diabetes knowledge through a web-based diabetes course in the general adult population. We hypothesised that participation in a web-based diabetes course would have a positive impact on diabetes knowledge retention. METHODS Participants were randomly assigned to an experimental or control group. Participants in the experimental group attended an interactive web-based diabetes course. The Diabetes Knowledge Questionnaire (DKQ24) was used to assess the diabetes knowledge levels. The DKQ24 was completed at the beginning and end of the observation period of 3 months. The experimental group also completed it immediately after the intervention. RESULTS At the end of the observation period, a statistically significant difference in the mean rank of DKQ24 scores was found in favor of the experimental group (p < .001). The results of the experimental group had a lower interquartile range (IQR = 3) than those of the control group (IQR = 5). CONCLUSIONS This study suggests that providing a web-based diabetes course to the general population is effective and can improve diabetes knowledge and retention.
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Affiliation(s)
- Ajda Cenčič
- Primary Healthcare Center Koper, Diabetes Outpatient Clinic, Koper, Slovenia
- Department of Nursing, Faculty of Health Sciences, University of Primorska, Izola, Slovenia
| | - Saša Bajec
- Primary Healthcare Center Nova Gorica, Nova Gorica, Slovenia
| | - Boštjan Žvanut
- Department of Nursing, Faculty of Health Sciences, University of Primorska, Izola, Slovenia
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17
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Farhan K, Imam SI, Tariq MB, Ahmed A, Suheb MK, Akilimali A. Connecting the dots: Human papillomavirus vaccination gaps and the upsurge of oral human papillomavirus infection in United States of America. Int J Gynaecol Obstet 2024; 165:529-530. [PMID: 38084756 DOI: 10.1002/ijgo.15306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 12/04/2023] [Indexed: 04/17/2024]
Abstract
SynopsisThis Editorial calls attention to the worrisome rise in oral HPV infections in the USA, which has been related to an increase in oral sex activity. It emphasizes the need for increased vaccination rates, dispelling myths and addressing disparities in oropharyngeal cancer prevention.
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Affiliation(s)
- Kanza Farhan
- Sindh Medical College, Jinnah Sindh Medical University, Karachi, Pakistan
| | - Syed Irtiza Imam
- Sindh Medical College, Jinnah Sindh Medical University, Karachi, Pakistan
| | | | - Aliza Ahmed
- Sindh Medical College, Jinnah Sindh Medical University, Karachi, Pakistan
| | - Mahammed Khan Suheb
- Department of Critical Care, St. Luke's Aurora Medical Center, Milwaukee, Wisconsin, USA
| | - Aymar Akilimali
- Department of Research, Medical Research Circle (MedReC), Bukavu, DR Congo
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18
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Gutermuth D, Hamstra MRW. Are there gender differences in promotion- prevention self-regulatory focus? Br J Psychol 2024; 115:306-323. [PMID: 37984379 DOI: 10.1111/bjop.12688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Accepted: 11/08/2023] [Indexed: 11/22/2023]
Abstract
The purpose of this research is to examine gender differences in promotion/prevention self-regulatory focus, a dispositional motivational orientation with major implications for human functioning. First, a review of literature using social cognitive theory as a framework suggests that, driven by socialization processes, (1) women may on average be more prevention focused than men - meaning more vigilant to maintain a secure status quo, whereas (2) men may on average be more promotion focused than women - meaning more eager to advance to a better situation than their status quo. Second, we provide data to examine these possible gender differences in self-regulatory focus with secondary analyses of (a) our own existing data on dispositional regulatory focus and of (b) a large scale, representative panel study (LISS Survey). The data suggest a highly consistent difference with women being more prevention focused than men, while the difference in promotion focus is much smaller and is only found in European samples. Auxiliary data suggest promotion-focused women hold less traditional gender role beliefs as well as showing that regulatory focus partially explains examples of behavioural differences between men and women. The analysis of gender difference in regulatory focus sheds new light on gender differences and biases already known, and on regulatory focus, and as such opens up many new and important areas of future inquiry.
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Affiliation(s)
| | - Melvyn R W Hamstra
- IESEG School of Management, UMR 9221 - LEM - Lille Économie Management, Lille, France
- Univ. Lille, UMR 9221 - LEM - Lille Économie Management, Lille, France
- CNRS, UMR 9221 - LEM - Lille Économie Management, Lille, France
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19
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Ishida T, Koshino Y, Yamanaka M, Ueno R, Taniguchi S, Ino T, Kasahara S, Samukawa M, Tohyama H. Larger hip external rotation motion is associated with larger knee abduction and internal rotation motions during a drop vertical jump. Sports Biomech 2024; 23:640-654. [PMID: 33663352 DOI: 10.1080/14763141.2021.1881151] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 01/21/2021] [Indexed: 01/14/2023]
Abstract
Associations among hip motions, knee abduction and internal rotation motion during a drop vertical jump (DVJ), which increases the risk of anterior cruciate ligament injury, remain unclear. The purpose of this study was to examine associations among knee abduction, internal rotation and hip joint motions during a DVJ. Fifty-seven young female participants performed a DVJ from a 30-cm height. Hip and knee kinematics and kinetics were analysed using a three-dimensional motion analysis system and force plates. Multiple regression analysis showed that peak knee abduction angle was negatively associated with knee internal rotation and hip internal rotation excursions from initial contact (IC) to peak knee flexion, and positively associated with peak knee abduction moment (R2 = 0.465, P< 0.001). Peak knee internal rotation angle was negatively associated with the hip flexion excursion from IC to peak knee flexion and peak hip adduction moment (R2 = 0.194, P= 0.001). In addition, hip internal rotation excursion was negatively associated with knee abduction and internal rotation excursion from IC to 50 ms after IC. To avoid a large knee abduction and internal rotation motion during jump-landing training, it might be beneficial to provide landing instructions to avoid a large hip external rotation motion.
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Affiliation(s)
- Tomoya Ishida
- Faculty of Health Sciences, Hokkaido University, Sapporo, Japan
| | - Yuta Koshino
- Faculty of Health Sciences, Hokkaido University, Sapporo, Japan
| | - Masanori Yamanaka
- Faculty of Health Science, Hokkaido Chitose College of Rehabilitation, Chitose, Japan
| | - Ryo Ueno
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | | | - Takumi Ino
- Faculty of Health Sciences, Hokkaido University of Science, Sapporo, Japan
| | | | - Mina Samukawa
- Faculty of Health Sciences, Hokkaido University, Sapporo, Japan
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20
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Murphy MC, Merrick N, Mosler AB, Allen G, Chivers P, Hart NH. Cardiorespiratory fitness is a risk factor for lower-limb and back injury in law enforcement officers commencing their basic training: a prospective cohort study. Res Sports Med 2024; 32:511-523. [PMID: 36284503 DOI: 10.1080/15438627.2022.2139618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 10/17/2022] [Indexed: 10/31/2022]
Abstract
We aimed to report the epidemiology of lower-limb and lumbosacral injuries in Police Force recruits. We performed a cohort study of Police Force recruits undergoing a six-month training program with prospective injury data collected between 2018 and 2021. Cardiorespiratory fitness was quantified by the beep-test and police-specific-functional-capacity was quantified using a specifically designed physical performance evaluation (PPE) tool. Injury frequency and prevalence were reported. Fifteen percent (n = 180) of study Police Force recruits (n = 1,181) sustained a lower-limb or lumbosacral injury. The six-month training program significantly improved cardiorespiratory fitness (p < 0.001) and functional capacity (p < 0.001). Increased cardiorespiratory fitness at baseline decreased injury risk (OR = 0.8, 95%CI: 0.66-0.97, p = 0.019). Injury rates decreased over time and females were injured significantly earlier than males (HR = 0.70, 95%CI: 0.52 to 0.95, p = 0.021). Interventions that can pre-condition Police Force recruits prior to the commencement of their basic physical training may reduce the number of lower-limb and lumbosacral injuries.
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Affiliation(s)
- Myles C Murphy
- Nutrition and Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
- School of Nursing, Midwifery, Health Sciences and Physiotherapy, The University of Notre Dame Australia, Fremantle, Western Australia, Australia
| | - Nicole Merrick
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Andrea B Mosler
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Bundoora, Victoria, Australia
| | - Garth Allen
- Western Australian Police Force, Western Australian Police Academy, Joondalup, Western Australia, Australia
| | - Paola Chivers
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
- Institute for Health Research, The University of Notre Dame Australia, Fremantle, Western Australia, Australia
| | - Nicolas H Hart
- Institute for Health Research, The University of Notre Dame Australia, Fremantle, Western Australia, Australia
- Caring Futures Institute, College of Nursing and Health Science, Flinders University, Adelaide, SA, Australia
- Exercise Medicine Research Institute, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
- School of Nursing, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
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21
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Elkind MSV. How Physical Activity Lowers Cardiovascular Risk: Exercise Can Change Your Mind. J Am Coll Cardiol 2024; 83:1554-1556. [PMID: 38631774 DOI: 10.1016/j.jacc.2024.03.369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Accepted: 03/08/2024] [Indexed: 04/19/2024]
Affiliation(s)
- Mitchell S V Elkind
- Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, USA; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA; American Heart Association, Dallas, Texas, USA.
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22
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Dhaliwal G, Ouanounou A. Tooth surface loss: causes, management and prevention. Quintessence Int 2024; 0:0. [PMID: 38634628 DOI: 10.3290/j.qi.b5223649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 04/19/2024]
Abstract
OBJECTIVES Tooth wear (TW), also referred to as tooth surface loss (TSL), occurs due to causes other than caries. This involves the loss of hard tissues, namely enamel, dentin and/or cementum. Types of TW/TSL are abrasion, abfraction, attrition and erosion. These multifactorial conditions can be caused things such as lifestyle, diet or even habits and may not be symptomatic. The focus of this article is to provide clinicians with detailed examples and explanations of the causes of tooth loss to aid in early diagnosis. Through early identification, the preventive measures outlined can be implemented to avoid excessive TW. The provision of a treatment flowchart and general treatment recommendations aims to help clinicians determine when to restore these lesions and the most appropriate treatment measures for the 4 types of wear. MATERIALS AND METHODS The PubMed (MEDLINE) search engine was used to gather information on TW restricted to a five-year period (26 August 2018 - 25 July 2022). Only English-language studies and reviews with the best balance of sensitivity and specificity were considered. A Boolean search of the PubMed dataset was implemented to combine a range of keywords: ("tooth wear" OR tooth attrition OR tooth erosion OR tooth abrasion OR tooth abfraction). Additional articles were also selected through Google Scholar. RESULTS By this process, many articles and studies were obtained, and the 48 most relevant published studies were chosen and used in the current review. The selected articles are in the reference list. CONCLUSION TW affects an increasing number of individuals and can have detrimental effects physically, mentally and emotionally. It is important to stress early diagnosis and management of tooth wear through monitoring, prevention and treatment where indicated.
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Williams EC, Frost MC, Bounthavong M, Edmonds AT, Lau MK, Edelman EJ, Harvey MA, Christopher MLD. Implementation of Opioid Safety Efforts: Influence of Academic Detailing on Adverse Outcomes Among Patients in the Veterans Health Administration. Subst Use Addctn J 2024:29767342241243309. [PMID: 38634339 DOI: 10.1177/29767342241243309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/19/2024]
Abstract
BACKGROUND The Veterans Health Administration (VA) implemented academic detailing (AD) to support safer opioid prescribing and overdose prevention initiatives. METHODS Patient-level data were extracted monthly from VA's electronic health record to evaluate whether AD implementation was associated with changes in all-cause mortality, opioid poisoning inpatient admissions, and opioid poisoning emergency department (ED) visits in an observational cohort of patients with long-term opioid prescriptions (≥45-day supply of opioids 6 months prior to a given month with ≤15 days between prescriptions). A single-group interrupted time series analysis using segmented logistic regression for mortality and Poisson regression for counts of inpatient admissions and ED visits was used to identify whether the level and slope of these outcomes changed in response to AD implementation. RESULTS Among 955 376 unique patients (19 431 241 person-months), there were 53 369 deaths (29 025 pre-AD; 24 344 post-AD), 1927 opioid poisoning inpatient admissions (610 pre-AD; 1317 post-AD), and 408 opioid poisoning ED visits (207 pre-AD; 201 post-AD). Immediately after AD implementation, there was a 5.8% reduction in the odds of all-cause mortality (95% confidence interval [CI]: 0.897, 0.990). However, patients had a significantly increased incidence rate of inpatient admissions for opioid poisoning immediately after AD implementation (incidence rate ratio = 1.523; 95% CI: 1.118, 2.077). No significant differences in ED visits for opioid poisoning were observed. CONCLUSIONS AD was associated with decreased all-cause mortality but increased inpatient hospitalization for opioid poisoning among patients prescribed long-term opioids. Mechanisms via which AD's efforts influenced opioid-related outcomes should be explored.
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Affiliation(s)
- Emily C Williams
- Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, WA, USA
- Health Services Research & Development (HSR&D), Center of Innovation for Veteran-Centered and Value-Driven Care, Veterans Affairs (VA) Puget Sound Health Care System, Seattle, WA, USA
| | - Madeline C Frost
- Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, WA, USA
- Health Services Research & Development (HSR&D), Center of Innovation for Veteran-Centered and Value-Driven Care, Veterans Affairs (VA) Puget Sound Health Care System, Seattle, WA, USA
| | - Mark Bounthavong
- Academic Detailing Service, Pharmacy Benefits Management, Veterans Health Administration, Department of Veterans Affairs Central Office, Washington, DC, USA
- VA Health Economics Resource Center, VA Palo Alto Health Care System, Menlo Park, CA, USA
- UCSD Skaggs School of Pharmacy and Pharmaceutical Sciences, La Jolla, CA, USA
| | - Amy T Edmonds
- Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, WA, USA
- Mathematica, Seattle, WA, USA
| | - Marcos K Lau
- Academic Detailing Service, Pharmacy Benefits Management, Veterans Health Administration, Department of Veterans Affairs Central Office, Washington, DC, USA
| | | | - Michael A Harvey
- Academic Detailing Service, Pharmacy Benefits Management, Veterans Health Administration, Department of Veterans Affairs Central Office, Washington, DC, USA
| | - Melissa L D Christopher
- Academic Detailing Service, Pharmacy Benefits Management, Veterans Health Administration, Department of Veterans Affairs Central Office, Washington, DC, USA
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24
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Guan H, Wang W. Factors Impacting Chinese Older Adults' Intention to Prevent COVID-19 in the Post-COVID-19 Pandemic Era: Survey Study. JMIR Form Res 2024; 8:e53608. [PMID: 38630517 DOI: 10.2196/53608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 12/21/2023] [Accepted: 01/14/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Understanding the factors influencing individuals' health decisions is a dynamic research question. Particularly, after China announced the deregulation of the COVID-19 epidemic, health risks escalated rapidly. The convergence of "no longer controlled" viruses and the infodemic has created a distinctive social period during which multiple factors may have influenced people's decision-making. Among these factors, the precautionary intentions of older individuals, as a susceptible health group, deserve special attention. OBJECTIVE This study aims to examine the intention of older adults to engage in preventive behaviors and the influencing factors, including social, media, and individual factors, within the context of the postepidemic era. Drawing upon the structural influence model of communication, this study tests the potential mediating roles of 3 different types of media exposure between cognitive and structural social capital and protective behavior intention, as well as the moderating role of negative emotions between social capital and media exposure. METHODS In this study, a web survey was used to collect self-reported quantitative data on social capital, media exposure, negative emotions, and the intention to prevent COVID-19 among older adults aged ≥60 years (N=399) in China. RESULTS The results indicate that cognitive social capital significantly influenced protective behavior intention (P<.001), with cell phone exposure playing an additional impactful role (P<.001). By contrast, newspaper and radio exposure and television exposure mediated the influence of structural social capital on protective behavior intention (P<.001). Furthermore, negative emotions played a moderating role in the relationship between cognitive social capital and cell phone exposure (P<.001). CONCLUSIONS This study suggests that using tailored communication strategies across various media channels can effectively raise health awareness among older adults dealing with major pandemics in China, considering their diverse social capital characteristics and emotional states.
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Affiliation(s)
- Huixin Guan
- USC-SJTU Institute of Cultural and Creative Industry, Shanghai Jiao Tong University, Shanghai, China
| | - Wei Wang
- USC-SJTU Institute of Cultural and Creative Industry, Shanghai Jiao Tong University, Shanghai, China
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25
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Tieu S, Koivusalo S, Lahti J, Engberg E, Laivuori H, Huvinen E. Genetic risk of type 2 diabetes modifies the association between lifestyle and glycemic health at 5 years postpartum among high-risk women. BMJ Open Diabetes Res Care 2024; 12:e003942. [PMID: 38631819 DOI: 10.1136/bmjdrc-2023-003942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 03/16/2024] [Indexed: 04/19/2024] Open
Abstract
INTRODUCTION Lifestyle interventions are effective in preventing type 2 diabetes, but genetic background may influence the individual response. In the Finnish gestational diabetes prevention study, RADIEL, lifestyle intervention during pregnancy and first postpartum year was effective in preventing gestational diabetes (GDM) and postpartum glycemic abnormalities only among women at highest genetic risk of type 2 diabetes. This study aimed to assess whether still 5 years postpartum the genetic risk modifies the association between lifestyle and glycemic health. RESEARCH DESIGN AND METHODS The RADIEL study (randomized controlled trial) aimed to prevent GDM with a lifestyle intervention among high-risk women (body mass index ≥30 kg/m2 and/or prior GDM). The follow-up study 5 years postpartum included anthropometric measurements, laboratory assessments, device-measured physical activity (PA), and questionnaires. A Healthy Lifestyle Score (HLS) indicated adherence to lifestyle goals (PA, diet, smoking) and a polygenic risk score (PRS) based on 50 type 2 diabetes risk alleles depicted the genetic risk. RESULTS Altogether 314 women provided genetic and glycemic data 5 years postpartum. The PRS for type 2 diabetes was not associated with glycemic abnormalities, nor was HLS in the total study sample. There was, however, an interaction between HLS and type 2 diabetes PRS on glycemic abnormalities (p=0.03). When assessing the association between HLS and glycemic abnormalities in PRS tertiles, HLS was associated with reduced risk of glycemic abnormalities only among women at the highest genetic risk (p=0.008). CONCLUSIONS These results extend our previous findings from pregnancy and first postpartum year demonstrating that still at 5 years postpartum, healthy lifestyle is associated with a lower risk of prediabetes/diabetes only among women at the highest genetic risk of type 2 diabetes.
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Affiliation(s)
- Sim Tieu
- Helsinki University Central Hospital, Helsinki, Finland
| | | | - Jari Lahti
- Department of Psychology, University of Helsinki, Helsinki, Finland
- Folkhälsan Research Center, Helsinki, Finland
| | - Elina Engberg
- Folkhälsan Research Center, Helsinki, Finland
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Hannele Laivuori
- Medical and Clinical Genetics, Helsinki University Hospital, Helsinki, Finland
- Tampere University, Tampere, Finland
| | - Emilia Huvinen
- Department of Obstetrics and Gynecology, University of Helsinki, Helsinki, Finland
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Zimmermann E, Tomczyk S. Fostering Digital Life Skills Through Social Media With Adolescents in 6 German States: Protocol for an Accessibility Study According to the RE-AIM Framework. JMIR Res Protoc 2024; 13:e51085. [PMID: 38631035 DOI: 10.2196/51085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 01/23/2024] [Accepted: 02/22/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Social media is essential in the lives of adolescents, with 97% of US teenagers engaging daily. While it facilitates communication, learning, and identity development, it also poses risks like harmful content exposure and psychological distress, particularly for adolescents in their critical developmental stage. Teaching digital life skills innovatively counters these risks, adapting traditional competencies such as decision-making, problem-solving, creative and critical thinking, communication, interpersonal skills, self-awareness, empathy, and emotional and stress management to digital challenges. OBJECTIVE This study evaluates the accessibility of the "leduin" program, a novel intervention designed to impart digital life skills through Instagram. The program aims to leverage social media's educational potential, focusing on effective strategies to engage adolescents. Emphasizing accessibility is crucial, as it determines the program's overall impact. METHODS The leduin program, developed through intervention mapping, applies behavior change techniques via social media for 9th and 10th graders. It is a 14-week spaced learning curriculum with daily sessions <5 minutes. Emphasizing the "reach" aspect of the reach, effectiveness, adoption, implementation, and maintenance (RE-AIM) model, the recruitment targets diverse educational settings across 6 German states, aiming for inclusivity. Recruitment will involve schools, youth centers, and therapeutic facilities. The study seeks at least 128 participants, a calculated minimum to detect medium-sized effects in the quasi-experimental design and explore varying engagement levels and program responses. Data collection includes preintervention, postintervention, and 6-month follow-up surveys, using multilevel regression, latent growth models, and qualitative analysis to extensively assess reach and gain first insights on effectiveness, acceptance, implementation, and maintenance. The study aims to reveal key factors influencing program participation and interaction; a detailed analysis of engagement patterns will reveal the effectiveness of the recruitment strategies and barriers to participation. Additionally, initial indications of the program's impact on life skills, social media-related skills, health status, risk behaviors, and academic performance will be analyzed. RESULTS Recruitment was planned from May 2023 until the beginning of the leduin program in October 2023. As of March 2024, we have recruited 283 participants. CONCLUSIONS The leduin program stands as an innovative and essential initiative in adolescent health promotion, harnessing the power of social media to teach important digital life skills. This study highlights the critical role of accessibility in the success of social media interventions. Effective adolescent engagement strategies are imperative, as they dictate the overall impact of such interventions. The insights gained from this study will be instrumental in shaping future programs, laying groundwork for a subsequent, more comprehensive cluster-randomized controlled trial. The study's design acknowledges the limitations of the current quasi-experimental approach, including the anticipated sample size and the absence of a control group, and aims to provide a foundational understanding for future research in this field. TRIAL REGISTRATION Deutsches Register Klinischer Studien DRKS00032308; https://drks.de/search/de/trial/DRKS00032308. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/51085.
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Affiliation(s)
- Elizabeth Zimmermann
- Institute for Health Psychology, Department of Psychology, University of Greifswald, Greifswald, Germany
| | - Samuel Tomczyk
- Institute for Health Psychology, Department of Psychology, University of Greifswald, Greifswald, Germany
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Surey J, Veitch M, Rogers S, Al Shakarchi N, Burridge S, Leonard M, Munday S, Story A, Banerjee A. Cardiovascular Disease Screening in homeless: A Feasibility Study. J Am Heart Assoc 2024; 13:e034413. [PMID: 38606771 DOI: 10.1161/jaha.124.034413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Accepted: 03/15/2024] [Indexed: 04/13/2024]
Affiliation(s)
- Julian Surey
- University College London Hospitals Find and Treat Service London UK
| | - Martha Veitch
- University College London Hospitals Find and Treat Service London UK
| | - Sally Rogers
- University College London Hospitals Find and Treat Service London UK
| | - Nader Al Shakarchi
- University College London Medical School London UK
- Mayo Clinic Rochester MN USA
| | | | - Mark Leonard
- University College London Hospitals Find and Treat Service London UK
| | - Sophie Munday
- University College London Hospitals Find and Treat Service London UK
| | - Alistair Story
- University College London Hospitals Find and Treat Service London UK
- Institute of Epidemiology & Health Care University College London London UK
| | - Amitava Banerjee
- Institute of Health Informatics University College London London UK
- Department of Cardiology Barts Health NHS Trust London UK
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Cuervo G, Quintana E, Regueiro A, Perissinotti A, Vidal B, Miro JM, Baddour LM. The Clinical Challenge of Prosthetic Valve Endocarditis: JACC Focus Seminar 3/4. J Am Coll Cardiol 2024; 83:1418-1430. [PMID: 38599718 DOI: 10.1016/j.jacc.2024.01.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 01/17/2024] [Accepted: 01/29/2024] [Indexed: 04/12/2024]
Abstract
During the past 6 decades, there have been numerous changes in prosthetic valve endocarditis (PVE), currently affecting an older population and increasing in incidence in patients with transcatheter-implanted valves. Significant microbiologic (molecular biology) and imaging diagnostic (fluorine-18 fluorodeoxyglucose-positron emission tomography/computed tomography) advances have been incorporated into the 2023 Duke-International Society for Cardiovascular Infectious Diseases infective endocarditis diagnostic criteria, thus increasing the diagnostic sensitivity for PVE without sacrificing specificity in validation studies. PVE is a life-threatening disease requiring management by multidisciplinary endocarditis teams in cardiac centers to improve outcomes. Novel surgical options are now available, and an increasing set of patients may avoid surgical intervention despite indication. Selected patients may complete parenteral or oral antimicrobial treatment at home. Finally, patients with prosthetic valves implanted surgically or by the transcatheter approach are candidates for antibiotic prophylaxis before invasive dental procedures.
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Affiliation(s)
- Guillermo Cuervo
- Department of Infectious Diseases, Hospital Clinic, August Pi I Sunyer Institute of Biomedical Research (IDIBAPS), University of Barcelona, Barcelona, Spain; Biomedical Network Research Center for Infectious Diseases (CIBERINFEC), Carlos III Health Institute, Madrid, Spain
| | - Eduard Quintana
- Department of Cardiovascular Surgery, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Ander Regueiro
- Department of Cardiology, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Andrés Perissinotti
- Department of Nuclear Medicine, Hospital Clinic, August Pi I Sunyer Institute of Biomedical Research (IDIBAPS) and Biomedical Research Networking Center of Bioengineering, Biomaterials, and Nanomedicine (CIBER-BBN), Carlos III Health Institute, Barcelona, Spain
| | - Barbara Vidal
- Department of Cardiology, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Jose M Miro
- Department of Infectious Diseases, Hospital Clinic, August Pi I Sunyer Institute of Biomedical Research (IDIBAPS), University of Barcelona, Barcelona, Spain; Biomedical Network Research Center for Infectious Diseases (CIBERINFEC), Carlos III Health Institute, Madrid, Spain.
| | - Larry M Baddour
- Division of Public Health, Infectious Diseases, and Occupational Medicine, Departments of Medicine and Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
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Opper CA, Browne FA, Howard BN, Zule WA, Wechsberg WM. Assessing Differences in mHealth Usability and App Experiences Among Young African American Women: Secondary Analysis of a Randomized Controlled Trial. JMIR Hum Factors 2024; 11:e51518. [PMID: 38625721 DOI: 10.2196/51518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 01/17/2024] [Accepted: 02/20/2024] [Indexed: 04/17/2024] Open
Abstract
BACKGROUND In North Carolina, HIV continues to disproportionately affect young African American women. Although mobile health (mHealth) technology appears to be a tool capable of making public health information more accessible for key populations, previous technology use and social determinants may impact users' mHealth experiences. OBJECTIVE The objective of this study was to evaluate mHealth usability, assessing differences based on previous technology use and social determinants among a sample of African American women in emerging adulthood. METHODS As part of a National Institute on Drug Abuse-funded randomized controlled trial with African American women (aged 18-25 years), counties were assigned to receive an evidence-based HIV risk reduction intervention through mHealth and participants were asked to complete usability surveys at 6- and 12-month follow-ups. Participants' first survey responses were analyzed through 2-tailed t tests and linear regression models to examine associations with previous technology use and social determinants (P<.05). RESULTS The mean System Usability Scale (SUS) score was 69.2 (SD 17.9; n=159), which was higher than the threshold of acceptability (68.0). Participants who had previously used a tablet indicated higher usability compared to participants without previous use (mean 72.9, SD 18.1 vs mean 57.6, SD 11.4; P<.001), and participants with previous smartphone use also reported higher usability compared to participants without previous use (mean 71.9, SD 18.3 vs mean 58.0, SD 10.7; P<.001). Differences in SUS scores were observed among those reporting homelessness (mean 58.3, SD 19.0 vs mean 70.8, SD 17.2; P=.01), unemployment (mean 65.9, SD 17.2 vs mean 71.6, SD 18.1; P=.04), or current school enrollment (mean 73.2, SD 18.5 vs mean 65.4, SD 16.5; P=.006). Statistically significant associations were not observed for food insecurity (mean 67.3, SD 18.6 vs mean 69.9, SD 17.7; P=.45). CONCLUSIONS Although above-average usability was observed overall, these findings demonstrate differences in mHealth usability based on past and current life experiences. As mHealth interventions become more prevalent, these findings may have important implications for ensuring that mHealth apps improve the reach of evidence-based interventions. TRIAL REGISTRATION ClinicalTrials.gov NCT02965014; https://clinicaltrials.gov/study/NCT02965014. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1186/s12889-018-5796-8.
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Affiliation(s)
- Claudia A Opper
- RTI International, Research Triangle Park, NC, United States
| | - Felicia A Browne
- RTI International, Research Triangle Park, NC, United States
- Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, United States
| | | | - William A Zule
- RTI International, Research Triangle Park, NC, United States
| | - Wendee M Wechsberg
- RTI International, Research Triangle Park, NC, United States
- Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, United States
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, United States
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Hjern A, Lindfors A, Sarkadi A, Bergqvist K, Bergström M. Child behaviour is a main concern for parents of 3-year-olds. Acta Paediatr 2024. [PMID: 38624175 DOI: 10.1111/apa.17233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 03/18/2024] [Accepted: 03/27/2024] [Indexed: 04/17/2024]
Abstract
AIM The aim of this study was to describe parental concerns about child health and behaviour and their sociodemographic predictors in 3-year-olds, in relation to the national guidelines of well-baby clinics. METHODS The study included parents of 33 526 children in Stockholm who had completed a questionnaire prior to a routine visit to a well-baby clinic at age 3 years. Multivariate regression was used to analyse predictors for concerns. RESULTS Child behaviour problems, defined as defiance and problem with adherence to daily routines, were the most common parental concerns (36.4%), with poor social skills and relations being second (21.8%). Regarding development, 9.6% had concerns about speech and 4.7% about motor development. Screen use (9.5%) and being underweight (6.3%) were other common parental concerns, while lifestyle concerns regarding physical activity and overweight were rare. Parents raised about twice as many concerns for first-born children compared with younger siblings. Child behaviour and developmental concerns were more frequent in families where the mother had primary education only and attended a well-baby clinic with a high Care Need Index. CONCLUSION Parents' concerns reflected the national guidelines about child development and behaviour, but not its emphasis on a healthy lifestyle.
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Affiliation(s)
- Anders Hjern
- Regional Unit for the Well-baby Clinics, Sachs Children's Hospital, Stockholm, Sweden
- Department of Medicine, Clinical Epidemiology, Karolinska Institutet, Stockholm, Sweden
- Centre for Health Equity Studies, Stockholm University/Karolinska Institutet, Stockholm, Sweden
| | - Anncharlotte Lindfors
- Regional Unit for the Well-baby Clinics, Sachs Children's Hospital, Stockholm, Sweden
| | - Anna Sarkadi
- Department of Public Health and Caring Sciences, CHAP, Uppsala University, Uppsala, Sweden
| | - Kersti Bergqvist
- Regional Unit for the Well-baby Clinics, Sachs Children's Hospital, Stockholm, Sweden
| | - Malin Bergström
- Regional Unit for the Well-baby Clinics, Sachs Children's Hospital, Stockholm, Sweden
- Department of Medicine, Clinical Epidemiology, Karolinska Institutet, Stockholm, Sweden
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Ramachandran A, Clottey KD, Gordon A, Hyett JA. Prediction and prevention of preterm birth: Quality assessment and systematic review of clinical practice guidelines using the AGREE II framework. Int J Gynaecol Obstet 2024. [PMID: 38619379 DOI: 10.1002/ijgo.15514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 03/02/2024] [Accepted: 03/18/2024] [Indexed: 04/16/2024]
Abstract
BACKGROUND Prediction of pregnancies at risk of preterm birth (PTB) may allow targeted prevention strategies. OBJECTIVES To assess quality of clinical practice guidelines (CPGs) and identify areas of agreement and contention in prediction and prevention of spontaneous PTB. SEARCH STRATEGY We searched for CPGs regarding PTB prediction and prevention in asymptomatic singleton pregnancies without language restriction in January 2024. SELECTION CRITERIA CPGs included were published between July 2017 and December 2023 and contained statements intended to direct clinical practice. DATA COLLECTION AND ANALYSIS CPG quality was assessed using the AGREE-II tool. Recommendations were extracted and grouped under domains of prediction and prevention, in general populations and high-risk groups. MAIN RESULTS We included 37 CPGs from 20 organizations; all were of moderate or high quality overall. There was consensus in prediction of PTB by identification of risk factors and cervical length screening in high-risk pregnancies and prevention of PTB by universal screening and treatment for asymptomatic bacteriuria, screening and treatment for BV in high-risk pregnancies, and use of preventative progesterone and cerclage. Areas of contention or limited consensus were the role of PTB clinics, universal cervical length measurement, biomarkers and cervical pessaries. CONCLUSIONS This review identified strengths and limitations of current PTB CPGs, and areas for future research.
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Affiliation(s)
- Aparna Ramachandran
- Faculty of Medicine and Health, University of Sydney, Sydney, Australia
- Sydney Institute for Women, Children and Their Families, Sydney, Australia
| | - Klorkor D Clottey
- Department of Women and Babies, Royal Prince Alfred Hospital, Sydney, Australia
| | - Adrienne Gordon
- Faculty of Medicine and Health, University of Sydney, Sydney, Australia
- Sydney Institute for Women, Children and Their Families, Sydney, Australia
- Department of Neonatology, Royal Prince Alfred Hospital, Sydney, Australia
| | - Jon A Hyett
- Sydney Institute for Women, Children and Their Families, Sydney, Australia
- Department of Obstetrics and Gynecology, School of Medicine, Western Sydney University, Sydney, Australia
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Yeargin S, Hirschhorn RM, Adams WM, Scarneo-Miller SE. Secondary School State Athletic Association Health and Safety Policy Development Processes. J Sch Health 2024. [PMID: 38621415 DOI: 10.1111/josh.13454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 03/07/2024] [Accepted: 03/17/2024] [Indexed: 04/17/2024]
Abstract
BACKGROUND The National Federation of State High School Associations provides recommendations regarding health and safety policies; however, policy development is governed at the state level. Given interstate differences in governance, the primary purpose was to describe processes that State High School Athletic Associations (SHSAAs) utilize to develop a new policy. The secondary objective was to determine what methods associations use to implement new policies. METHODS A cross-sectional survey requested SHSAA (n = 51) representatives to report how athlete health and safety policies are introduced, revised, approved, and implemented within their state. The 22-question survey was developed to gather variables for the aims of the study. Descriptive statistics were calculated for each survey item. RESULTS Of states who responded (n = 33), most reported a 2-committee (n = 24, 72.7%) process for developing and vetting policies, with initiation from the Sports Medicine Advisory Committee (n = 27, 81.8%), followed by an executive-level committee (n = 18, 66.7%). States reported total time from policy initiation to final approval ranged from 2 weeks to over 12 months. When a new policy was approved, most states indicated implementation began with an e-mail (n = 24, 72.7%) sent to Athletic Directors (n = 26, 78.8%). School principal or district superintendent were reported as the position in charge of compliance (36.4%, n = 12). CONCLUSIONS Most SHSAAs use a 2-step process to write and review an athlete health and safety policy before approval. SHSAAs that require a longer policy development time could delay the implementation of important health measures. SHSAAs could consider additional communication methods to ensure information reaches all stakeholders.
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Affiliation(s)
- Susan Yeargin
- University of South Carolina, 921 Assembly St, PHRC Rm 226, Columbia, SC, 29208
| | - Rebecca M Hirschhorn
- Louisiana State University, School of Kinesiology, 2213 Pleasant Hall, Baton Rouge, LA, 70803
| | - William M Adams
- Sports Medicine Research, Division of Sports Medicine, United States Olympic & Paralympic Committee, 1 Olympic Plaza, Colorado Springs, CO, 80917
| | - Samantha E Scarneo-Miller
- School of Medicine, Division of Athletic Training, West Virginia University, 1 Medical Center Drive, 8501A Health Science Center South, Morgantown, WV, 26508
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Eisner-Fellay T, Suris JC, Barrense-Dias Y. Adolescent behavioural risk screening in primary care: physician's point of view. Fam Pract 2024; 41:123-130. [PMID: 37972300 PMCID: PMC11017776 DOI: 10.1093/fampra/cmad106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Despite regular consultation between adolescents/young adults (AYA) and their physicians, they are not regularly screened for psychosocial risk behaviours. This study examines physicians' self-reported psychosocial risk behaviour screening in AYA. It aims to highlight which elements hinder or improve screening abilities. METHODOLOGY The design was a cross-sectional quantitative survey. Data were obtained through a self-reported questionnaire sent out to primary care physicians (PCP) in Switzerland in 2018. The target population consisted of 1,824 PCP (29% response rate). Participants were asked whether they screened youths from 3 age groups [10-14 y/o, 15-20 y/o, and 21-25y/o] for the HEEADSSS items during child well visits and routine checkups. Barriers to screening included primary consultation motive prioritization, insufficient time, patient compliance, reimbursement, lack of skills related to adolescent health, lack of referral options. Data were analysed first through a bivariate analysis using Chi-square tests then through a multinomial logistic regression. RESULTS The majority of physicians partook in preventive screening for 3-5 psychosocial risk elements. They reported the primary consultation motive as well as a lack of available time as having a high impact on their screening habits. Physician's experience and having discussed confidentiality were related to an increase in the number of topics addressed. Confidentiality remained a significant variable throughout all analyses. CONCLUSION Barriers such as lack of consultation time and prioritization issues were found by physicians to be critical but did not hinder screening habits. The main element impacting screening habits was assuring confidentiality and the second is self-efficacy.
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Affiliation(s)
- Taslina Eisner-Fellay
- Research Group on Adolescent Health, Department of Epidemiology and Health Services, Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Joan-Carles Suris
- Research Group on Adolescent Health, Department of Epidemiology and Health Services, Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Yara Barrense-Dias
- Research Group on Adolescent Health, Department of Epidemiology and Health Services, Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
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Ammerman RT, Rybak TM, Herbst RB, Mara CA, Zion C, Patel MA, Burstein E, Lauer BA, Fiat AE, Jordan P, Burkhardt MC, McClure JM, Stark LJ. Integrated Behavioral Health Prevention for Infants in Pediatric Primary Care: A Mixed-Methods Pilot Study. J Pediatr Psychol 2024; 49:298-308. [PMID: 38204356 PMCID: PMC11018362 DOI: 10.1093/jpepsy/jsad098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 12/19/2023] [Accepted: 12/27/2023] [Indexed: 01/12/2024] Open
Abstract
OBJECTIVE Pediatric primary care is a promising setting in which to deliver preventive behavioral health services to young children and their families. Integrated behavioral health care models typically emphasize treatment rather than prevention. This pilot study examined the efficacy of an integrated behavioral health preventive (IBH-P) intervention delivered by psychologists and focused on supporting parenting in low-income mothers of infants as part of well-child visits in the first 6 months of life. METHODS Using a mixed-methods approach that included a pilot randomized clinical trial and post-intervention qualitative interviews, 137 mothers were randomly assigned to receive IBH-P or usual care. Self-report measures of parenting, child behavior, and stress were obtained at pre- and/or post-intervention. Direct observation of mother-infant interactions was conducted at post-intervention. RESULTS No differences between groups were found on maternal attunement, knowledge of child development, nurturing parenting, or infant behavior. A secondary analysis on a subsample with no prior exposure to IBH-P with older siblings found that mothers in IBH-P reported increased self-efficacy relative to controls. In the qualitative interviews, mothers stated that they valued IBH-P, learning about their baby, liked the integration in primary care, and felt respected and comfortable with their provider. CONCLUSIONS Findings are discussed in terms of the next steps in refining IBH-P approaches to prevention in primary care.
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Affiliation(s)
- Robert T Ammerman
- Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States
| | - Tiffany M Rybak
- Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States
| | - Rachel B Herbst
- Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States
| | - Constance A Mara
- Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States
| | - Cynthia Zion
- Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States
| | - Meera A Patel
- Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States
| | - Emma Burstein
- Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States
| | - Brea A Lauer
- Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States
| | - Aria E Fiat
- Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States
| | - Phoebe Jordan
- Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States
| | - Mary Carol Burkhardt
- Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States
| | - Jessica M McClure
- Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States
| | - Lori J Stark
- Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States
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Hebard S, Weaver G, Hansen WB, Ruppert S. Evaluation of a Pilot Program to Prevent the Misuse of Prescribed Opioids Among Health Care Workers: Repeated Measures Survey Study. JMIR Form Res 2024; 8:e53665. [PMID: 38607664 DOI: 10.2196/53665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 02/13/2024] [Accepted: 03/13/2024] [Indexed: 04/13/2024] Open
Abstract
BACKGROUND Overprescription of opioids has led to increased misuse of opioids, resulting in higher rates of overdose. The workplace can play a vital role in an individual's intentions to misuse prescription opioids with injured workers being prescribed opioids, at a rate 3 times the national average. For example, health care workers are at risk for injuries, opioid dispensing, and diversion. Intervening within a context that may contribute to risks for opioid misuse while targeting individual psychosocial factors may be a useful complement to interventions at policy and prescribing levels. OBJECTIVE This pilot study assessed the effects of a mobile-friendly opioid misuse intervention prototype tailored for health care workers using the preparation phase of a multiphase optimization strategy design. METHODS A total of 33 health care practitioners participated in the pilot intervention, which included 10 brief web-based lessons aimed at impacting psychosocial measures that underlie opioid misuse. The lesson topics included: addiction beliefs, addiction control, Centers for Disease Control and Prevention guidelines and recommendations, beliefs about patient-provider relationships and communication, control in communicating with providers, beliefs about self-monitoring pain and side effects, control in self-monitoring pain and side effects, diversion and disposal beliefs, diversion and disposal control, and a conclusion lesson. Using a treatment-only design, pretest and posttest surveys were collected. A general linear repeated measures ANOVA was used to assess mean differences from pretest to posttest. Descriptive statistics were used to assess participant feedback about the intervention. RESULTS After completing the intervention, participants showed significant mean changes with increases in knowledge of opioids (+0.459; P<.001), less favorable attitudes toward opioids (-1.081; P=.001), more positive beliefs about communication with providers (+0.205; P=.01), more positive beliefs about pain management control (+0.969; P<.001), and increased intentions to avoid opioid use (+0.212; P=.03). Of the 33 practitioners who completed the program, most felt positive about the information presented, and almost 70% (23/33) agreed or strongly agreed that other workers in the industry should complete a program like this. CONCLUSIONS While attempts to address the opioid crisis have been made through public health policies and prescribing initiatives, opioid misuse continues to rise. Certain industries place workers at greater risk for injury and opioid dispensing, making interventions that target workers in these industries of particular importance. Results from this pilot study show positive impacts on knowledge, attitudes, and beliefs about communicating with providers and pain management control, as well as intentions to avoid opioid misuse. However, the dropout rate and small sample size are severe limitations, and the results lack generalizability. Results will be used to inform program revisions and future optimization trials, with the intention of providing insight for future intervention development and evaluation of mobile-friendly eHealth interventions for employees.
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Affiliation(s)
| | - GracieLee Weaver
- Department of Public Health Education, University of North Carolina Greensboro, Greensboro, NC, United States
| | | | - Scarlett Ruppert
- Department of Public Health Education, University of North Carolina Greensboro, Greensboro, NC, United States
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Hou X, Wang J, Kang Z, Yang Y, Yao X, Zhang F, Yao J, Yu J, Liu X, Liang F, Yu X, Song M. Pseudomyopia treated with auricular point sticking combined with periocular needle-embedding therapy and prevention of true myopia: a multicenter randomized controlled trial. Zhongguo Zhen Jiu 2024; 44:405-410. [PMID: 38621727 DOI: 10.13703/j.0255-2930.20231122-0004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
Abstract
OBJECTIVES To observe the clinical effect and safety of auricular point sticking combined with periocular needle-embedding therapy for pseudomyopia and prevention of true myopia. METHODS A total of 269 children with pseudomyopia were randomized into an observation group (134 cases, 2 cases dropped out) and a control group (135 cases, 5 cases dropped out). In the control group, the healthy education was provided. In the observation group, besides the intervention as the control group, the auricular point sticking was delivered at gan (CO12), pi (CO13), xin (CO15) and yan (LO5) on one ear in each treatment, combined with periocular needle-embedding technique at bilateral Cuanzhu (BL 2), Yuyao (EX-HN 4) and Sibai (ST 2). There were 2 weeks of interval after 4 weeks of treatment. One course of treatment was composed of 6 weeks and 2 courses were required. Separately, before treatment, after 6 and 12 weeks of treatment, and after 12 weeks (the 1st follow-up visit) and 24 weeks (the 2nd follow-up visit) of treatment completion, the spherical equivalent (SE), SE progression, axial length (AL) progression, accommodative amplitude (AMP), the score of the TCM symptom and the general symptom were observed in the two groups. The safety and compliance were evaluated in the two groups. RESULTS After 6 and 12 weeks of treatment, and in the 1st and 2nd follow-up visits, SE increased when compared with that before treatment in the two groups (P<0.05), and AMP was larger than that before treatment in the observation group (P<0.05). After 12 weeks of treatment, and in the 1st and 2nd follow-up visits, the progression of SE was slower in the observation group compared with that in the control group (P<0.01, P<0.001). After 6 and 12 weeks of treatment, and in the 1st and 2nd follow-up visits, the progression of AL in the observation group was lower than that of the control group (P<0.05, P<0.01, P<0.001); and in the 1st and 2nd follow-up visits, AMP of the observation group was larger when compared with that in the control group (P<0.05, P<0.001). After 6 and 12 weeks of treatment, and in the 1st and 2nd follow-up visits, the total scores of TCM symptom and general symptom were reduced in comparison with those before treatment in the observation group (P<0.05); after 6 and 12 weeks of treatment, the total scores of TCM symptom and general symptom were lower than those before treatment in the control group (P<0.05). In the 1st and 2nd follow-up visits, the difference of the total score of TCM symptom and general symptom in the observation group was larger than that of the control group (P<0.05). In the observation group, compared with the control group, the scores for pale/dark complexion in the 1st and 2nd follow-up visits and that for lassitude in the 2nd follow-up visit were lower (P<0.05), the score for poor concentration after 12 weeks of treatment and that for poor sleep and memory in the 2nd follow-up visit were lower (P<0.05). There were no adverse reactions in the two groups. The compliance was 98.5% in the observation group and was 96.3% in the control group, without statistical difference (P>0.05). CONCLUSIONS On the basis of health education, auricular point sticking combined with periocular needle-embedding therapy can effectively prevent from true myopia, control the increase of SE, delay the growth of AL and improve AMP in children with pseudomyopia. This compound therapeutic regimen can relieve the general symptom and comprehensively prevent from myopia through multiple approaches, with high safety and satisfactory compliance.
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Affiliation(s)
- Xinyue Hou
- Eye Hospital, China Academy of Chinese Medical Sciences, Beijing 100040, China
- China Academy of Chinese Medical Sciences, Beijing 100040
| | - Jianquan Wang
- Eye Hospital, China Academy of Chinese Medical Sciences, Beijing 100040, China
| | - Zefeng Kang
- Eye Hospital, China Academy of Chinese Medical Sciences, Beijing 100040, China.
| | - Yingxin Yang
- Beijing Hospital of TCM, Capital Medical University
| | | | | | - Jing Yao
- First Affiliated Hospital of Heilongjiang University of CM
| | - Jingsheng Yu
- First Affiliated Hospital of Hunan University of CM
| | - Xinquan Liu
- Longhua Hospital Affiliated to Shanghai University of TCM
| | | | - Xiaoyi Yu
- First Affiliated Hospital of Guangzhou University of CM
| | - Man Song
- Fuzhou TCM Hospital Affiliated to Fujian University of TCM
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Vanbaelen T, De Baetselier I, Manoharan-Basil SS, Kenyon C. Oral streptococcal susceptibility to azithromycin may be associated with doxycycline use: A post-hoc analysis with implications for doxycycline post exposure prophylaxis. Int J STD AIDS 2024:9564624241246301. [PMID: 38607607 DOI: 10.1177/09564624241246301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
OBJECTIVE Tetracycline and macrolide resistance are frequently linked in streptococci and other species. We aimed to assess the association between doxycycline use and azithromycin MICs in oral streptococci. METHODS Linear regression was used to assess the association between doxycycline use in the prior year and the median MIC per participant of oral streptococcal colonies isolated at the baseline visit of the ResistAZM study. The analysis controlled for receipt of other antimicrobials as well as time since antimicrobial consumption. RESULTS Fifty-six individual colonies confirmed to be streptococci were isolated from 19 individuals at baseline. The azithromycin MICs of these isolates varied considerably between 0.25 mg/L and >256 mg/L (median 28 mg/L; IQR 1-192 mg/L). The consumption of doxycycline in the preceding 12 months was positively associated with median streptococcal azithromycin MIC (coef. 151.6 [95% CI 10.6-292.7]; p = .037). CONCLUSION This post-hoc analysis found that doxycycline use was associated with streptococcal azithromycin susceptibility. Numerous limitations of the study design mean that this study is best considered hypothesis generating. Prospective studies are required to assess if the use of doxycycline could select for macrolide resistance in oral streptococci.
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Affiliation(s)
- Thibaut Vanbaelen
- STI Unit, Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Irith De Baetselier
- Clinical Reference Laboratory, Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | | | - Chris Kenyon
- STI Unit, Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
- Division of Infectious Diseases and HIV Medicine, University of Cape Town, Cape Town, South Africa
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Salmons HI, Carstens MF, Limberg AK, Bettencourt JW, Payne AN, Karczewski DC, Ryan ZT, Morrey ME, Sanchez-Sotelo J, Berry DJ, Dudakovic A, Abdel MP. Efficacy of ADIPOR1 and ADIPOR2 peptide-agonist AdipoRon in preventing contracture in a rabbit model of arthrofibrosis. J Orthop Res 2024. [PMID: 38605593 DOI: 10.1002/jor.25853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 03/19/2024] [Accepted: 04/01/2024] [Indexed: 04/13/2024]
Abstract
AdipoRon is an adiponectin receptor 1, 2 (ADIPOR1 and ADIPOR2) agonist with potential antifibrotic effects. Whether AdipoRon can mitigate joint stiffness in a rabbit model of arthrofibrosis is unknown. We examined the efficacy of intravenous (IV) AdipoRon at mitigating contracture in a rabbit model of knee arthrofibrosis. Fifty-six female New Zealand White rabbits were divided into three dosing groups: vehicle (dimethyl sulfoxide, DMSO), 2.5 mg/kg AdipoRon, and 5 mg/kg AdipoRon. AdipoRon, in DMSO, was administered IV preoperatively and for 5 days postoperatively (30 rabbits, Aim 1). AdipoRon was again dosed similarly after Kirschner wire (K-wire) removal at 8 weeks (26 rabbits; Aim 2). The primary outcome of joint passive extension angle (PEA,°) was measured at 8, 10, 12, 16, and 24 weeks following index surgery. At 24 weeks, rabbits were euthanized and limbs were harvested to measure posterior capsular stiffness (N cm/°). In Aim 1, the 5 mg/kg treated rabbits had a significant increase in PEA when compared to controls at 16-week (p < 0.05). In Aim 2, the 5 mg/kg treated rabbits had a significant increase in PEA when compared to controls at 10-week (p < 0.05). In both aims, no significant differences were observed at later time points. Capsular stiffness was no different in any group. We are the first to report the efficacy of IV AdipoRon in a rabbit model of arthrofibrosis. We identified a significant dose-dependent decrease in joint PEA at early time points; however, no differences were observed between groups at later time points. Clinical Significance: The present investigation provided the first assessment of AdipoRon's efficacy in mitigating knee stiffness in the current gold standard rabbit model of arthrofibrosis. Results of this investigation provided further evidence as to the potential role of AdipoRon as a preventative for arthrofibrosis in large mammals.
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Affiliation(s)
- Harold I Salmons
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Mason F Carstens
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Afton K Limberg
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | | | - Ashley N Payne
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | | | - Zachary T Ryan
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Mark E Morrey
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | | | - Daniel J Berry
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Amel Dudakovic
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Matthew P Abdel
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA
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Vallée A, Saridogan E, Petraglia F, Keckstein J, Polyzos N, Wyns C, Gianaroli L, Tarlatzis B, Ayoubi JM, Feki A. Horizons in Endometriosis: Proceedings of the Montreux Reproductive Summit, 14-15 July 2023. Facts Views Vis Obgyn 2024; 16:1-32. [PMID: 38603778 DOI: 10.52054/fvvo.16.s1.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2024] Open
Abstract
Endometriosis is a complex and chronic gynaecological disorder that affects millions of women worldwide, leading to significant morbidity and impacting reproductive health. This condition affects up to 10% of women of reproductive age and is characterised by the presence of endometrial-like tissue outside the uterus, potentially leading to symptoms such as chronic pelvic pain, dysmenorrhoea, dyspareunia, and infertility. The Montreux summit brought a number of experts in this field together to provide a platform for discussion and exchange of ideas. These proceedings summarise the six main topics that were discussed at this summit to shed light on future directions of endometriosis classification, diagnosis, and therapeutical management. The first question addressed the possibility of preventing endometriosis in the future by identifying risk factors, genetic predispositions, and further understanding of the pathophysiology of the condition to develop targeted interventions. The clinical presentation of endometriosis is varied, and the correlation between symptoms severity and disease extent is unclear. While there is currently no universally accepted optimal classification system for endometriosis, several attempts striving towards its optimisation - each with its own advantages and limitations - were discussed. The ideal classification should be able to reconcile disease status based on the various diagnostic tools, and prognosis to guide proper patient tailored management. Regarding diagnosis, we focused on future tools and critically discussed emerging approaches aimed at reducing diagnostic delay. Preserving fertility in endometriosis patients was another debatable aspect of management that was reviewed. Moreover, besides current treatment modalities, potential novel medical therapies that can target underlying mechanisms, provide effective symptom relief, and minimise side effects in endometriotic patients were considered, including hormonal therapies, immunomodulation, and regenerative medicine. Finally, the question of hormonal substitution therapy after radical treatment for endometriosis was debated, weighing the benefits of hormone replacement.
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Walton ZE, Frigault MJ, Maus MV. Current and emerging pharmacotherapies for cytokine release syndrome, neurotoxicity, and hemophagocytic lymphohistiocytosis-like syndrome due to CAR T cell therapy. Expert Opin Pharmacother 2024:1-17. [PMID: 38588525 DOI: 10.1080/14656566.2024.2340738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 03/01/2024] [Indexed: 04/10/2024]
Abstract
INTRODUCTION Chimeric antigen receptor (CAR) T cells have revolutionized the treatment of multiple hematologic malignancies. Engineered cellular therapies now offer similar hope to transform the management of solid tumors and autoimmune diseases. However, toxicities can be serious and often require hospitalization. AREAS COVERED We review the two chief toxicities of CAR T therapy, cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS), and the rarer immune effector cell-associated hemophagocytic lymphohistiocytosis-like syndrome. We discuss treatment paradigms and promising future pharmacologic strategies. Literature and therapies reviewed were identified by PubMed search, cited references therein, and review of registered trials. EXPERT OPINION Management of CRS and ICANS has improved, aided by consensus definitions and guidelines that facilitate recognition and timely intervention. Further data will define optimal timing of tocilizumab and corticosteroids, current foundations of management. Pathophysiologic understanding has inspired off-label use of IL-1 receptor antagonism, IFNγ and IL-6 neutralizing antibodies, and janus kinase inhibitors, with data emerging from ongoing clinical trials. Further strategies to reduce toxicities include novel pharmacologic targets and safety features engineered into CAR T cells themselves. As these potentially curative therapies are used earlier in oncologic therapy and even in non-oncologic indications, effective accessible strategies to manage toxicities are critical.
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Affiliation(s)
- Zandra E Walton
- Cellular Immunotherapy Program, Massachusetts General Hospital Cancer Center, Boston, MA, USA
- Division of Rheumatology, Massachusetts General Hospital, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Matthew J Frigault
- Cellular Immunotherapy Program, Massachusetts General Hospital Cancer Center, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Marcela V Maus
- Cellular Immunotherapy Program, Massachusetts General Hospital Cancer Center, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
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Berthelot N, Larouche K, Garon-Bissonnette J, Deschênes K, Drouin-Maziade C, Lemieux R. Spillover effects on the relationship with the partner of a mentalization-based intervention for pregnant women. Infant Ment Health J 2024. [PMID: 38598747 DOI: 10.1002/imhj.22113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 02/09/2024] [Accepted: 03/20/2024] [Indexed: 04/12/2024]
Abstract
The birth of a child has been associated with a decline in couple satisfaction, which has implications for the child's social-emotional development. This study investigated the potential spillover effect on pregnant women's perceptions of their relationships with their partners of the Supporting the Transition to and Engagement in Parenthood (STEP) program, a brief trauma-informed mentalization-based prenatal group intervention. Participants (94% White) were recruited in prenatal clinics and through online advertisements in Quebec, Canada. Both quantitative and qualitative data were collected from participants assigned to the STEP program (n = 42) and those receiving treatment-as-usual (TAU; n = 125). Women participating in STEP reported significant improvements in their relationships with their partners compared to those assigned to TAU. More precisely, they reported higher couple satisfaction, enhanced communication, and increased interest in their partners' emotional experience. The qualitative analysis further substantiated these results, with participants reporting having involved their partners in their pregnancy, shared their insights about themselves with their partners and gained fresh perspectives on their relationships. Participants in STEP also expressed sharing program materials with their partners and considered that such interventions should be extended to expecting fathers. This study underscores the potential of mentalization-based interventions to indirectly contribute to couple relationships, which may have positive implications for parenting and the infant.
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Affiliation(s)
- Nicolas Berthelot
- Department of Nursing Sciences, Université du Québec à Trois-Rivières, Trois-Rivieres, Quebec, Canada
- Centre d'études interdisciplinaires sur le développement de l'enfant et la famille, Trois-Rivieres, Quebec, Canada
- CERVO Brain Research Center, Quebec City, Quebec, Canada
- Interdisciplinary Research Center on Intimate Partner Relationship Problems and Sexual Abuse, Montreal, Quebec, Canada
- Groupe de recherche et d'intervention auprès de l'enfant vulnérable et négligé, Trois-Rivieres, Quebec, Canada
| | - Karl Larouche
- Department of Nursing Sciences, Université du Québec à Trois-Rivières, Trois-Rivieres, Quebec, Canada
- Centre d'études interdisciplinaires sur le développement de l'enfant et la famille, Trois-Rivieres, Quebec, Canada
- CERVO Brain Research Center, Quebec City, Quebec, Canada
- Interdisciplinary Research Center on Intimate Partner Relationship Problems and Sexual Abuse, Montreal, Quebec, Canada
- Groupe de recherche et d'intervention auprès de l'enfant vulnérable et négligé, Trois-Rivieres, Quebec, Canada
| | - Julia Garon-Bissonnette
- Department of Nursing Sciences, Université du Québec à Trois-Rivières, Trois-Rivieres, Quebec, Canada
- Centre d'études interdisciplinaires sur le développement de l'enfant et la famille, Trois-Rivieres, Quebec, Canada
- Interdisciplinary Research Center on Intimate Partner Relationship Problems and Sexual Abuse, Montreal, Quebec, Canada
- Groupe de recherche et d'intervention auprès de l'enfant vulnérable et négligé, Trois-Rivieres, Quebec, Canada
- Department of Psychology and Human Development, Vanderbilt University, Nashville, Tennessee, USA
| | - Kim Deschênes
- Centre d'études interdisciplinaires sur le développement de l'enfant et la famille, Trois-Rivieres, Quebec, Canada
- CERVO Brain Research Center, Quebec City, Quebec, Canada
- Interdisciplinary Research Center on Intimate Partner Relationship Problems and Sexual Abuse, Montreal, Quebec, Canada
- Groupe de recherche et d'intervention auprès de l'enfant vulnérable et négligé, Trois-Rivieres, Quebec, Canada
- Department of Psychology, Université du Québec à Trois-Rivières, Trois-Rivieres, Quebec, Canada
| | - Christine Drouin-Maziade
- Department of Nursing Sciences, Université du Québec à Trois-Rivières, Trois-Rivieres, Quebec, Canada
- Centre d'études interdisciplinaires sur le développement de l'enfant et la famille, Trois-Rivieres, Quebec, Canada
- Interdisciplinary Research Center on Intimate Partner Relationship Problems and Sexual Abuse, Montreal, Quebec, Canada
- Groupe de recherche et d'intervention auprès de l'enfant vulnérable et négligé, Trois-Rivieres, Quebec, Canada
| | - Roxanne Lemieux
- Department of Nursing Sciences, Université du Québec à Trois-Rivières, Trois-Rivieres, Quebec, Canada
- Centre d'études interdisciplinaires sur le développement de l'enfant et la famille, Trois-Rivieres, Quebec, Canada
- Groupe de recherche et d'intervention auprès de l'enfant vulnérable et négligé, Trois-Rivieres, Quebec, Canada
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Zhao C, Zhang T, Zhu Q, Chen Z, Ren H, Shrestha N, Meng L, Shen Y, Luo F. PROCESS Trial: Effect of Duloxetine Premedication for Postherpetic Neuralgia Within 72 Hours of Herpes Zoster Reactivation-A Randomized Controlled Trial. Clin Infect Dis 2024; 78:880-888. [PMID: 38015658 DOI: 10.1093/cid/ciad714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Revised: 11/10/2023] [Accepted: 11/19/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND Postherpetic neuralgia (PHN) is the most common chronic complication of herpes zoster (HZ) and results in severe refractory neuropathic pain. This study aimed at evaluating the efficacy of premedication with duloxetine in the prevention of PHN. METHODS The PROCESS trial is a multicenter, randomized, open-label, blinded-endpoint trial used a 1:1 duloxetine:control ratio. Adults 50 years or older with HZ who presented with vesicles within 72 hours were recruited. The primary outcome was the incidence of PHN at 12 weeks. PHN was defined as any pain intensity score other than 0 mm on the visual analog scale (VAS) at week 12 after the onset of the rash. The secondary outcomes were the number of participants with VAS >0 and VAS ≥3. The modified intention-to-treat (mITT) principle and per-protocol (PP) principle were used for the primary outcome analysis. RESULTS A total of 375 participants were randomly assigned to the duloxetine group and 375 were assigned to the control group. There was no significant difference in the incidence of PHN in the duloxetine group compared with the control group in the mITT analysis (86 [22.9%] of 375 vs 108 [28.8%] of 375; P = .067). PP analysis produced similar results. However, there were significant differences between the 2 groups in the number of participants with VAS >0 and VAS ≥3 (P < .05 for all comparisons). CONCLUSIONS Although absolute prevention of PHN does not occur, this trial found that premedication with duloxetine can reduce pain associated with HZ, and therefore can have clinically relevant benefits. Clinical Trials Registration. Clinicaltrials.gov, NCT04313335. Registered on 18 March 2020.
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Affiliation(s)
- Chunmei Zhao
- Department of Pain Management, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Tingjie Zhang
- Department of Pain Management, Peking University People's Hospital, Beijing, China
| | - Qian Zhu
- Department of Pain Management, China-Japan Friendships Hospital, Beijing, China
| | - Zheng Chen
- Emergency Department, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Hao Ren
- Department of Pain Management, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Niti Shrestha
- Department of Pain Management, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Lan Meng
- Department of Pain Management, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Ying Shen
- Department of Pain Management, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Fang Luo
- Department of Pain Management, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
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Maurin C, Atkinson S, Hamouche L, Bussières JF. Incidents et accidents médicamenteux en établissement de santé : une analyse descriptive au sein d’un CHU mère-enfant de 2018 à 2022. Can J Hosp Pharm 2024; 77:e3528. [PMID: 38601133 PMCID: PMC10984259 DOI: 10.4212/cjhp.3528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 10/11/2023] [Indexed: 04/12/2024]
Abstract
Background The safety of care provided is based on an analysis of medication incidents and accidents. Objective The primary objective was to describe medication-related incidents and accidents (I&A) within a university-affiliated hospital. Methods This retrospective descriptive study was based on data from a 500-bed mother-child university-affiliated hospital. All I&As declared between April 1, 2018, and March 31, 2022, were considered. The analysis included all medication-related I&As that occurred during an admission or in an outpatient setting. Some variables were recoded manually. Descriptive statistical analyses were performed. Results A total of 23 284 I&As were considered, including 7578 medication-related I&As. Daily averages of 15.9 ± 14.0 I&As and 5.2 ± 0.3 medication-related I&As were reported. There were 22.4 medication-related I&As/1000 inpatient days. The majority of medication-related I&As occurred in surgery (20%, 1530/7578), oncology (19%, 1405/7578), and pediatrics (16%, 1200/7578). Most were associated with incorrect dosing (21%, 1575/7578); infiltration, extravasation, or removed lines (19%, 1405/7578); and omissions (16%, 1205/7578). Physical consequences were reported in 15% (1158/7578) of the medication-related I&As. Conversely, psychological consequences were reported in less than 1% (44/7578) of medication-related I&As. Conclusions This study provides a comprehensive descriptive profile over a 4-year period. Most of the reported I&As did not lead to consequences for patients. The sharing of ratios promotes comparative analysis with other facilities and can contribute to discussions about risk reduction. A culture of reporting events is present within this health care facility.
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Affiliation(s)
- Charlotte Maurin
- , candidate au D. Pharm., est assistante de recherche à l'Unité de recherche en pratique pharmaceutique, département de pharmacie, CHU Sainte-Justine, Montréal (Québec)
| | - Suzanne Atkinson
- , B. Pharm., M. Sc., chef-adjointe aux services pharmaceutiques, unité de recherche en pratique pharmaceutique, département de pharmacie, CHU Sainte-Justine, Montréal (Québec)
| | - Linda Hamouche
- , B.S.N., M. Sc., conseillère, gestion des risques, direction de la qualité, évaluation, performance et éthique, CHU Sainte-Justine, Montréal (Québec)
| | - Jean-François Bussières
- , B. Pharm., M. Sc., M.B.A., F.C.S.H.P., F.O.P.Q., responsable, unité de recherche en pratique pharmaceutique, CHU Sainte-Justine; professeur titulaire de clinique, Faculté de pharmacie, Université de Montréal, Montréal (Québec)
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Carbone A, Ferrara F, Baliga RR, Bossone E. Imaging Follow-up of Non-Severe Aortic Stenosis: "When the winds of change blow, some people build walls and others build windmills". Eur J Prev Cardiol 2024:zwae138. [PMID: 38597142 DOI: 10.1093/eurjpc/zwae138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Revised: 04/05/2024] [Accepted: 04/09/2024] [Indexed: 04/11/2024]
Affiliation(s)
- Andreina Carbone
- Department of Public Health, University of Naples Federico II, Naples, Italy
- Unit of Cardiology, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Francesco Ferrara
- Cardio-Thoracic-Vascular Department, University Hospital of Salerno, Salerno, Italy
| | - Ragavendra R Baliga
- Division of Cardiovascular Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio, US
| | - Eduardo Bossone
- Department of Public Health, University of Naples Federico II, Naples, Italy
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Weber AN, Trebach J, Brenner MA, Thomas MM, Bormann NL. Managing Opioid Withdrawal Symptoms During the Fentanyl Crisis: A Review. Subst Abuse Rehabil 2024; 15:59-71. [PMID: 38623317 PMCID: PMC11016949 DOI: 10.2147/sar.s433358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 04/05/2024] [Indexed: 04/17/2024] Open
Abstract
Illicitly manufactured fentanyl (IMF) is a significant contributor to the increasing rates of overdose-related deaths. Its high potency and lipophilicity can complicate opioid withdrawal syndromes (OWS) and the subsequent management of opioid use disorder (OUD). This scoping review aimed to collate the current OWS management of study populations seeking treatment for OWS and/or OUD directly from an unregulated opioid supply, such as IMF. Therefore, the focus was on therapeutic interventions published between January 2010 and November 2023, overlapping with the period of increasing IMF exposure. A health science librarian conducted a systematic search on November 13, 2023. A total of 426 studies were screened, and 173 studies were reviewed at the full-text level. Forty-nine studies met the inclusion criteria. Buprenorphine and naltrexone were included in most studies with the goal of transitioning to a long-acting injectable version. Various augmenting agents were tested (buspirone, memantine, suvorexant, gabapentin, and pregabalin); however, the liberal use of adjunctive medication and shortened timelines to initiation had the most consistently positive results. Outside of FDA-approved medications for OUD, lofexidine, gabapentin, and suvorexant have limited evidence for augmenting opioid agonist initiation. Trials often have low retention rates, particularly when opioid agonist washout is required. Neurostimulation strategies were promising; however, they were developed and studied early. Precipitated withdrawal is a concern; however, the rates were low and adequately mitigated or managed with low- or high-dose buprenorphine induction. Maintenance treatment continues to be superior to detoxification without continued management. Shorter induction protocols allow patients to initiate evidence-based treatment more quickly, reducing the use of illicit or non-prescribed substances.
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Affiliation(s)
| | - Joshua Trebach
- Department of Emergency Medicine, University of Iowa, Iowa City, IA, USA
| | - Marielle A Brenner
- Department of Emergency Medicine, University of Iowa, Iowa City, IA, USA
| | | | - Nicholas L Bormann
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
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Chesdachai S, Esquer Garrigos Z, DeSimone CV, DeSimone DC, Baddour LM. Infective Endocarditis Involving Implanted Cardiac Electronic Devices: JACC Focus Seminar 1/4. J Am Coll Cardiol 2024; 83:1326-1337. [PMID: 38569763 DOI: 10.1016/j.jacc.2023.11.036] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 10/26/2023] [Accepted: 11/13/2023] [Indexed: 04/05/2024]
Abstract
Cardiac implantable electronic device-related infective endocarditis (CIED-IE) encompasses a range of clinical syndromes, including valvular, device lead, and bloodstream infections. However, accurately diagnosing CIED-IE remains challenging owing in part to diverse clinical presentations, lack of standardized definition, and variations in guideline recommendations. Furthermore, current diagnostic modalities, such as transesophageal echocardiography and [18F]-fluorodeoxyglucose positron emission tomography-computed tomography have limited sensitivity and specificity, further contributing to diagnostic uncertainty. This can potentially result in complications and unnecessary costs associated with inappropriate device extraction. Six hypothetical clinical cases that exemplify the diverse manifestations of CIED-IE are addressed herein. Through these cases, we highlight the importance of optimizing diagnostic accuracy and stewardship, understanding different pathogen-specific risks for bloodstream infections, guiding appropriate device extraction, and preventing CIED-IE, all while addressing key knowledge gaps. This review both informs clinicians and underscores crucial areas for future investigation, thereby shedding light on this complex and challenging syndrome.
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Affiliation(s)
- Supavit Chesdachai
- Division of Public Health, Infectious Diseases and Occupational Medicine, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA.
| | - Zerelda Esquer Garrigos
- Division of Public Health, Infectious Diseases and Occupational Medicine, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA; Division of Infectious Diseases, Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | | | - Daniel C DeSimone
- Division of Public Health, Infectious Diseases and Occupational Medicine, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Larry M Baddour
- Division of Public Health, Infectious Diseases and Occupational Medicine, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
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Che Q, Huo R, Zhao C, Yang W, Xiang X, Tang S, Shi J, Lu C, Li H. Real-world experience of Fuzheng Yiqing granule as chemoprophylaxis against COVID-19 infection among close contacts: A prospective cohort study. J Evid Based Med 2024. [PMID: 38591668 DOI: 10.1111/jebm.12591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 02/26/2024] [Indexed: 04/10/2024]
Abstract
BACKGROUND The objective of the current study was to evaluate whether the use of traditional Chinese medicine, Fuzheng Yiqing granule (FZYQG), was associated with a reduced infection risk of COVID-19 in close contacts. RESEARCH DESIGN AND METHODS This was a prospective cohort study across 203 quarantine centres for close contacts and secondary contacts of COVID-19 patients in Yangzhou city. FZYQG group was defined as quarantined individuals who voluntarily took FZYQG; control group did not take FZYQG. The primary outcome was the coronavirus test positive rate during quarantine period. Logistic regression with propensity score inverse probability weighting was used for adjusted analysis to evaluate independent association between FZYQG and test positive rate. RESULTS From July 13, 2021 to September 30, 2021, 3438 quarantined individuals took FZYQG and 2248 refused to take the granule. Test positive rate was significantly lower among quarantined individuals who took FZYQG (0.29% vs. 1.73%, risk ratio 0.17, 95% confidence interval (CI): 0.08-0.34, p < 0.001). On logistic regression, odds for test positive were decreased in FZYQG group (odds ratio: 0.16, 95% CI: 0.08-0.32, p < 0.001). CONCLUSIONS Close and secondary contacts of COVID-19 patients who received FZYQG had a lower test positive rate than control individuals in real-world experience. TRIAL REGISTRATION This study has been registered on Chinese Clinical Trial Registry (ChiCTR2100049590) on August 5, 2021.
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Affiliation(s)
- Qianzi Che
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Ruili Huo
- China Academy of Chinese Medical Sciences, Beijing, China
| | - Chen Zhao
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Wei Yang
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xinghua Xiang
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Shihuan Tang
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, China
| | - Jiaheng Shi
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Cheng Lu
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Hongmei Li
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, China
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48
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Baddour LM, Fuster V. Today's Infective Endocarditis: Not What You Learned in Medical School. J Am Coll Cardiol 2024; 83:1324-1325. [PMID: 38569762 DOI: 10.1016/j.jacc.2024.02.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/05/2024]
Affiliation(s)
- Larry M Baddour
- Division of Public Health, Infectious Diseases and Occupational Health, Department of Medicine, Mayo Clinic College of Medicine and Science, Mayo Clinic, Rochester, Minnesota, USA.
| | - Valentin Fuster
- Icahn School of Medicine at Mount Sinai, New York, New York, New York, USA; Centro Nacional de Investigaciones Cardiovasculares Carlos III, Madrid, Spain
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Kouidi E, Hanssen H, Anding-Rost K, Cupisti A, Deligiannis A, Grupp C, Koufaki P, Leeson P, Segura-Orti E, Van Craenenbroeck A, Van Craenenbroeck E, Clyne N, Martin H. The role of exercise training on cardiovascular risk factors and heart disease in patients with chronic kidney disease G3-G5 and G5D: A Clinical Consensus Statement of the European Association of Preventive Cardiology (EAPC) of the ESC and the European Association of Rehabilitation in Chronic Kidney Disease (EURORECKD). Eur J Prev Cardiol 2024:zwae130. [PMID: 38593202 DOI: 10.1093/eurjpc/zwae130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 03/23/2024] [Accepted: 04/05/2024] [Indexed: 04/11/2024]
Abstract
Cardiovascular (CV) morbidity and mortality is high in patients with chronic kidney disease (CKD). Most patients reveal a high prevalence of CV risk factors such as diabetes or arterial hypertension and many have manifest cardiovascular disease (CVD), such as coronary artery disease and chronic heart failure with an increased risk of clinical events including sudden cardiac death. Diabetes mellitus and hypertension contribute to the development of CKD and the prevalence of CKD is in the range of 20%-65% in diabetic and 30%-50% in hypertensive patients. Therefore, prevention and optimal treatment of CV risk factors and comorbidities are key strategies to reduce CV risk and improve survival in CKD. Beyond common CV risk factors, patients with CKD are often physically inactive and have low physical function leading to subsequent frailty with muscle fatigue and weakness, sarcopenia and increased risk of falling. Consequently, the economic health burden of CKD is high, requiring feasible strategies to counteract this vicious cycle. Regular physical activity and exercise training have been shown to be effective in improving risk factors, reducing CVD and reducing frailty and falls. Nonetheless, combining exercise training and a healthy lifestyle with pharmacological treatment is not frequently applied in clinical practice. For that reason, this Clinical Consensus Statement reviews the current literature and provides evidence-based data regarding the role of exercise training in reducing CV and overall burden in patients with CKD. The aim is to increase awareness among cardiologists, nephrologists, and health care professionals of the potential of exercise therapy in order to encourage implementation of exercise training in clinical practice, eventually reducing CV risk and disease, as well as reducing frailty in patients with CKD G3 to G5D.
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Affiliation(s)
- Evangelia Kouidi
- Sports Medicine Laboratory, Aristotle University of Thessaloniki, Aristotle University of Thessaloniki, DPESS, Thessaloniki, Greece
| | - Henner Hanssen
- Department of Sport, Exercise and Health, Sports and Exercise Medicine, Medical Faculty, University of Basel, Switzerland
| | | | - Adamasco Cupisti
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Asterios Deligiannis
- Sports Medicine Laboratory, Aristotle University of Thessaloniki, Aristotle University of Thessaloniki, DPESS, Thessaloniki, Greece
| | - Clemens Grupp
- Medizinische Klinik III mit Zentrum für Altersmedizin, Klinikum der Sozialstiftung Bamberg, Bamberg, Germany
| | - Pelagia Koufaki
- School of Health Sciences, Queen Margaret University, Edinburgh, UK
| | - Paul Leeson
- Oxford Cardiovascular Clinical Research Facility, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Eva Segura-Orti
- Department of Physiotherapy, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain
| | - Amaryllis Van Craenenbroeck
- Department of Nephrology, University Hospitals Leuven, Leuven, Belgium. Transplantation, KU Leuven, Leuven, Belgium
| | | | - Naomi Clyne
- Department of Nephrology, Clinical Sciences Lund, Skåne University Hospital and Lund University, Lund, Sweden
| | - Halle Martin
- Department of Preventive Sports Medicine and Sports Cardiology, University Hospital Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
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50
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Manti S, Galletta F, Bencivenga CL, Bettini I, Klain A, D'Addio E, Mori F, Licari A, Miraglia Del Giudice M, Indolfi C. Food Allergy Risk: A Comprehensive Review of Maternal Interventions for Food Allergy Prevention. Nutrients 2024; 16:1087. [PMID: 38613120 PMCID: PMC11013058 DOI: 10.3390/nu16071087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 04/05/2024] [Accepted: 04/07/2024] [Indexed: 04/14/2024] Open
Abstract
Food allergy represents a global health problem impacting patients' and caregivers' quality of life and contributing to increased healthcare costs. Efforts to identify preventive measures starting from pregnancy have recently intensified. This review aims to provide an overview of the role of maternal factors in food allergy prevention. Several studies indicate that avoiding food allergens during pregnancy does not reduce the risk of developing food allergies. International guidelines unanimously discourage avoidance diets due to potential adverse effects on essential nutrient intake and overall health for both women and children. Research on probiotics and prebiotics during pregnancy as preventive measures is promising, though evidence remains limited. Consequently, guidelines lack specific recommendations for their use in preventing food allergies. Similarly, given the absence of conclusive evidence, it is not possible to formulate definitive conclusions on the supplementation of vitamins, omega-3 fatty acids (n-3 PUFAs), and other antioxidant substances. A combination of maternal interventions, breastfeeding, and early introduction of foods to infants can reduce the risk of food allergies in the child. Further studies are needed to clarify the interaction between genetics, immunological pathways, and environmental factors.
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Affiliation(s)
- Sara Manti
- Pediatric Unit, Department of Human Pathology in Adult and Developmental Age 'Gaetano Barresi', University of Messina, 98124 Messina, Italy
| | - Francesca Galletta
- Pediatric Unit, Department of Human Pathology in Adult and Developmental Age 'Gaetano Barresi', University of Messina, 98124 Messina, Italy
| | - Chiara Lucia Bencivenga
- Department of Woman, Child and of General and Specialized Surgery, University of Campania 'Luigi Vanvitelli', 80138 Naples, Italy
| | - Irene Bettini
- Pediatric Unit, IRCCS Azienda Ospedaliera-Universitaria di Bologna, 40138 Bologna, Italy
| | - Angela Klain
- Department of Woman, Child and of General and Specialized Surgery, University of Campania 'Luigi Vanvitelli', 80138 Naples, Italy
| | - Elisabetta D'Addio
- Department of Woman, Child and of General and Specialized Surgery, University of Campania 'Luigi Vanvitelli', 80138 Naples, Italy
| | - Francesca Mori
- Allergy Unit, Meyer Children's Hospital, IRCCS, 50139 Florence, Italy
| | - Amelia Licari
- Department of Clinical, Surgical, Diagnostic, and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
- Pediatric Clinic, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
| | - Michele Miraglia Del Giudice
- Department of Woman, Child and of General and Specialized Surgery, University of Campania 'Luigi Vanvitelli', 80138 Naples, Italy
| | - Cristiana Indolfi
- Department of Woman, Child and of General and Specialized Surgery, University of Campania 'Luigi Vanvitelli', 80138 Naples, Italy
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