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Cancer Medicine Jul 2024Healthy cancer survivorship involves patients' active engagement with preventative health behaviors and follow-up care. While clinicians and patients have typically held...
A qualitative study of stakeholders' experiences with and acceptability of a technology-supported health coaching intervention (SHARE-S) delivered in coordination with cancer survivorship care.
PURPOSE
Healthy cancer survivorship involves patients' active engagement with preventative health behaviors and follow-up care. While clinicians and patients have typically held dual responsibility for activating these behaviors, transitioning some clinician effort to technology and health coaches may enhance guideline implementation. This paper reports on the acceptability of the Shared Healthcare Actions & Reflections Electronic systems in survivorship (SHARE-S) program, an entirely virtual multicomponent intervention incorporating e-referrals, remotely-delivered health coaching, and automated text messages to enhance patient self-management and promote healthy survivorship.
METHODS
SHARE-S was evaluated in single group hybrid implementation-effectiveness pilot study. Patients were e-referred from the clinical team to health coaches for three health self-management coaching calls and received text messages to enhance coaching. Semi-structured qualitative interviews were conducted with 21 patient participants, 2 referring clinicians, and 2 health coaches to determine intervention acceptability (attitudes, appropriateness, suitability, convenience, and perceived effectiveness) and to identify important elements of the program and potential mechanisms of action to guide future implementation.
RESULTS
SHARE-S was described as impactful and convenient. The nondirective, patient-centered health coaching and mindfulness exercises were deemed most acceptable; text messages were less acceptable. Stakeholders suggested increased flexibility in format, frequency, timing, and length of participation, and additional tailored educational materials. Patients reported tangible health behavior changes, improved mood, and increased accountability and self-efficacy.
CONCLUSIONS
SHARE-S is overall an acceptable and potentially effective intervention that may enhance survivors' self-management and well-being. Alterations to tailored content, timing, and dose should be tested to determine impact on acceptability and outcomes.
Topics: Humans; Female; Male; Middle Aged; Qualitative Research; Cancer Survivors; Mentoring; Aged; Pilot Projects; Survivorship; Adult; Neoplasms; Self-Management; Text Messaging; Patient Acceptance of Health Care; Health Behavior; Telemedicine
PubMed: 38956976
DOI: 10.1002/cam4.7441 -
Lower Urinary Tract Symptoms Jul 2024This study aimed to evaluate the efficacy and safety of Vibegron for the treatment of residual overactive bladder (OAB) symptoms after laser vaporization of the prostate... (Randomized Controlled Trial)
Randomized Controlled Trial
Efficacy and safety of Vibegron for the treatment of residual overactive bladder symptoms after laser vaporization of the prostate: A single-center prospective randomized controlled trial (VAPOR TRIAL).
OBJECTIVES
This study aimed to evaluate the efficacy and safety of Vibegron for the treatment of residual overactive bladder (OAB) symptoms after laser vaporization of the prostate (photo-selective vaporization of the prostate, contact laser vaporization of the prostate, and thulium laser vaporization).
METHODS
This randomized, open-label, parallel-group, single-center superiority trial with a 12-week observation (jRCTs071190040) enrolled male patients with OAB aged 40 years or older who had undergone laser vaporization of the prostate for not less than 12 weeks and not more than 1 year earlier. Patients were allocated to receive Vibegron 50 mg once daily or follow-up without treatment for 12 weeks.
RESULTS
Forty-seven patients were enrolled between January 2020 and March 2023. The median age (interquartile range) was 75.5 (72.5-78.5) years for the Vibegron group and 76.5 (71.0-81.0) years for the control group. The intergroup difference in the mean change (95% confidence interval) in the 24-hour urinary frequency at 12 weeks after randomization was -3.66 (-4.99, -2.33), with a significant decrease for the Vibegron group. The Overactive Bladder Symptom Score, International Prostate Symptom Score, IPSS storage score, and Overactive Bladder Questionnaire score significantly improved for the Vibegron group. Voided volume per micturition also increased for the Vibegron group.
CONCLUSIONS
The administration of 50 mg of Vibegron once daily for 12 weeks showed significant improvement compared with follow-up without treatment in bladder storage (OAB) symptoms after laser vaporization of the prostate for symptomatic benign prostatic hyperplasia.
Topics: Humans; Male; Aged; Urinary Bladder, Overactive; Prospective Studies; Laser Therapy; Prostatic Hyperplasia; Treatment Outcome; Aged, 80 and over; Pyrimidinones; Pyrrolidines
PubMed: 38956950
DOI: 10.1111/luts.12529 -
Early Intervention in Psychiatry Jul 2024Research has indicated a rise in the prevalence of depression and anxiety among adolescents over the past three decades. However, the factors underpinning increases in...
AIM
Research has indicated a rise in the prevalence of depression and anxiety among adolescents over the past three decades. However, the factors underpinning increases in mental health difficulties remain poorly understood. This study examines psychological, social and environmental risk and protective factors that may explain changes in depression and anxiety among adolescents.
METHODS
Data were taken from two nationally representative My World Surveys of adolescents aged 12-19 years in 2012 (N = 5,490) and 2019 (N = 9,844). Survey data on depression and anxiety and a range of potential risk (e.g., alcohol use, psychotic symptoms) and protective factors (e.g., resilience, self-esteem) were assessed at both time points. Multiple group analyses assessed whether the predictive ability of risk/protective factors changed from wave 1 to wave 2.
RESULTS
Results showed that the prevalence of depression and anxiety increased significantly between 2012 and 2019, particularly among females. Predictors accounted for between 37% and 61% of the variance in outcomes across waves. While some risk/protective factors were consistent predictors of depression and anxiety at both waves (e.g., bullying, discrimination, optimism), reporting female gender and having higher formal help-seeking tendencies more strongly predicted anxiety at wave 2, while lower self-esteem and lower resilience (personal competence) strongly predicted both depression and anxiety at wave 2.
CONCLUSION
Findings highlight the need to prioritize adolescent mental health service provision, especially in females. Self-esteem and resilience are potentially important targets for supporting adolescent mental health. Further research is required to understand the causal factors associated with increases in anxiety and depression.
PubMed: 38956877
DOI: 10.1111/eip.13562 -
The Journal of Contemporary Dental... Apr 2024The purpose of this study was to evaluate the mandibular growth and/or projection following maxillary incisor proclination, overbite correction, and maxillary...
AIM
The purpose of this study was to evaluate the mandibular growth and/or projection following maxillary incisor proclination, overbite correction, and maxillary dentoalveolar expansion without the use of any class II mechanics, in growing class II division 2 patients treated with clear aligners.
MATERIALS AND METHODS
Before and after treatment cone-beam computed tomographic (CBCT) generated lateral and posteroanterior cephalograms of thirty-two patients with skeletal class II division 2, 16 in the treatment group and 16 in the untreated group, were reviewed to evaluate treatment-related changes. Upper incisors were proclined and protruded, as well as upper arch expansion and overbite correction were performed as part of their regular treatment. Cephalometric analysis was performed to evaluate skeletal and dental changes. Unpaired statistical -tests were performed to determine if significant skeletal class II correction was achieved in the treatment group.
RESULTS
In the treatment group, after treatment, the upper incisors became more proclined and protruded, and the inter-molar width increased while the overbite was reduced compared to the control group. An increase in skeletal mandibular growth and forward projection was also observed, thus contributing to an improvement of the sagittal skeletal relationship as evidenced by ANB and Wits values compared to the control group.
CONCLUSION
A combination of upper incisor proclination, correction of deep overbite, and maxillary dentoalveolar expansion using clear aligners appears to contribute to an improvement of the skeletal class II relationship in growing patients with class II division 2.
CLINICAL SIGNIFICANCE
This study shows that unlocking the mandible by correcting a deep overbite, proclining upper incisors, and expanding the upper arch in growing class II division 2 patients can improve skeletal class II using clear aligners. How to cite this article: Mirzasoleiman P, El-Bialy T, Wiltshire WA, Evaluation of Mandibular Projection in Class II Division 2 Subjects Following Orthodontic Treatment Using Clear Aligners. J Contemp Dent Pract 2024;25(4):295-302.
Topics: Humans; Malocclusion, Angle Class II; Mandible; Cephalometry; Cone-Beam Computed Tomography; Female; Male; Adolescent; Child; Incisor; Overbite; Orthodontics, Corrective
PubMed: 38956842
DOI: 10.5005/jp-journals-10024-3664 -
Brain and Behavior Jul 2024Mild cognitive impairment (MCI) can be the prodromal phase of Alzheimer's disease (AD) where appropriate intervention might prevent or delay conversion to AD. Given...
PURPOSE
Mild cognitive impairment (MCI) can be the prodromal phase of Alzheimer's disease (AD) where appropriate intervention might prevent or delay conversion to AD. Given this, there has been increasing interest in using magnetic resonance imaging (MRI) and neuropsychological testing to predict conversion from MCI to AD. Recent evidence suggests that the choroid plexus (ChP), neural substrates implicated in brain clearance, undergo volumetric changes in MCI and AD. Whether the ChP is involved in memory changes observed in MCI and can be used to predict conversion from MCI to AD has not been explored.
METHOD
The current study used data from the Alzheimer's Disease Neuroimaging Initiative (ADNI) database to investigate whether later progression from MCI to AD (progressive MCI [pMCI], n = 115) or stable MCI (sMCI, n = 338) was associated with memory scores using the Rey Auditory Verbal Learning Test (RAVLT) and ChP volumes as calculated from MRI. Classification analyses identifying pMCI or sMCI group membership were performed to compare the predictive ability of the RAVLT and ChP volumes.
FINDING
The results indicated a significant difference between pMCI and sMCI groups for right ChP volume, with the pMCI group showing significantly larger right ChP volume (p = .01, 95% confidence interval [-.116, -.015]). A significant linear relationship between the RAVLT scores and right ChP volume was found across all participants, but not for the two groups separately. Classification analyses showed that a combination of left ChP volume and auditory verbal learning scores resulted in the most accurate classification performance, with group membership accurately predicted for 72% of the testing data.
CONCLUSION
These results suggest that volumetric ChP changes appear to occur before the onset of AD and might provide value in predicting conversion from MCI to AD.
Topics: Humans; Alzheimer Disease; Cognitive Dysfunction; Male; Female; Aged; Magnetic Resonance Imaging; Disease Progression; Verbal Learning; Choroid Plexus; Aged, 80 and over; Neuropsychological Tests
PubMed: 38956818
DOI: 10.1002/brb3.3611 -
Brain and Behavior Jul 2024Stroke damage to the primary visual cortex induces large, homonymous visual field defects that impair daily living. Here, we asked if vision-related quality of life... (Meta-Analysis)
Meta-Analysis
BACKGROUND/OBJECTIVES
Stroke damage to the primary visual cortex induces large, homonymous visual field defects that impair daily living. Here, we asked if vision-related quality of life (VR-QoL) is impacted by time since stroke.
SUBJECTS/METHODS
We conducted a retrospective meta-analysis of 95 occipital stroke patients (female/male = 26/69, 27-78 years old, 0.5-373.5 months poststroke) in whom VR-QoL was estimated using the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ) and its 10-item neuro-ophthalmic supplement (Neuro10). Visual deficit severity was represented by the perimetric mean deviation (PMD) calculated from 24-2 Humphrey visual fields. Data were compared with published cohorts of visually intact controls. The relationship between VR-QoL and time poststroke was assessed across participants, adjusting for deficit severity and age with a multiple linear regression analysis.
RESULTS
Occipital stroke patients had significantly lower NEI-VFQ and Neuro10 composite scores than controls. All subscale scores describing specific aspects of visual ability and functioning were impaired except for ocular pain and general health, which did not differ significantly from controls. Surprisingly, visual deficit severity was not correlated with either composite score, both of which increased with time poststroke, even when adjusting for PMD and age.
CONCLUSIONS
VR-QoL appears to improve with time postoccipital stroke, irrespective of visual deficit size or patient age at insult. This may reflect the natural development of compensatory strategies and lifestyle adjustments. Thus, future studies examining the impact of rehabilitation on daily living in this patient population should consider the possibility that their VR-QoL may change gradually over time, even without therapeutic intervention.
Topics: Humans; Quality of Life; Female; Middle Aged; Male; Stroke; Aged; Adult; Retrospective Studies; Vision Disorders; Occipital Lobe; Visual Fields
PubMed: 38956813
DOI: 10.1002/brb3.3582 -
Brain and Behavior Jul 2024Chemosensory function in pregnant women is far from being fully understood due to the lack of data and inconsistencies between the results of self-reports and objective...
INTRODUCTION
Chemosensory function in pregnant women is far from being fully understood due to the lack of data and inconsistencies between the results of self-reports and objective studies.
METHODS
In the present study in pregnant and non-pregnant women (n = 14, n = 13), we measured EEG-derived electrophysiological response measures supported by psychophysical olfactory and trigeminal tests.
RESULTS
Results indicate that the olfactory event-related potential amplitudes or latencies of the P1, N1, and P2 components remain unchanged in pregnant women. In accordance with these findings, no difference was observed between pregnant and non-pregnant women in psychophysical olfactory tests. However, pregnant women displayed a lower degree of sensitivity to trigeminal stimuli compared to non-pregnant controls, which was also reflected in the electrophysiological responses to trigeminal stimuli.
CONCLUSION
Counterintuitive as they may seem, our findings demonstrate a "flattening" of chemosomatosensory responses. Psychological processes occurring during pregnancy, such as changes in socioemotional perception of odors resulting from the diminished stress response, may provide a background to these results. Overall, the present results indicate the absence of major differences between non-pregnant and pregnant women in terms of measured olfactory function though chemosomatosensory function of the pregnant women appears to be decreased.
Topics: Humans; Female; Pregnancy; Adult; Trigeminal Nerve; Electroencephalography; Evoked Potentials; Young Adult; Olfactory Perception; Smell; Odorants
PubMed: 38956811
DOI: 10.1002/brb3.3597 -
European Journal of Sport Science Jul 2024Cannabidiol (CBD) is a non-intoxicating phytocannabinoid which has been proposed to possess anti-inflammatory and analgesic properties. Given the potential for... (Randomized Controlled Trial)
Randomized Controlled Trial
Cannabidiol (CBD) is a non-intoxicating phytocannabinoid which has been proposed to possess anti-inflammatory and analgesic properties. Given the potential for perceptions of pain to limit exercise performance, the aim of the present study was to investigate if 3 weeks of daily CBD supplementation (150 mg day) improved performance in a 10-min performance-trial on a cycle ergometer. In a randomized, double-blind and placebo-controlled study, 22 healthy participants (n = 11 male and n = 11 female) completed two 10-min performance trials on a WattBike cycle ergometer interspersed with a 3-week supplementation period. Supplementation involved either 150 mg day oral CBD or 150 mg day of a visually identical placebo (PLA). During trials, ratings of perceived exertion (RPE [6-20]), heart rate (HR) and blood lactate (BLa) were collected every 2 min. Mean power (W) was also taken throughout the exercise at each time point. All data were analyzed using two-way ANOVAs. There were no significant differences (P > 0.05) between CBD or PLA groups for mean power (W) during the 10-min performance trial. There were also no significant differences (P > 0.05) in any of the physiological or perceptual parameters (HR, BLa and RPE) between conditions. Three weeks supplementation of a broad-spectrum CBD supplement did not improve performance via any change in RPE during a 10-min time trial on a cycle ergometer, and as such, this evidence does not support the claim that broad-spectrum CBD supplements could be performance-enhancing in this exercise modality.
Topics: Humans; Cannabidiol; Male; Double-Blind Method; Female; Dietary Supplements; Heart Rate; Adult; Athletic Performance; Young Adult; Lactic Acid; Exercise Test; Physical Exertion
PubMed: 38956805
DOI: 10.1002/ejsc.12116 -
European Journal of Sport Science Jul 2024The neurological effects and underlying pathophysiological mechanisms of sports-related concussion (SRC) in active young boxers remain poorly understood. This study aims...
The neurological effects and underlying pathophysiological mechanisms of sports-related concussion (SRC) in active young boxers remain poorly understood. This study aims to investigate the impairment of white matter microstructure and assess changes in glymphatic function following SRC by utilizing neurite orientation dispersion and density imaging (NODDI) on young boxers who have sustained SRC. A total of 60 young participants were recruited, including 30 boxers diagnosed with SRC and 30 healthy individuals engaging in regular exercise. The assessment of whole-brain white matter damage was conducted using diffusion metrics, while the evaluation of glymphatic function was performed through diffusion tensor imaging (DTI) analysis along the perivascular space (DTI-ALPS) index. A two-sample t-test was utilized to examine group differences in DTI and NODDI metrics. Spearman correlation and generalized linear mixed models were employed to investigate the relationship between clinical assessments of SRC and NODDI measurements. Significant alterations were observed in DTI and NODDI metrics among young boxers with SRC. Additionally, the DTI-ALPS index in the SRC group exhibited a significantly higher value than that of the control group (left side: 1.58 vs. 1.48, P = 0.009; right side: 1.61 vs. 1.51, P = 0.02). Moreover, it was observed that the DTI-ALPS index correlated with poorer cognitive test results among boxers in this study population. Repetitive SRC in active young boxers is associated with diffuse white matter injury and glymphatic dysfunction, highlighting the detrimental impact on brain health. These findings highlight the importance of long-term monitoring of the neurological health of boxers.
Topics: Humans; White Matter; Diffusion Tensor Imaging; Glymphatic System; Male; Brain Concussion; Adolescent; Neurites; Boxing; Female; Case-Control Studies; Young Adult; Athletic Injuries
PubMed: 38956796
DOI: 10.1002/ejsc.12113 -
Asian Journal of Endoscopic Surgery Jul 2024The left kidney is often preferred for living donor kidney transplantation because of its anatomical advantages. However, the right kidney may be procured due to donor... (Comparative Study)
Comparative Study
Safety and graft outcome of right retroperitoneal laparoscopic donor nephrectomy for living donor kidney transplantation: A comparison with left retroperitoneal laparoscopic donor nephrectomy.
INTRODUCTION
The left kidney is often preferred for living donor kidney transplantation because of its anatomical advantages. However, the right kidney may be procured due to donor conditions. Few studies have assessed the safety and graft outcome of right retroperitoneal laparoscopic donor nephrectomy (RDN). This study aimed to compare the outcomes between right and left RDN with respect to donor outcome and the graft function of recipients.
METHODS
This retrospective study included 230 consecutive living donor kidney transplants performed at our institution between May 2019 and March 2023. We reviewed the outcomes of kidney transplant in the right and left kidneys after RDN.
RESULTS
A total of 230 living donor kidney transplants were performed, with 32 donors receiving right RDN (right RDN group) and 198 donors receiving left RDN (left RDN group). The renal veins and ureters were significantly shorter in the right RDN group than in the left RDN group (both p < .001). Donor operation and warm ischemia time were significantly longer in the right RDN group than in the left RDN group (p = .012 and p < .001, respectively). None of the groups exhibited any cases of delayed graft function owing to donor-related reasons. Perioperative changes in the estimated glomerular filtration rate of recipients and death-censored graft survival were not significantly different between the two groups.
CONCLUSIONS
In RDN, the outcomes of right donor nephrectomy were comparable to those of left donor nephrectomy in terms of donor safety and recipient renal function.
Topics: Humans; Nephrectomy; Kidney Transplantation; Living Donors; Female; Retrospective Studies; Male; Laparoscopy; Adult; Middle Aged; Retroperitoneal Space; Graft Survival; Treatment Outcome; Tissue and Organ Harvesting
PubMed: 38956792
DOI: 10.1111/ases.13355