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International Journal of Molecular... Oct 2023Cystic Fibrosis is a chronic disease affecting multiple systems, including the GI tract. Clinical manifestation in patients can start as early as infancy and vary across... (Review)
Review
Cystic Fibrosis is a chronic disease affecting multiple systems, including the GI tract. Clinical manifestation in patients can start as early as infancy and vary across different age groups. With the advent of new, highly effective modulators, the life expectancy of PwCF has improved significantly. Various GI aspects of CF care, such as nutrition, are linked to an overall improvement in morbidity, lung function and the quality of life of PwCF. The variable clinical presentations and management of GI diseases in pediatrics and adults with CF should be recognized. Therefore, it is necessary to ensure efficient transfer of information between pediatric and adult providers for proper continuity of management and coordination of care at the time of transition. The transition of care is a challenging process for both patients and providers and currently there are no specific tools for GI providers to help ensure a smooth transition. In this review, we aim to highlight the crucial features of GI care at the time of transition and provide a checklist that can assist in ensuring an effective transition and ease the challenges associated with it.
Topics: Humans; Adult; Child; Cystic Fibrosis; Patient Transfer; Quality of Life; Gastroenterologists; Gastrointestinal Diseases
PubMed: 37958749
DOI: 10.3390/ijms242115766 -
Cognitive Neurodynamics Oct 2023Phrases-guessing is one of the essential reasoning abilities in problem solving for human beings. However, it is still an open question about why individuals perform...
Phrases-guessing is one of the essential reasoning abilities in problem solving for human beings. However, it is still an open question about why individuals perform differently during the same reasoning task. In this study, we utilized a bilingual phrase-guessing task to explore the neural activities under the individually different performances with electroencephalography. Participants who had no knowledge of Greek were required to guess the meaning of a Greek phrase (long or short in length) by making an either-or selection as to which translation-equivalent Chinese word corresponds to Greek word. Names of color were used as experimental stimuli for which two Chinese words denoted the same color with one as a conventional color name and the other as a novel color name. The experiment yielded length of phrases (long vs. short) and novelty of phrases (novel vs. conventional) as variables. The behavioral results revealed significant length-by-novelty interaction on the number of selections. However, neither main effects nor interactive effects were found on response time. Further, the amplitude spectrums of high alpha rhythm, low alpha rhythm, and low beta rhythm during the task were positively associated with the participants' number of selections for a long Greek phrase with a novel and complex Chinese phrase (LNc) and a short Greek phrase with a conventional Chinese phrase (SCo), while negatively correlated with the response time of selections for LNc and SCo. Our findings suggested that the consistency between participants' behavior and electrophysiological oscillations (alpha and beta bands) could be employed as biomarkers for decoding the phrase-guessing procedure.
PubMed: 37786656
DOI: 10.1007/s11571-022-09896-x -
Brain and Language Aug 2023We examined whether meanings automatically activate linguistic forms, and whether these forms affect semantic decisions. Participants were presented sequentially with...
We examined whether meanings automatically activate linguistic forms, and whether these forms affect semantic decisions. Participants were presented sequentially with pairs of pictures and decided whether the objects in the pictures were related. At no point did they name the pictures. The object names of the experimental stimuli were ambiguous either in orthography (homographs), phonology (homophones), or both (homonyms), or unambiguous. We show that the lexical characteristics of the name of the objects affect a semantic decision about real world relations, in an online measure (N400), in addition to offline behavioral measures. We show a dissociation between conceptual and lexical recognition, where an earlier component (N230), was affected by relatedness, but was not sensitive to the lexical characteristics. We interpret this as supporting the hypothesis that semantic recognition occurs before the automatic lexical activation of the object name, but that once linguistic representations are activated, they affect semantic integration.
Topics: Humans; Male; Female; Electroencephalography; Evoked Potentials; Semantics; Vocabulary; Linguistics
PubMed: 37437410
DOI: 10.1016/j.bandl.2023.105302 -
BMC Public Health Sep 2023Many Australians experience mental health challenges, but only a third access face-to-face psychological services, due to multiple barriers including long waitlists....
What consumers, general practitioners and mental health professionals want: the co-design and prototype testing of a transdiagnostic, acceptance and commitment therapy-based online intervention to reduce distress and promote wellbeing among Australian adults.
BACKGROUND
Many Australians experience mental health challenges, but only a third access face-to-face psychological services, due to multiple barriers including long waitlists. Additional strategies to prevent or help people de-escalate distress at an early stage are needed. Web-based mental health interventions are becoming increasingly acceptable to consumers and referring General Practitioners (GPs), but most are designed for specific disorders/populations. This study explores consumers' and health professionals' preferences and recommendations for the design of a transdiagnostic, Acceptance and Commitment Therapy (ACT)-based, online intervention for Australian adults.
METHODS
Thirty-five people (consumers, carers, GPs, mental health professionals) participated in one or more co-design stages. Stage 1: semi-structured interviews to establish what is wanted from such websites (n = 22). Stage 2: feedback emailed on branding options (n = 20). Stage 3: feedback provided via Zoom or an online survey after testing a website prototype (n = 19). Data were analysed using Thematic Framework Analysis and descriptive statistics.
RESULTS
Stage 1 highlighted nine key design principles (plus 25 subthemes) that participants emphasised as important to ensure the website would have broad appeal and meet their needs: (1) user choice is valued highly; (2) ACT-based content is acceptable as it is focused on helping people be proactive and 'get unstuck'; (3) non-pathologising, direct, empowering, lay language is endorsed; (4) a positive look and feel is appreciated; (5) images and videos are important to break up text and maintain engagement; (6) short text messages to aid engagement are valued; (7) provision of tailored psychoeducation for highly distressed and suicidal users is endorsed; (8) personal and proactive brand name is preferred (icanactnow); (9) diverse marketing and training activities are recommended. In Stage 2, icanactnow branding preferences were elicited (simplicity, colours to represent growth and a call to action). Stage 3 resulted in the inclusion of a safety plan template and a tailored entry portal for people referred to icanactnow by health professionals. High levels of satisfaction with the prototype were reported.
CONCLUSIONS
These findings informed icanactnow and provide insights for the development of other online mental health interventions, in ways that appeal to both consumers and professionals recommending them.
Topics: Humans; Adult; Acceptance and Commitment Therapy; General Practitioners; Internet-Based Intervention; Mental Health; Australia
PubMed: 37710234
DOI: 10.1186/s12889-023-16688-3 -
Journal of Speech, Language, and... Aug 2023Learning to read is a complex, multifaceted process that relies on several speech and language-related subskills. Individual differences in word reading outcomes are...
PURPOSE
Learning to read is a complex, multifaceted process that relies on several speech and language-related subskills. Individual differences in word reading outcomes are indicated among children with inaccurate speech sound productions, with some of these children developing later reading difficulties. There are inconsistent reports as to whether phonological deficits and/or weaknesses in oral language explain these subsequent reading difficulties. Thus, it remains unclear how variability in speech production accuracy in early childhood may impact reading development. Therefore, the present longitudinal study seeks to clarify the relation between speech sound production accuracy in kindergarten and subsequent reading outcomes with a focus on additional potential mediating factors.
METHOD
Speech accuracy, core preliteracy skills (phonological awareness, rapid naming, and letter-name knowledge), and additional potential mediators (phonological memory and oral language abilities) were characterized at the start of formal reading instruction. Word reading, decoding, reading fluency, and comprehension were assessed at the end of second grade. Mediation analyses were conducted to examine factors that mediate the relation between speech accuracy in kindergarten and subsequent reading outcomes.
RESULTS
Initial associations between early speech sound production accuracy and subsequent reading outcomes were indicated; however, mediation effects of preliteracy skills (phonological awareness and letter-name knowledge) were identified for word reading, decoding, and reading fluency outcomes. For reading comprehension, mediation effects of preliteracy and vocabulary skills were observed.
CONCLUSIONS
The relation between speech sound production accuracy and subsequent word reading, decoding, reading fluency, and comprehension was observed to be mediated by preliteracy skills, specifically phonological awareness and letter-name knowledge. For reading comprehension only, vocabulary knowledge were of additional importance.
SUPPLEMENTAL MATERIAL
https://doi.org/10.23641/asha.23671491.
Topics: Child; Child, Preschool; Humans; Phonetics; Reading; Longitudinal Studies; Speech; Vocabulary; Dyslexia
PubMed: 37473736
DOI: 10.1044/2023_JSLHR-22-00142 -
Journal of Medical Internet Research Jul 2023Social media is an important information source for a growing subset of the population and can likely be leveraged to provide insight into the evolving drug overdose...
BACKGROUND
Social media is an important information source for a growing subset of the population and can likely be leveraged to provide insight into the evolving drug overdose epidemic. Twitter can provide valuable insight into trends, colloquial information available to potential users, and how networks and interactivity might influence what people are exposed to and how they engage in communication around drug use.
OBJECTIVE
This exploratory study was designed to investigate the ways in which unsupervised machine learning analyses using natural language processing could identify coherent themes for tweets containing substance names.
METHODS
This study involved harnessing data from Twitter, including large-scale collection of brand name (N=262,607) and street name (N=204,068) prescription drug-related tweets and use of unsupervised machine learning analyses (ie, natural language processing) of collected data with data visualization to identify pertinent tweet themes. Latent Dirichlet allocation (LDA) with coherence score calculations was performed to compare brand (eg, OxyContin) and street (eg, oxys) name tweets.
RESULTS
We found people discussed drug use differently depending on whether a brand name or street name was used. Brand name categories often contained political talking points (eg, border, crime, and political handling of ongoing drug mitigation strategies). In contrast, categories containing street names occasionally referenced drug misuse, though multiple social uses for a term (eg, Sonata) muddled topic clarity.
CONCLUSIONS
Content in the brand name corpus reflected discussion about the drug itself and less often reflected personal use. However, content in the street name corpus was notably more diverse and resisted simple LDA categorization. We speculate this may reflect effective use of slang terminology to clandestinely discuss drug-related activity. If so, straightforward analyses of digital drug-related communication may be more difficult than previously assumed. This work has the potential to be used for surveillance and detection of harmful drug use information. It also might be used for appropriate education and dissemination of information to persons engaged in drug use content on Twitter.
Topics: Humans; Data Collection; Prescription Drugs; Social Media; Substance-Related Disorders; Unsupervised Machine Learning; Machine Learning; Data Mining; Natural Language Processing
PubMed: 37505795
DOI: 10.2196/48405 -
Academic Productivity Among Underrepresented Minority and Women Urologists at Academic Institutions.Urology Aug 2023To characterize academic productivity for underrepresented minorities (URMs) vs non-URMs and by gender in Urology.
OBJECTIVE
To characterize academic productivity for underrepresented minorities (URMs) vs non-URMs and by gender in Urology.
METHODS
A database was created from 145 Urology residency programs. URM status was determined by origin of name, photo, biography, Twitter, LinkedIn, and Doximity. A PubMed query was performed for publication output. URM status, gender, post-graduate year/years of practice, and Doximity residency rank were factors in multivariable analysis.
RESULTS
For residents, the median total publications was 2 [1,5] for URMs and 2 [1,5] for non-URMs (P=.54). The median first/last author publications was 1 [0,2] for URMs and 1 [0,2] for non-URMs (P=.79). The median total publications was 2 [0,4] for women and 2 [1,6] for men (P=.003). The median first/last author publications was 1 [0,2] for women and 1 [0,2] for men (P=.14). For faculty, the median total publications was 12 [3,32] for URMs and 19 [6,45] for non-URMs (P=.0002). The median first/last author publications was 4.5 [1,12] for URMs and 7 [2,20] for non-URM faculty (P=.0002). The median total publications was 11 [5,25] for women and 20 [6,49] for men (P<.0001). The median first/last author publications was 4 [1,11] for women and 8 [2,22] for men (P<.0001). On multivariable analysis, there was no difference in total publications and first/last author publications for URMs vs non-URMs. There remained a difference between genders for residents and faculty with total publications but not first/last author publications (P=.002/P=.10 residents, P=.004/P=.07 faculty).
CONCLUSION
Academic productivity was not different in URMs and non-URMs for both residents and faculty. Men residents and faculty had more total publications compared to women.
Topics: Humans; Male; Female; United States; Urologists; Minority Groups; Internship and Residency; Schools; Urology; Faculty, Medical
PubMed: 37149061
DOI: 10.1016/j.urology.2023.03.044 -
Health Physics Aug 2023The US Navy, including the US Marine Corps and Naval Nuclear Propulsion Program (NNPP), has a robust radiological protection and monitoring program meeting (and...
The US Navy, including the US Marine Corps and Naval Nuclear Propulsion Program (NNPP), has a robust radiological protection and monitoring program meeting (and typically exceeding, in the name of conservatism) federal law requirements. The program covers the variety of ways in which the Navy produces and uses ionizing radiation and radioactive sources: in medicine, nuclear ship propulsion and repair, industrial and aircraft radiography, and myriad other unique uses in carrying out its vital mission. In executing these programs, thousands of people across the world are employed as active-duty Sailors and Marines, government civilians, and government contractors. These workers include physicians, reactor operators, radiation safety officers, and nuclear repair workers, to name but a few. The health protection standards for these workers are promulgated in the publicly available Navy Medicine P-5055 Radiation Health Protection Manual (NAVMED P-5055), published February 2011 with Change 2 published December 2022, and are applicable to Navy and Marine Corps and NNPP radiation protection programs. The NAVMED P-5055 outlines the individual medical requirements for those qualified and able to receive exposure to ionizing radiation as part of their duties and requires that "Radiation workers receive focused medical examinations to establish whether or not cancer is present which would medically disqualify a person from receiving occupational radiation exposure." Additionally, without scientific or medical basis, the NAVMED P-5055 requires disqualifying those employees who have a history of cancer, cancer therapy, radiation therapy including radiopharmaceuticals received for therapeutic purposes, or bone marrow suppression from drawing dosimetry, entering radiation areas, or handling radioactive material. This policy, which exists regardless of lifetime occupational radiation dose or projected future radiation dose, applies to all cancers except adequately treated basal cell carcinoma. The policy is not supported by relevant scientific and medical literature; does not align with reasonable professional ethical standards; does not conform to US Navy radiological training, which stipulates the assumed increased risk of developing cancer from Navy and Marine Corps and NNPP occupational radiation exposure is small; and removes critical leadership and mentoring capability from the workforce unnecessarily. This article discusses in detail (1) this policy and its ramifications to the Navy and Marine Corps and NNPP workforce and (2) recommendations, benefits, and impacts for the Navy and Marine Corps and NNPP to remove this policy and still maintain a robust radiation protection program.
Topics: Humans; United States; Radiation Injuries; Military Personnel; Neoplasms; Radiation Protection; Occupational Exposure
PubMed: 37071047
DOI: 10.1097/HP.0000000000001695 -
American Journal of Surgery Oct 2023Prehospital interventions may increase the time to definitive care. Compared to ground ambulance, we hypothesize improved mortality for patients with isolated,... (Review)
Review
BACKGROUND
Prehospital interventions may increase the time to definitive care. Compared to ground ambulance, we hypothesize improved mortality for patients with isolated, penetrating torso injuries transported via private vehicle.
METHODS
We reviewed the National Trauma Data Bank (2017-2021) for adults with isolated, penetrating torso injuries stratified by mechanism (stabbing vs. firearm) and transport mode (private vehicle vs. ground ambulance). We performed a multivariable logistic regression to estimate the effect of transport mode on mortality.
RESULTS
48,444 patients met our inclusion criteria. Patients transported by ambulance, injured by stabbing (n = 26,633) and by firearm (n = 21,811) had adjusted odds ratios of 1.81 (95%CI 1.05-3.14, p = 0.03) and 1.66 (95%CI 1.32-2.09,p < 0.001) respectively for mortality compared to private vehicle transport.
CONCLUSION
Patients with penetrating torso injuries have nearly twice the odds of mortality when transported by ground ambulance than private vehicles, despite injury severity. The "scoop and run" strategy may confer a survival benefit in this population.
Topics: Adult; Humans; Trauma Centers; Wounds, Penetrating; Ambulances; Hospital Mortality; Firearms; Retrospective Studies; Emergency Medical Services; Injury Severity Score
PubMed: 37453802
DOI: 10.1016/j.amjsurg.2023.06.033 -
Medicine Oct 2023Cleft lip and/or palate is the most prevalent type of head and neck deformity, accounting for 65% of cases. The occurrence of this condition is influenced by both...
Cleft lip and/or palate is the most prevalent type of head and neck deformity, accounting for 65% of cases. The occurrence of this condition is influenced by both genetic and environmental factors. Cleft defects are classified into 2 types: syndromic cleft lip and palate syndrome and non-syndromic cleft lip and palate syndrome. Cleft lip with or without cleft palate is the most common type of cleft defect, and the surgical repair is the primary treatment option for patients. Our study was a retrospective case-control study that included 132 cases of patients with cleft defects and 132 healthy babies without cleft defects serving as controls. Personal information, including the name, age, and origin of the participants, was collected. Additionally, we collected information on all potential risk factors, including medical history, daily habits, consanguinity between parents, and family history. Information was collected in Excel and analyzed using the Statistical Package for Social Sciences and a Chi-Square test was performed to determine the results and their relationship to cleft lip and palate. Our study identified various risk factors that have a significant association with cleft lip and palate with a P-value <5% in addition to factors that are not considered risk factors. Using relative risk analysis, we were able to rank the top 5 most significant and influential risk factors. The most impactful factor was not taking folic acid during pregnancy. The primary risk factors associated with cleft lip and palate include a family history of the condition, lack of folic acid supplementation, maternal age over 35 years, and high temperatures exceeding 39 °C. Consequently, we recommend that mothers who intend to conceive should take folic acid supplements at a dose of 0.4 to 0.8 mg during the initial trimester of pregnancy. Additionally, we advise careful monitoring of all risk factors, particularly during the first trimester of pregnancy.
Topics: Infant; Pregnancy; Female; Humans; Adult; Cleft Lip; Cleft Palate; Case-Control Studies; Retrospective Studies; Risk Factors; Folic Acid; Otolaryngology
PubMed: 37861535
DOI: 10.1097/MD.0000000000034419