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Cureus May 2024People with visual impairments and blindness face challenges in performing regular tasks such as maintaining proper sanitation, which makes them vulnerable to intestinal...
INTRODUCTION
People with visual impairments and blindness face challenges in performing regular tasks such as maintaining proper sanitation, which makes them vulnerable to intestinal parasitic infections.
AIMS AND OBJECTIVES
This study aims to examine the prevalence and distribution of intestinal parasitic infections in children and adolescents with ocular diseases and to assess if the lockdown during the COVID-19 pandemic affected these rates.
METHODS
This retrospective, hospital record-based study was conducted among children and adolescents attending the Regional Institute of Ophthalmology in Kolkata, India. It involved routine stool examinations as part of their treatment during 2019-2020. Early morning stool specimens were collected and brought to the institute laboratory in containers. Stools were examined under a microscope for cysts, ova, parasites, and adult worms. Findings were recorded in the laboratory record book. These data were then extracted into a spreadsheet and analyzed using IBM SPSS Statistics for Windows, Version 26 (Released 2019; IBM Corp., Armonk, New York).
RESULTS
The prevalence of intestinal parasitic infections was 8.59% (59 out of 687 patients). Among those 59 positive cases, , , , , spp., , and were detected in 27 (45.8%), 15 (25.4%), 8 (13.6%), 6 (10.2%), 3 (5.1%), 2 (3.4%), and 1 (1.7%) patients, respectively. The positivity rate of stool samples was higher from September and thereafter from January to March. The sample positivity rate was higher post-pandemic and lockdown, but not statistically significant (11.5% vs. 5.3%; χ²=4.044, df=1, p=0.44).
CONCLUSION
was the most commonly observed intestinal parasite in children and adolescents with ocular disease in our setting. Seasonal variation was noted with higher case positivity at the end of the rainy season and thereafter in winter. Therefore, we propose to strengthen the routine deworming program during this period in Eastern India. Higher sample positivity after the pandemic may be attributed to school closures during the lockdown period, which might have caused some children to miss their routine deworming medication.
PubMed: 38864043
DOI: 10.7759/cureus.60152 -
BMC Nutrition Jun 2024Several side effects within the patients undergoing hematopoietic stem cell transplantation (HSCT), especially ones that influence nutrition intake, can cause weight...
The effect of oral nutrition supplement (ONS) on the nutritional and clinical status of patients undergoing autologous hematopoietic stem cell transplantation: study protocol for a randomized controlled clinical trial.
INTRODUCTION
Several side effects within the patients undergoing hematopoietic stem cell transplantation (HSCT), especially ones that influence nutrition intake, can cause weight loss and malnutrition. Based on studies, oral nutritional supplement (ONS) may reinforce their nutrient intake and progress clinical outcomes. The objective of this research is to investigate the effect of oral nutrition supplements on the nutritional and clinical status of patients undergoing autologous hematopoietic stem cell transplantation.
METHODS
After block randomization used the website www.randomization , 38 patients will be enrolled in this study, patients will be allocated to the intervention (ONS) or control groups in a 1: 1 ratio. Patients in the ONS group will receive 250 ml of standard formula (Ensure®, Abbott Nutrition) which has 14-15% protein twice a day, in the morning and bedtime snacks for 21 days. All the procedures done in the control group will be the same as the ONS group except receiving ONS. We will examine the outcomes include; weight, appetite, hand grip strength, calf circumference, mid-arm circumference, total energy intake, protein intake, carbohydrate intake, fat intake, severity of oral mucositis, rate of infection during hospitalization, graft failure, recurrence rate after transplantation, the number of days it takes for neutrophil and platelet engraftment to occur, number of readmissions after transplantation during three months, mortality rate up to three months after transplantation and the three-day food diary record; all the evaluations will be carried out in three steps; 7 days before transplant, on the 14th day after transplantation, and on the 90th day after the transplantation.
DISCUSSION
These patients' weight loss and malnourishment are significant concerns. The use of ONS in patients receiving HSCT has not been the subject of any research.
TRIAL REGISTRATION
This clinical trial was registered in Iranian Registry of Clinical Trials ( http://www.irct.ir ) on 2022-12-09 with the code number IRCT20220208053971N2.
PubMed: 38858716
DOI: 10.1186/s40795-024-00893-3 -
Frontiers in Neurology 2024Neurologic circadian influences, including sleep/wake transitions, processes (e.g., hormonal variation), and behavioral patterns (e.g., consumption of food and oral...
INTRODUCTION
Neurologic circadian influences, including sleep/wake transitions, processes (e.g., hormonal variation), and behavioral patterns (e.g., consumption of food and oral medications), may affect seizure patterns. Specific circadian patterns of seizures have been reported depending on type, onset location, and severity; however, data on patterns for patients with seizure clusters and effectiveness of rescue therapy by time of day are limited.
METHODS
We conducted analyses using patient diary data from the phase 3 safety study of diazepam nasal spray, which is indicated for acute treatment of seizure clusters in patients with epilepsy aged ≥6 years. Patients were administered age- and weight-based doses; second doses could be administered if needed to control a seizure cluster. We assessed clock timing of seizure-cluster onset along with second-dose use as a proxy for effectiveness. Treatment-emergent adverse events were recorded.
RESULTS
Seizure-cluster onset was observed to be generally highest during mornings and late evenings and lowest in the early evening and middle of the night. Second-dose use was not consistently associated with a specific time of day. The safety profile was consistent with that expected from previous studies of diazepam nasal spray.
CONCLUSION
These results suggest that diazepam nasal spray can be effectively administered at any time of day.
PubMed: 38854958
DOI: 10.3389/fneur.2024.1335421 -
MedRxiv : the Preprint Server For... May 2024Sleep-wake disturbances frequently present in Veterans with mild traumatic brain injury (mTBI). These TBI-related sleep impairments confer significant burden and...
Feasibility and acceptability for LION, a fully remote, randomized clinical trial within the VA for light therapy to improve sleep in Veterans with and without TBI: An MTBI sponsored protocol: LION: A remote RCT protocol within VA.
Sleep-wake disturbances frequently present in Veterans with mild traumatic brain injury (mTBI). These TBI-related sleep impairments confer significant burden and commonly exacerbate other functional impairments. Therapies to improve sleep following mTBI are limited and studies in Veterans are even more scarce. In our previous pilot work, morning bright light therapy (MBLT) was found to be a feasible behavioral sleep intervention in Veterans with a history of mTBI; however, this was single-arm, open-label, and non-randomized, and therefore was not intended to establish efficacy. The present study, LION (light vs ion therapy) extends this preliminary work as a fully powered, sham-controlled, participant-masked randomized controlled trial (NCT03968874), implemented as fully remote within the VA (target n=120 complete). Randomization at 2:1 allocation ratio to: 1) active: MBLT (n=80), and 2) sham: deactivated negative ion generator (n=40); each with identical engagement parameters (60-min duration; within 2-hrs of waking; daily over 28-day duration). Participant masking via deception balanced expectancy assumptions across arms. Outcome measures were assessed following a 14-day baseline (pre-intervention), following 28-days of device engagement (post-intervention), and 28-days after the post-intervention assessment (follow-up). Primary outcomes were sleep measures, including continuous wrist-based actigraphy, self-report, and daily sleep dairy entries. Secondary/exploratory outcomes included cognition, mood, quality of life, circadian rhythm via dim light melatonin onset, and biofluid-based biomarkers. Participant drop out occurred in <10% of those enrolled, incomplete/missing data was present in <15% of key outcome variables, and overall fidelity adherence to the intervention was >85%, collectively establishing feasibility and acceptability for MBLT in Veterans with mTBI.
PubMed: 38853958
DOI: 10.1101/2024.05.30.24308195 -
Primary Care Diabetes Jun 2024To identify risk factors for nocturnal/morning hypo- and hyperglycaemia in type 1 diabetes.
AIMS
To identify risk factors for nocturnal/morning hypo- and hyperglycaemia in type 1 diabetes.
METHODS
Data on self-management practices were obtained from 3-day records. We studied the associations between self-management practices on the first recording day and the self-reported blood glucose (BG) concentrations on the subsequent night/morning.
RESULTS
Of the 1025 participants (39 % men, median age 45 years), 4.4 % reported nocturnal hypoglycaemia (<3.9 mmol/l), 9.8 % morning hypoglycaemia, 51.5 % morning euglycaemia, and 34.3 % morning hyperglycaemia (≥8.9 mmol/l). Within hypoglycaemic range, insulin pump use was associated with higher nocturnal BG concentration (B=0.486 [95 % Confidence Interval=0.121-0.852], p=0.009). HbA was positively (0.046 [0.028-0.065], p<0.001), while antecedent fibre intake (-0.327 [-0.543 - -0.111], p=0.003) and physical activity (PA) (-0.042 [-0.075 - -0.010], p=0.010) were inversely associated with morning BG concentration. The odds of morning hypoglycaemia were increased by previous day hypoglycaemia (OR=2.058, p=0.002) and alcohol intake (1.031, p=0.001). Previous day PA (0.977, p=0.031) and fibre intake (0.848, p=0.017) were inversely, while HbA (1.027, p<0.001) was positively associated with the risk of morning hyperglycaemia.
CONCLUSIONS
Alcohol avoidance may prevent nocturnal hypoglycaemia, while PA and fibre intake may reduce hyperglycaemia risk. Avoidance of daytime hypoglycaemia and keeping HbA in control may help maintain normoglycaemia also at night-time.
PubMed: 38852028
DOI: 10.1016/j.pcd.2024.06.007 -
Journal of Dairy Science Jun 2024Although 3-NOP has been proven to reduce enteric methane (CH) by ∼30% in indoor systems of dairying when the additive is mixed throughout a total mixed ration (TMR),...
Although 3-NOP has been proven to reduce enteric methane (CH) by ∼30% in indoor systems of dairying when the additive is mixed throughout a total mixed ration (TMR), there has been very limited research to date in grazing systems in which the most convenient method of additive supplementation is at milking twice daily. To investigate the effect of twice daily 3-NOP supplementation on enteric CH emissions, a 12-week study was undertaken in which treatment cows (n = 26) were supplemented with 3-NOP (80 mg per kg dry matter intake; DMI) twice daily at morning and evening milking, while control cows (n = 26) received no additive supplementation. Enteric CH, hydrogen (H) and carbon dioxide (CO) were measured using GreenFeed units, while milk production, body weight (BW), body condition score (BCS) and DMI were monitored to determine the effect of 3-NOP supplementation on productivity. There was no significant effect of 3-NOP supplementation on any of the aforementioned parameters with the exception of CH and H production, respectively. Cows supplemented with 3-NOP produced ∼36% more H (P < 0.001) across a 24-h period, with reductions in CH production of 28.5% recorded in the 3 h after additive consumption (P < 0.001), however, levels of CH production returned to that of the control group thereafter. When CH production was considered across the entire 24-h period, the cows offered 3-NOP produced ∼5% less CH than the control (P < 0.050). Future research should focus on methods to increase the efficacy of the additive throughout the day which would include the deployment of a slow-release form or an out of parlor feeding system that allows animals consume the product at additional time points.
PubMed: 38851571
DOI: 10.3168/jds.2024-24772 -
Psychiatry Research Aug 2024Anxiety symptoms vary moment-to-moment within a day. One factor that may influence these variations is chronotype. Evening chronotypes prefer to engage in activities...
Anxiety symptoms vary moment-to-moment within a day. One factor that may influence these variations is chronotype. Evening chronotypes prefer to engage in activities (e.g., sleep, physical and social activity) later in the day, and evening chronotype is implicated in psychopathology, including anxiety-related disorders. However, it is unknown whether chronotype influences diurnal variation in anxiety symptoms and whether these effects are amplified in individuals with a probable anxiety-related disorder. We examined the diurnal variation in anxiety symptoms and daily activities in morning and evening chronotypes with and without probable generalized anxiety disorder (GAD) or obsessive-compulsive disorder (OCD) in a community sample of adults (N = 410). Evening chronotypes reported higher anxiety symptoms, particularly in the evening hours, and lower engagement in daily activities, predominantly in the morning hours. Evening chronotypes with probable GAD or OCD reported worse anxiety symptoms in the evening. Our findings indicate that anxiety symptoms and engagement in daily activities fluctuate considerably across the day, and these patterns differ depending on chronotype. Evening chronotypes have more anxiety symptoms in the evening, despite preferring this time of day. Personalized treatment approaches that consider chronotype and target certain times of day may be efficient in alleviating peaks in anxiety symptoms.
Topics: Humans; Male; Female; Adult; Circadian Rhythm; Anxiety Disorders; Anxiety; Middle Aged; Obsessive-Compulsive Disorder; Young Adult; Sleep; Activities of Daily Living; Adolescent; Chronotype
PubMed: 38850890
DOI: 10.1016/j.psychres.2024.116006 -
JMIR Formative Research Jun 2024Efficacy of smartphone-based interventions depends on intervention content quality and level of exposure to that content. Smartphone-based survey completion rates tend...
BACKGROUND
Efficacy of smartphone-based interventions depends on intervention content quality and level of exposure to that content. Smartphone-based survey completion rates tend to decline over time; however, few studies have identified variables that predict this decline over longer-term interventions (eg, 26 weeks).
OBJECTIVE
This study aims to identify predictors of survey completion and message viewing over time within a 26-week smoking cessation trial.
METHODS
This study examined data from a 3-group pilot randomized controlled trial of adults who smoke (N=152) and were not ready to quit smoking within the next 30 days. For 182 days, two intervention groups received smartphone-based morning and evening messages based on current readiness to quit smoking. The control group received 2 daily messages unrelated to smoking. All participants were prompted to complete 26 weekly smartphone-based surveys that assessed smoking behavior, quit attempts, and readiness to quit. Compliance was operationalized as percentages of weekly surveys completed and daily messages viewed. Linear regression and mixed-effects models were used to identify predictors (eg, intervention group, age, and sex) of weekly survey completion and daily message viewing and decline in compliance over time.
RESULTS
The sample (mean age 50, SD 12.5, range 19-75 years; mean years of education 13.3, SD 1.6, range 10-20 years) was 67.8% (n=103) female, 74.3% (n=113) White, 77% (n=117) urban, and 52.6% (n=80) unemployed, and 61.2% (n=93) had mental health diagnoses. On average, participants completed 18.3 (71.8%) out of 25.5 prompted weekly surveys and viewed 207.3 (60.6%) out of 345.1 presented messages (31,503/52,460 total). Age was positively associated with overall weekly survey completion (P=.003) and daily message viewing (P=.02). Mixed-effects models indicated a decline in survey completion from 77% (114/148) in the first week of the intervention to 56% (84/150) in the last week of the intervention (P<.001), which was significantly moderated by age, sex, ethnicity, municipality (ie, rural/urban), and employment status. Similarly, message viewing declined from 72.3% (1533/2120) in the first week of the intervention to 44.6% (868/1946) in the last week of the intervention (P<.001). This decline in message viewing was significantly moderated by age, sex, municipality, employment status, and education.
CONCLUSIONS
This study demonstrated the feasibility of a 26-week smartphone-based smoking cessation intervention. Study results identified subgroups that displayed accelerated rates in the decline of survey completion and message viewing. Future research should identify ways to maintain high levels of interaction with mobile health interventions that span long intervention periods, especially among subgroups that have demonstrated declining rates of intervention engagement over time.
TRIAL REGISTRATION
ClinicalTrials.gov NCT03405129; https://clinicaltrials.gov/ct2/show/NCT03405129.
PubMed: 38848557
DOI: 10.2196/56003 -
The Journal of Education in... 2024Faculty development is important but often limited by conflict with ongoing responsibilities. The Oregon Health & Science University Department of Anesthesiology &...
BACKGROUND
Faculty development is important but often limited by conflict with ongoing responsibilities. The Oregon Health & Science University Department of Anesthesiology & Perioperative Medicine schedules more faculty physicians to work on Wednesdays, with nonclinical time in the morning and a clinical assignment in the afternoon, to facilitate a resident physician academic half-day (AHD). We designed a novel faculty development course to run in the mornings of the AHD using Kern's 6-step approach to curriculum development and hypothesized that it would be feasible and satisfactory.
METHODS
A needs assessment was performed. Two experts in medical education developed the curriculum and sought faculty with medical education training to lead sessions. Five participants completed pre-intervention, daily session, and post-intervention surveys. Satisfaction was evaluated by surveys. Feasibility was evaluated by session attendance and surveys. Kirkpatrick's model for program evaluation was used, and a thematic analysis was performed.
RESULTS
All participants responded "Strongly Agree" to all participant satisfaction post-intervention questions. All participants were able to meet the >50% attendance goal, only missing sessions when pre-call, post-call, on vacation, or ill. All participants reported changes in behavior and reported developing their clinician educator professional identities. One participant reported re-affirming their commitment to academic medicine.
CONCLUSIONS
This faculty development pilot course provided during work hours was feasible, and participants were highly satisfied. In addition, thematic analysis suggests that the course helped faculty develop a clinician educator professional identity and changed their behavior. Future work will include a qualitative study to understand the impact on participant behavior and professional identity formation.
PubMed: 38846923
DOI: 10.46374/VolXXVI_Issue2_MillerJuve -
Therapeutic Advances in Musculoskeletal... 2024Radiographic axial spondyloarthritis (r-axSpA), formerly known as ankylosing spondylitis (AS), is a chronic, inflammatory rheumatic disease associated with symptoms such...
BACKGROUND
Radiographic axial spondyloarthritis (r-axSpA), formerly known as ankylosing spondylitis (AS), is a chronic, inflammatory rheumatic disease associated with symptoms such as inflammatory back pain, morning stiffness, and arthritis. First-line recommendations for patients with AS include treatment with nonsteroidal anti-inflammatory drugs (NSAIDs) for reducing pain and stiffness.
OBJECTIVES
The objective of our study is to evaluate the efficacy and short-term NSAID-sparing effect of secukinumab in patients with AS currently treated with NSAIDs.
DESIGN
We assessed the clinical Assessment of SpondyloArthritis International Society (ASAS20) response to secukinumab and evaluated the extent to which the use of concomitant NSAID can be reduced between weeks 4 and 12 in r-axSpA patients treated with secukinumab 150 mg compared with placebo.
METHODS
ASTRUM was a prospective 24-week randomized controlled trial of adult patients with active r-axSpA [Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) ⩾4] who had a documented inadequate response to ⩾2 NSAIDs. Patients were randomized (1:1:1) to initiate treatment with subcutaneous secukinumab 150 mg from either week 0 (group 1), week 4 (group 2), or week 16 (group 3). From week 4 onward, tapering of NSAIDs was allowed in all groups.
RESULTS
This study included 211 patients ( = 71, 70, and 70 in groups 1, 2, and 3, respectively). ASAS20 response at week 12 for pooled groups 1 and 2 group 3 was 51.1% 44.3% ( = 0.35). A higher proportion of patients in groups 1 and 2 achieved ASAS40 and BASDAI50 and showed improvements in other secondary clinical outcomes as compared to group 3 at week 16. More patients in groups 1 and 2 group 3 stopped their NSAID intake from baseline through week 16.
CONCLUSION
Treatment with secukinumab improved clinical outcomes and showed a short-term NSAID-sparing effect in patients with r-axSpA, even though the primary endpoint was not met.
TRIAL REGISTRATION
ClinicalTrials.gov; NCT02763046, EudraCT 2015-004575-74.
PubMed: 38846755
DOI: 10.1177/1759720X241255486