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Nigerian Journal of Clinical Practice Jun 2024The burden of perinatal asphyxia remains high in our environment and when asphyxia is severe, vital organs are affected, with resultant multiorgan hypoxic-iscahemic...
BACKGROUND
The burden of perinatal asphyxia remains high in our environment and when asphyxia is severe, vital organs are affected, with resultant multiorgan hypoxic-iscahemic injury to the heart, the brain, adrenals and other organs.
STUDY AIM
To evaluate for myocardial injury in asphyxiated term neonates with hypoxic ischaemic encephalopathy using serum cardiac troponin-I (cTnI).
METHODS
The study was a hospital-based descriptive cross-sectional study involving sixty term asphyxiated neonates and sixty gestational age-and sex-matched controls. The subjects were term neonates with five-minute Apgar score ≤ 6 and HIE while the controls were healthy term neonates with five-minute Apgar score > 6. Five-minute Apgar score was utilized to classify asphyxia into mild, moderate and severe asphyxia. The degree of encephalopathy was determined by modified Sarnat and Sarnat criteria. The serum cTnI was measured in subjects and controls at 12-24 hours of life using Enzyme-linked immunosorbent assay technique. The serum bilirubin levels were also measured in participants to exclude hyperbilirubinemia.
RESULTS
The median serum cTnI levels was significantly higher in the subjects (0.56ng/mL; 0.25-0.94ng/mL) than in the controls (0.50ng/mL; 0.00-0.67ng/mL), respectively; p=0.001. Similarly, the median serum cTnI level in HIE stage II (0.56ng/mL; 0.38-0.72ng/mL) or III (0.56ng/ml; 0.50-0.94ng/mL) was also significantly higher than the median value in HIE stage I (0.38ng/mL;0.25-0.72ng/mL) or in controls (0.50ng/mL; 0.00-0.67ng/mL); p<0.001. There was significant positive correlation between serum cTnI levels and severity of HIE in asphyxiated neonates (rs = 0.505, p < 0.001).
CONCLUSION
serum cTnI levels were elevated in severely asphyxiated neonates with HIE. The concentration of serum cTnI demonstrated significant positive correlation with HIE severity. Hence, the presence of HIE in asphyxiated neonates should prompt an evaluation for myocardial injury using serum cTnI. Any derangement noted should warrant instituting cardiovascular support in order to improve outcome and reduce asphyxia-related mortality.
Topics: Humans; Infant, Newborn; Asphyxia Neonatorum; Troponin I; Female; Nigeria; Male; Cross-Sectional Studies; Case-Control Studies; Hospitals, Teaching; Apgar Score; Biomarkers; Hypoxia-Ischemia, Brain
PubMed: 38943306
DOI: 10.4103/njcp.njcp_169_24 -
BMC Psychology Jun 2024This study explores the intricate web of symptoms experienced by academically gifted high school students, focusing on procrastination, rumination, perfectionism, and...
BACKGROUND
This study explores the intricate web of symptoms experienced by academically gifted high school students, focusing on procrastination, rumination, perfectionism, and cognitive flexibility. The well-being of these gifted adolescents remains a pivotal concern, and understanding the dynamics of these symptoms is vital.
METHODS
A diverse sample of 207 academically gifted high school students from Mashhad, Iran, participated in this study. Using convenience sampling, participants from grades 10, 11, and 12 were included, with detailed assessments conducted through questionnaires measuring the mentioned symptoms.
RESULTS
Our network analysis uncovers compelling insights into the interplay of these symptoms: Procrastination, though moderately central, exerts significant influence within the network, underscoring its relevance. Cognitive flexibility, while centrally positioned, curiously exhibits a negative influence, potentially serving as a protective factor. Negative perfectionism emerges as the keystone symptom, with both high centrality and a positive influence. Rumination displays substantial centrality and a positive influence, indicating its role in symptom exacerbation. Positive perfectionism, moderately central, lacks direct influence on other symptoms.
CONCLUSION
This network analysis provides a nuanced understanding of the relationships among procrastination, rumination, perfectionism, and cognitive flexibility in academically gifted adolescents. Negative perfectionism and cognitive flexibility emerge as critical factors deserving attention in interventions aimed at enhancing the well-being of this unique group. Further research should explore causal relationships to refine targeted interventions.
Topics: Humans; Adolescent; Procrastination; Male; Female; Students; Perfectionism; Child, Gifted; Rumination, Cognitive; Iran; Surveys and Questionnaires; Adolescent Behavior
PubMed: 38943210
DOI: 10.1186/s40359-024-01868-6 -
Cardiovascular Diabetology Jun 2024The Triglyceride-glucose (TyG) index, a surrogate marker of insulin resistance, has been implicated in the risk of ischemic stroke. However, the interplay between TyG...
BACKGROUND
The Triglyceride-glucose (TyG) index, a surrogate marker of insulin resistance, has been implicated in the risk of ischemic stroke. However, the interplay between TyG levels, lifestyle factors, and their collective impact on stroke risk in non-diabetic populations remains inadequately explored. This study aims to evaluate the association of ischemic stroke with the joint development of the TyG index and lifestyle in the non-diabetic population.
METHODS
In this prospective cohort study, data was collected across three consecutive biennial surveys of the Kailuan Study from 2006 to 2011. The dual-trajectory model was used to determine the temporal development of TyG levels and lifestyle scores. Statistical analysis involved Cox regression models to evaluate the association between TyG-lifestyle trajectories and ischemic stroke risk, adjusting for potential confounders.
RESULTS
A total of 44,403 participants were included, with five distinct TyG levels and lifestyle scores trajectory subtypes identified. In the multivariable-adjusted analyses, significant differences in ischemic stroke risk among the trajectory subtypes. Group 5, characterized by the highest TyG levels and moderate lifestyle scores, exhibited the greatest ischemic stroke risk (HR = 1.81, 95% CI: 1.51-2.18), while group 4, with moderate TyG levels and higher lifestyle scores, demonstrated the lowest risk (HR = 1.19, 95% CI: 1.04-1.37), compared with group 3. Participants with elevated TyG levels were at an increased risk of ischemic stroke in cases of pronounced insulin resistance, even with a healthy lifestyle.
CONCLUSIONS
This study reveals the significant associations between the identified TyG and lifestyle trajectories and the stratification of ischemic stroke risk among non-diabetics. The TyG index is a valuable indicator for assessing insulin resistance. However, the potential benefits of lifestyle changes for those with significantly high TyG levels need to be clarified by more research to develop more effective stroke prevention strategies.
Topics: Humans; Male; Middle Aged; Female; Prospective Studies; Ischemic Stroke; Risk Factors; Risk Assessment; Biomarkers; Blood Glucose; China; Aged; Insulin Resistance; Life Style; Triglycerides; Risk Reduction Behavior; Time Factors; Adult; Prognosis; Healthy Lifestyle
PubMed: 38943172
DOI: 10.1186/s12933-024-02313-z -
International Breastfeeding Journal Jun 2024Despite global public health organizations endorsing breastfeeding or human milk (HM) as the optimal source of nutrition for infants, detailed knowledge of how HM...
BACKGROUND
Despite global public health organizations endorsing breastfeeding or human milk (HM) as the optimal source of nutrition for infants, detailed knowledge of how HM composition influences infant growth is lacking. In this commentary we summarize and interpret the key findings of a large systematic review on HM components and child growth (N = 141 articles included). We highlight the most consistent associations, discuss study quality issues, explore socio-economic and time trends in this body of research, and identify gaps and future research directions.
KEY FINDINGS OF SYSTEMATIC REVIEW
We grouped HM components into three categories: micronutrients (28 articles), macronutrients (57 articles), and bioactives (75 articles). Overall, we struggled to find consistent associations between HM components and infant growth. The majority of studies (85%) were of moderate or low-quality, with inconsistent HM collection and analysis strategies being identified as the most substantial quality concerns. Additional quality issues included failing to account for potential confounding by factors such as breastfeeding exclusivity and maternal body mass index.
CONSIDERATIONS FOR FUTURE HUMAN MILK RESEARCH
Many opportunities exist for the future of HM research. Using untargeted metabolomics will expand our understanding of HM components beyond previously defined and well-understood components. Machine learning will allow researchers to investigate HM as an integrated system, rather than a collection of individual components. Future research on HM composition should incorporate evidence-based HM sampling strategies to encompass circadian variation as well as infant consumption. Additionally, researchers need to focus on developing high quality growth data using consistent growth metrics and definitions. Building multidisciplinary research teams will help to ensure that outcomes are meaningful and clinically relevant.
CONCLUSION
Despite a large body of literature, there is limited quality evidence on the relationship between HM composition and infant growth. Future research should engage in more accurate collection of breastfeeding data, use standardized HM collection strategies and employ assays that are validated for HM. By systematically evaluating the existing literature and identifying gaps in existing research methods and practice, we hope to inspire standardized methods and reporting guidelines to support robust strategies for examining relationships between HM composition and child growth.
Topics: Humans; Milk, Human; Infant; Breast Feeding; Infant, Newborn; Infant Nutritional Physiological Phenomena; Anthropometry; Female; Child Development
PubMed: 38943170
DOI: 10.1186/s13006-024-00652-x -
BMC Public Health Jun 2024The American Heart Association recently introduced a new model for cardiovascular health (CVH) known as Life's Essential 8 (LE8). The impact of LE8 on hypertensive...
BACKGROUND
The American Heart Association recently introduced a new model for cardiovascular health (CVH) known as Life's Essential 8 (LE8). The impact of LE8 on hypertensive individuals is currently unclear. In our study, we investigated the correlation between comprehensive and individual CVH indicators as defined by LE8, and the mortality rates in hypertension patients.
METHODS
We analyzed a total of 8,448 hypertensive individuals aged ≥ 20 years who participated in the National Health and Nutrition Examination Survey from 2007 to 2016. These participants were nonpregnant and noninstitutionalized. We identified their mortality by linking their data to the National Death Index until December 31, 2019. The overall cardiovascular health (CVH) was assessed using the LE8 score, which ranged from 0 to 100. Additionally, we evaluated the scores for each component of diet, physical activity, tobacco/nicotine exposure, sleep duration, body mass index, non-high-density lipoprotein cholesterol, blood glucose, and blood pressure. The CVH were categorized into low (0-49), moderate (50-79), and high (80-100) CVH.
RESULTS
Over an average follow-up period of 7.41 years, 1,482 (17.54%) of the participants died, among which 472 deaths were attributed to CVD. When compared to adults with lower total CVH scores, those with elevated total CVH scores displayed a 37% reduced risk of mortality from all causes (adjusted hazard ratio [aHR] = 0.63, 95% confidence interval [CI] = 0.45-0.88). In relation to CVD-specific mortality, the corresponding aHRs for moderate and high total CVH scores were 0.76 (0.60-0.97) and 0.54 (0.31-0.94), respectively. Furthermore, after adjusting for potential confounders, it was observed that higher scores on the LE8 index were associated with a reduced risk of both all-cause mortality (aHR for every 10-score increase, 0.91; 95% CI = 0.86-0.96) and CVD-specific mortality (aHR for every 10-score increase, 0.82; 95% CI = 0.75-0.90). Notably, a linear dose-response relationship was observed in this association. Similar patterns were identified in the relationship between health behavior and both all-cause and CVD-specific mortality.
CONCLUSIONS
Achieving a higher CVH score, as per the new LE8 guidelines, has been found to be associated with a reduced risk of mortality from all causes and specifically from CVD in patients with hypertension. Therefore, public health and healthcare initiatives that focus on promoting higher CVH scores could potentially yield significant benefits in terms of reducing mortality rates among individuals with hypertension.
Topics: Humans; Male; Female; Middle Aged; Hypertension; Cardiovascular Diseases; Adult; Nutrition Surveys; Aged; Cohort Studies; United States; Cause of Death; Risk Factors
PubMed: 38943146
DOI: 10.1186/s12889-024-19189-z -
BMC Oral Health Jun 2024Mothers usually have the primary role in raising children and developing health-related behaviors. This study aims to evaluate the relationship between dental anxiety...
BACKGROUND
Mothers usually have the primary role in raising children and developing health-related behaviors. This study aims to evaluate the relationship between dental anxiety and oral hygiene status of mothers and children's dental anxiety and gingival health.
METHODS
The study included 305 children, aged 4-12 years, who came to the dentist for the first time and their mothers. All the demographic and oral hygiene information were collected through a questionnaire. The dental anxiety of the mothers and children was assessed using the Modified Dental Anxiety Scale (MDAS) and Venham Picture Test (VPT), respectively. The oral examination of the mother and children was performed, and their PI, GI, and DMFT scores were recorded.
RESULTS
While the correlation between MDAS and VPT was positive and strong in children aged 8-12, it was positive but weak in the 4-7 age group. A significant relationship was detected between the mother's PI, GI, DMFT, and the child's VPT score. According to the mothers' dental anxiety, there were no statistically significant differences in PI, GI, and dmft values in children aged between 4 to 7. A moderately positive and statistically significant relationship between maternal dental anxiety and children's DMFT was identified in children aged 8-12.
CONCLUSIONS
Children's dental anxiety was significantly influenced by maternal dental anxiety, post-treatment complications experienced by the mother, and the oral health status of the mother.
TRIAL REGISTRATION
Clinical Trials-ID: NCT05563532; Registration Date: 17.09.2022.
Topics: Humans; Dental Anxiety; Child; Child, Preschool; Oral Health; Female; Mothers; Male; DMF Index; Adult; Surveys and Questionnaires; Mother-Child Relations; Periodontal Index
PubMed: 38943136
DOI: 10.1186/s12903-024-04530-0 -
BMC Public Health Jun 2024Public health events (PHEs) have emerged as significant threats to human life, health, and economic growth. PHEs, such as COVID-19, have prompted a reevaluation for...
Public health events (PHEs) have emerged as significant threats to human life, health, and economic growth. PHEs, such as COVID-19, have prompted a reevaluation for enhanced regular prevention and control (RPC). In this study, we focus on the core concept of prevention and control intensity (PCI), and establish a neoclassical economic growth model from the long-term and macro perspective to balance life protection and economic growth. The model construct the mechanism of PCI on economic growth through population dynamics and capital accumulation under the backdrop of RPC for PHEs. We find the conditions for PCI when the economy achieves steady state, and provides an algorithm establishing the optimal strategy that maximises per capita disposable income based on the optimal PCI and consumption. Simulation result quantifies an inverted U-shaped relationship between PCI and capital per capita, output per capita and consumption per capita in the steady state. The model suggests that, given the PHEs of inducing potential unemployment shock, it is worthwhile to combine the implementation of moderate PCI with coordinated policies of income distribution.
Topics: Humans; Economic Development; Public Health; COVID-19; Models, Economic
PubMed: 38943103
DOI: 10.1186/s12889-024-19106-4 -
BMC Public Health Jun 2024Childhood obesity is increasingly recognized as a major public health challenge worldwide, and excessive sedentary screen time is emerging as a key risk factor. This...
BACKGROUND
Childhood obesity is increasingly recognized as a major public health challenge worldwide, and excessive sedentary screen time is emerging as a key risk factor. This study aimed to assess the recreational screen sedentary time of Chinese primary school-aged children and investigate the relationship between screen-related family factors and the outcome variable.
METHODS
Our study used data from a cross-sectional survey collected from fifth-grade students and their parents in Beijing, China, from April to May 2018 (n = 2,373). The questions included basic demographic information, family socioeconomic status, students' and parents' sedentary and exercising habits, within-family communicational factors, and health belief patterns. The recreational screen sedentary time of the children was compared across demographic groups. The study employed multivariate linear regression models to examine associations between children's screen time and various family factors, as well as the moderating effect of overall family communication.
RESULTS
Our findings revealed an average daily recreational screen sedentary time of 2.4 h among participants. Screen time significantly varied across demographic categories, including children's sex, age, residence, parents' education, household income, family size, and primary family member. After adjustment, the proportion of child-owned digital devices (p < 0.01), child's personal room (p < 0.05), family screen-viewing together (p < 0.01), and parental screen time (p < 0.01) were positively related to children's recreational sedentary screen time. Parental restrictions on screen time (p < 0.001) and attitudes toward reducing sitting time (p < 0.01) were correlated with a decrease in children's screen time. The overall family communication environment significantly moderated the effects of parental practice of restricting children's screen time (p < 0.001), positive reinforcement by parents (p < 0.05), and parents' recreational sedentary screen time (p < 0.001).
CONCLUSIONS
Our findings underscored the significance of family dynamics, parental practices, and communication in shaping children's screen time behaviors, providing valuable insights for tailored interventions and strategies to reduce childhood obesity.
Topics: Humans; Cross-Sectional Studies; Screen Time; Male; Female; Sedentary Behavior; Child; Communication; China; Beijing; Parents; Pediatric Obesity; Surveys and Questionnaires; Exercise
PubMed: 38943094
DOI: 10.1186/s12889-024-19128-y -
BMC Cardiovascular Disorders Jun 2024Pulmonary transit time (PTT) can be measured automatically from arterial input function (AIF) images of dual sequence first-pass perfusion imaging. PTT has been...
BACKGROUND
Pulmonary transit time (PTT) can be measured automatically from arterial input function (AIF) images of dual sequence first-pass perfusion imaging. PTT has been validated against invasive cardiac catheterisation correlating with both cardiac output and left ventricular filling pressure (both important prognostic markers in heart failure). We hypothesized that prolonged PTT is associated with clinical outcomes in patients with heart failure.
METHODS
We recruited outpatients with a recent diagnosis of non-ischaemic heart failure with left ventricular ejection fraction (LVEF) < 50% on referral echocardiogram. Patients were followed up by a review of medical records for major adverse cardiovascular events (MACE) defined as all-cause mortality, heart failure hospitalization, ventricular arrhythmia, stroke or myocardial infarction. PTT was measured automatically from low-resolution AIF dynamic series of both the LV and RV during rest perfusion imaging, and the PTT was measured as the time (in seconds) between the centroid of the left (LV) and right ventricle (RV) indicator dilution curves.
RESULTS
Patients (N = 294) were followed-up for median 2.0 years during which 37 patients (12.6%) had at least one MACE event. On univariate Cox regression analysis there was a significant association between PTT and MACE (Hazard ratio (HR) 1.16, 95% confidence interval (CI) 1.08-1.25, P = 0.0001). There was also significant association between PTT and heart failure hospitalisation (HR 1.15, 95% CI 1.02-1.29, P = 0.02) and moderate correlation between PTT and N-terminal pro B-type natriuretic peptide (NT-proBNP, r = 0.51, P < 0.001). PTT remained predictive of MACE after adjustment for clinical and imaging factors but was no longer significant once adjusted for NT-proBNP.
CONCLUSIONS
PTT measured automatically during CMR perfusion imaging in patients with recent onset non-ischaemic heart failure is predictive of MACE and in particular heart failure hospitalisation. PTT derived in this way may be a non-invasive marker of haemodynamic congestion in heart failure and future studies are required to establish if prolonged PTT identifies those who may warrant closer follow-up or medicine optimisation to reduce the risk of future adverse events.
Topics: Humans; Heart Failure; Male; Female; Middle Aged; Aged; Predictive Value of Tests; Time Factors; Prognosis; Ventricular Function, Left; Myocardial Perfusion Imaging; Stroke Volume; Risk Factors; Pulmonary Circulation; Natriuretic Peptide, Brain; Peptide Fragments; Pulmonary Artery; Risk Assessment; Ventricular Function, Right; Magnetic Resonance Imaging
PubMed: 38943084
DOI: 10.1186/s12872-024-04003-w -
BMC Geriatrics Jun 2024Research examining the healthy aging trajectory of retired older adults with multimorbidity is limited, leaving uncertainties regarding the optimal physical activity...
BACKGROUND
Research examining the healthy aging trajectory of retired older adults with multimorbidity is limited, leaving uncertainties regarding the optimal physical activity (PA) intensity and frequency necessary to sustain healthy aging during retirement.
METHODS
Our study investigated the moderating effects of PA on the healthy aging trajectories of retired older adults living with multimorbidity in the United States (US). We utilized data from 1,238 retired individuals aged 50 to 102 who contributed 11,142 observations over 16 years from the Health and Retirement Study (HRS). We employed mixed effects modeling to assess the impact of various classes of multimorbidity on this group and examine how different PA, PA intensities, and PA frequencies influence the disability, physical, and cognitive functioning domains of healthy aging.
RESULTS
The results reveal that while outcomes differed significantly, retired older adults in the US attained healthy aging at baseline. However, their ability to maintain healthy aging declined over time, with multimorbidity, especially musculoskeletal and neurological conditions, accelerating this decline. Fortunately, PA, especially light to moderate intensities, is associated with improving healthy aging and moderating the impact of multimorbidity on the disability and cognitive functioning domains of healthy aging. However, the specific moderating effects of PA depend on its frequency, intensity, and chronic conditions.
CONCLUSIONS
The significant variability in healthy aging attainment among retired older adults underlies the need to consider these differences when addressing healthy aging issues in the US. Accounting for these variations would aid in evaluating the potential impact of future interventions and contribute to achieving health equity. Fortunately, our dynamic findings facilitate this objective by identifying specific frequencies and intensities of PA tailored to different aspects of multimorbidity and healthy aging. This highlights PA, especially light-to-moderate intensity, as an essential, cost-effective, and amenable strategy for alleviating the impact of multimorbidity on healthy aging.
Topics: Humans; Aged; Multimorbidity; Male; Female; Healthy Aging; Aged, 80 and over; Exercise; Middle Aged; United States; Retirement; Longitudinal Studies
PubMed: 38943080
DOI: 10.1186/s12877-024-05067-1