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The Journal of Clinical Endocrinology... Jul 2024This study sought to elucidate the interactions among physical activity (PA) patterns, mean glucose concentrations, and the incidence of nocturnal hypoglycemia events in...
AIMS
This study sought to elucidate the interactions among physical activity (PA) patterns, mean glucose concentrations, and the incidence of nocturnal hypoglycemia events in children and adolescents with type 1 diabetes, examining the moderating influence of daily dosage on these associations.
MATERIAL AND METHODS
Eighty-two participants aged 6 to 18 years (43.9% girls) from the Diactive-1 Cohort Study, diagnosed with type 1 diabetes, were included. Data collection involved continuous glucose monitoring, accelerometry to assess real-world PA, as well as documentation of daily insulin doses and carbohydrate counting over the same seven days.
RESULTS
A total of 19 participants experienced at least one nocturnal hypoglycemia event over a span of 574 measurement days (106 days with and 451 days without nocturnal hypoglycemia). Higher levels of vigorous PA (VPA) were associated with lower same-day mean glucose levels (p = 0.014). Additionally, higher levels of moderate PA (p = 0.023), VPA (p = 0.011), and moderate-to-vigorous PA (p = 0.010) were associated with a greater number of nocturnal hypoglycemia events. Specifically, a significant association was identified between VPA and nocturnal hypoglycemia events when the daily insulin dose were at or above 1.04 units per kilogram of body weight per day (p = 0.016).
CONCLUSIONS
Daily VPA is associated with glucose reductions, potentially leading to more hypoglycemic episodes, particularly when there's an excess of daily insulin. This highlights the need for careful insulin management in children and adolescents with type 1 diabetes engaging in VPA.
PubMed: 38954647
DOI: 10.1210/clinem/dgae451 -
ACS Applied Materials & Interfaces Jul 2024Na-O batteries have emerged as promising candidates due to their high theoretical energy density (1,601 Wh kg), the potential for high energy storage efficiency, and the...
Na-O batteries have emerged as promising candidates due to their high theoretical energy density (1,601 Wh kg), the potential for high energy storage efficiency, and the abundance of sodium in the earth's crust. Considering the safety issue, quasi-solid-state composite polymer electrolytes are among the promising solid-state electrolyte candidates. Their higher mechanical toughness provides superior resistance to dendritic penetration compared with traditional liquid electrolytes. The flexibility of the composite polymer electrolyte matrix allows it to conform to various battery configurations and considerably reduces safety concerns related to the combustion risks associated with conventional liquid electrolytes. In this study, we employed poly(ethylene oxide) (PEO) and sodium bis(trifluoromethanesulfonyl)imide (NaTFSI) as the polymer matrix and sodium ion-conducting agent, respectively. We incorporated nanosized NZSP (25 wt %) to create the composite polymer electrolyte membrane. This CPE design facilitates ion conduction pathways through both sodium salt and NZSP. By utilizing a liquid electrolyte infiltration method, we successfully enhanced its ionic conductivity, achieving an ionic conductivity of 10 S cm at room temperature.
PubMed: 38954646
DOI: 10.1021/acsami.4c04613 -
The Journal of Bone and Joint Surgery.... Jul 2024The Short Musculoskeletal Function Assessment (SMFA) is a well validated, widely used patient-reported outcome (PRO) measure for orthopaedic patients. Despite its...
Minimal Clinically Important Difference (MCID) for the Short Musculoskeletal Function Assessment (SMFA) in Severe Lower Extremity Trauma: Pooled Data from 7 Multicenter, Prospective Clinical Trials.
BACKGROUND
The Short Musculoskeletal Function Assessment (SMFA) is a well validated, widely used patient-reported outcome (PRO) measure for orthopaedic patients. Despite its widespread use and acceptance, this measure does not have an agreed upon minimal clinically important difference (MCID). The purpose of the present study was to create distributional MCIDs with use of a large cohort of research participants with severe lower extremity fractures.
METHODS
Three distributional approaches were used to calculate MCIDs for the Dysfunction and Bother Indices of the SMFA as well as all its domains: (1) half of the standard deviation (one-half SD), (2) twice the standard error of measurement (2SEM), and (3) minimal detectable change (MDC). In addition to evaluating by patient characteristics and the timing of assessment, we reviewed these calculations across several injury groups likely to affect functional outcomes.
RESULTS
A total of 4,298 SMFA assessments were collected from 3,185 patients who had undergone surgical treatment of traumatic injuries of the lower extremity at 60 Level-I trauma centers across 7 multicenter, prospective clinical studies. Depending on the statistical approach used, the MCID associated with the overall sample ranged from 7.7 to 10.7 for the SMFA Dysfunction Index and from 11.0 to 16.8 for the SMFA Bother Index. For the Dysfunction Index, the variability across the scores was small (<5%) within the sex and age subgroups but was modest (12% to 18%) across subgroups related to assessment timing.
CONCLUSIONS
A defensible MCID can be found between 7 and 11 points for the Dysfunction Index and between 11 and 17 points for the Bother Index. The precise choice of MCID may depend on the preferred statistical approach and the population under study. While differences exist between MCID values based on the calculation method, values were consistent across the categories of the various subgroups presented.
LEVEL OF EVIDENCE
Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
PubMed: 38954643
DOI: 10.2106/JBJS.23.01201 -
The Journal of Bone and Joint Surgery.... Jul 2024There is increasing evidence that musculoskeletal tissues are differentiallys regulated by sex hormones in males and females. The influence of sex hormones, in addition...
There is increasing evidence that musculoskeletal tissues are differentiallys regulated by sex hormones in males and females. The influence of sex hormones, in addition to other sex-based differences such as in anatomical alignment and immune-system function, impact the prevalence and severity of disease as well as the types of injuries that affect the musculoskeletal system and the outcomes of prevention measures and treatment. Literature specifically addressing sex differences related to the musculoskeletal system is limited, underscoring the imperative for both basic and clinical research on this topic. This review highlights areas of research that have implications for bone and cartilage health, including growth and development, sports injuries, osteoarthritis, osteoporosis, and bone frailty. It is clear that important aspects of the musculoskeletal system have been understudied. Consideration of how sex hormone therapy will affect musculoskeletal tissues in prepuberty, during puberty, and in adults is vital, yet little is known. The purpose of this article is to foster awareness and interest in advancing our understanding of how sex differences influence orthopaedic practice.
PubMed: 38954642
DOI: 10.2106/JBJS.24.00194 -
The Journal of Bone and Joint Surgery.... Jul 2024The influence of sex and gender-related factors on health and disease at all levels of scale, across all health conditions, and throughout the entire life course is...
The influence of sex and gender-related factors on health and disease at all levels of scale, across all health conditions, and throughout the entire life course is increasingly clear. A series of policies instituted by the National Institutes of Health (NIH) that require researchers to include appropriate populations and to analyze the data accordingly have strengthened the evidence base around the health of women. Translating these advances to the entire research ecosystem can catalyze rigorous biomedical discovery that can improve health. We encourage journals, publishers, and funders to align their policies and expectations regarding sex and gender considerations in research with those of the NIH and other international funding agencies.
PubMed: 38954641
DOI: 10.2106/JBJS.24.00172 -
The Journal of Physical Chemistry. A Jul 2024Machine learning is capable of effectively predicting the potential energies of molecules in the presence of high-quality data sets. Its application in the construction...
Machine learning is capable of effectively predicting the potential energies of molecules in the presence of high-quality data sets. Its application in the construction of ground- and excited-state potential energy surfaces is attractive to accelerate nonadiabatic molecular dynamics simulations of photochemical reactions. Because of the huge computational cost of excited-state electronic structure calculations, the construction of a high-quality data set becomes a bottleneck. In the present work, we first built two data sets. One was obtained from surface hopping dynamics simulations at the semiempirical OM2/MRCI level. Another was extracted from the dynamics trajectories at the CASSCF level, which was reported previously. The ground- and excited-state potential energy surfaces of ethylene-bridged azobenzene at the CASSCF computational level were constructed based on the former low-level data set. Although non-neural network machine learning methods can achieve good or modest performance during the training process, only neural network models provide reliable predictions on the latter external test data set. The BPNN and SchNet combined with the Δ-ML scheme and the force term in the loss functions are recommended for dynamics simulations. Then, we performed excited-state dynamics simulations of the photoisomerization of ethylene-bridged azobenzene on machine learning potential energy surfaces. Compared with the lifetimes of the first excited state (S) estimated at different computational levels, our results on the isomer are in good agreement with the high-level estimation. However, the overestimation of the isomer is unimproved. It suggests that smaller errors during the training process do not necessarily translate to more accurate predictions on high-level potential energies or better performance on nonadiabatic dynamics simulations, at least in the present case.
PubMed: 38954640
DOI: 10.1021/acs.jpca.4c02028 -
ACS Nano Jul 2024The advent of catheter-based minimally invasive surgical instruments has provided an effective means of diagnosing and treating human disease. However, conventional... (Review)
Review
The advent of catheter-based minimally invasive surgical instruments has provided an effective means of diagnosing and treating human disease. However, conventional medical catheter devices are limited in functionalities, hindering their ability to gather tissue information or perform precise treatment during surgery. Recently, electronic catheters have integrated various sensing and therapeutic technologies through micro/nanoelectronics, expanding their capabilities. As micro/nanoelectronic devices become more miniaturized, flexible, and stable, electronic surgical catheters are evolving from simple tools to multiplexed sensing and theranostics for surgical applications. The review on multifunctional electronic surgical catheters is lacking and thus is not conducive to the reader's comprehensive understanding of the development trend in this field. This review covers the advances in multifunctional electronic catheters for precise and intelligent diagnosis and therapy in minimally invasive surgery. It starts with the summary of clinical minimally invasive surgical instruments, followed by the background of current clinical catheter devices for sensing and therapeutic applications. Next, intelligent electronic catheters with integrated electronic components are reviewed in terms of electronic catheters for diagnosis, therapy, and multifunctional applications. It highlights the present status and development potential of catheter-based minimally invasive surgical devices, while also illustrating several significant challenges that remain to be overcome.
PubMed: 38954632
DOI: 10.1021/acsnano.4c03871 -
Journal of Drugs in Dermatology : JDD Jul 2024Despite growing diversity in the United States population, studies show that medical education lacks representation of conditions in darker skin tones. Given that...
Despite growing diversity in the United States population, studies show that medical education lacks representation of conditions in darker skin tones. Given that medical conditions present differently in different skin tones, limited exposure to images of darker tones in medical training may contribute to incorrect or delayed diagnoses, perpetuating health inequities. This study examines the preclinical curriculum at the Georgetown University School of Medicine (GUSOM) to report on its image representation with respect to skin tone and to assess the impact of a student-driven initiative in achieving visual learning equity (VLE). Of 1050 preclinical images, 58.2% depicted conditions in light/white skin tones, 31.3% in medium/brown, and 10.5% in dark/black. The microbiology and pathology courses had the highest percentages of dark/black and medium/brown images. Infectious disease images made up 36.3% of all images with 54.6% light/white, 31.5% medium/brown, and 13.9% dark/black. Overall, the first images representing conditions were 63.5% light/white, 30.0% medium/brown, and 6.6% dark/black. When dark/black images were presented first, 64.3% were of infectious diseases, compared to 35.1% for medium/brown and only 28.4% for white/light first images that were infectious diseases. A significant increase in images of conditions in darker skin tones was observed in the IRD course 2022 compared to the IRD course 2020 (P<.001). Our study highlights an underrepresentation of darker skin tones compared to lighter skin tones in the GUSOM preclinical curriculum. A student-led initiative significantly increased the representation of darker skin tones in dermatologic images, demonstrating the potential impact of such efforts in achieving VLE in medical education.J Drugs Dermatol. 2024;23(7):519-524. doi:10.36849/JDD.7992.
Topics: Humans; Cross-Sectional Studies; Dermatology; Skin Diseases; Curriculum; Skin Pigmentation; Education, Medical, Undergraduate; United States; Students, Medical
PubMed: 38954624
DOI: 10.36849/JDD.7992 -
Journal of Drugs in Dermatology : JDD Jul 2024Despite the widespread interest in dermatology on TikTok, studies have shown most related videos are not produced by board-certified dermatologists (BCDs) or other...
Despite the widespread interest in dermatology on TikTok, studies have shown most related videos are not produced by board-certified dermatologists (BCDs) or other health professionals. To see if this trend extended to sun protection, we examined TikTok videos associated with sun safety to determine the proportion produced by BCDs. From August 25, 2023, to August 27, 2023, investigators input the following hashtags into the TikTok search bar: #sunscreen, #sunprotection, #spf, #skincancer, and #skinprotection. The top 100 videos in each category were analyzed and categorized based on the content creator. Additionally, we assessed whether videos explicitly addressed skin of color (SOC). Of the analyzed videos, only 16.6% originated from BCDs. Beauty bloggers/bloggers were the most prevalent creators in this category (38.7%), followed by patients/consumers (33.7%). Only 2.8% of the videos pertained to SOC patients. This highlights a gap in the type of educational content generated by dermatologists on TikTok, with sun safety being a potential subject to target within social media. Additionally, the small representation of videos addressing SOC patients underscores the need for more diverse and inclusive educational skincare content on TikTok.J Drugs Dermatol. 2024;23(7):571-574. doi:10.36849/JDD.8179.
Topics: Humans; Cross-Sectional Studies; Sunscreening Agents; Social Media; Sunburn; Dermatology; Video Recording; Sunlight; Skin Pigmentation; Dermatologists; Skin Neoplasms; Patient Education as Topic
PubMed: 38954614
DOI: 10.36849/JDD.8179 -
The American Journal of Case Reports Jul 2024BACKGROUND Guillain-Barre syndrome (GBS) is a rare immune-mediated peripheral nerve disorder. Among non-infectious factors, surgery has been identified as a potential... (Review)
Review
BACKGROUND Guillain-Barre syndrome (GBS) is a rare immune-mediated peripheral nerve disorder. Among non-infectious factors, surgery has been identified as a potential trigger of the disease. This report presents the case of a 74-year-old man who developed GBS 15 days after a right lower lobectomy for lung adenocarcinoma. CASE REPORT We present a case of a patient who was a former smoker who underwent uniportal video-assisted (U-VATS) right lower lobectomy for localized lung adenocarcinoma. Fifteen days after surgery, he exhibited bilateral lower-limb weakness, widespread paresthesia, and postural instability. Comprehensive diagnostic workup, including clinical assessment, serological tests, cerebrospinal fluid (CSF) analysis, and nerve conduction studies (NCS), confirmed the diagnosis. Notably, CSF analysis revealed albumin-cytological dissociation, with albumin 453.2 mg/L, protein 757 mg/L, glucose 67 mg/dl, 3 white blood cells (WBC)/uL, and polymorphonucleates (PMN) 33%. NCS demonstrated motor and sensory abnormalities. Prompt administration of intravenous immunoglobulins (IVIG) 2 g/kg daily for 5 days resulted in complete recovery within 3 months. CONCLUSIONS This case emphasizes the importance of prompt recognition and management of GBS as a postoperative complication. Neurological examination, neuroimaging, and electrophysiological studies are essential for accurate diagnosis. IVIG therapy remains a cornerstone in GBS management, with favorable outcomes observed in this case. Enhanced awareness among clinicians about the potential association between surgery and GBS is vital to prevent more serious complications and ensure optimal patient management. Further research is crucial to determine the precise pathogenesis and mechanisms of GBS following lung surgery.
Topics: Humans; Guillain-Barre Syndrome; Male; Aged; Lung Neoplasms; Adenocarcinoma of Lung; Postoperative Complications; Adenocarcinoma; Immunoglobulins, Intravenous; Thoracic Surgery, Video-Assisted; Pneumonectomy
PubMed: 38954599
DOI: 10.12659/AJCR.944035