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Multiple Sclerosis and Related Disorders Jan 2024The DYSPHAGIA IN MULTIPLE SCLEROSIS (DYMUS) questionnaire is the only specific tool developed to screen for dysphagia in people with Multiple Sclerosis (pwMS). However,...
BACKGROUND
The DYSPHAGIA IN MULTIPLE SCLEROSIS (DYMUS) questionnaire is the only specific tool developed to screen for dysphagia in people with Multiple Sclerosis (pwMS). However, some limitations of DYMUS could potentially be addressed by the SWALLOWING DISTURBANCE QUESTIONNAIRE (SDQ), which has not yet been validated in pwMS. The objective of this study was to translate and validate the SDQ into the Italian language for use in pwMS to detect swallowing disturbances.
METHODS
We translated the SDQ into Italian and adapted it for use in Italian pwMS. PwMS aged > 18 years, assessed for disability using the Expanded Disability Status Scale (EDSS), completed the SDQ and DYMUS questionnaires and performed the 3-OUNCE WATER SWALLOW TEST (WST). Clinical and demographic data were collected for each patient. The Italian version of the SDQ was retested after 30 days.
RESULTS
A total of 84 pwMS were recruited for the study, consisting of 73.8 % women and 48.8 % with a relapsing-remitting form of MS. The mean age of participants was 44.5 years (SD: ±12.46), with a mean disease duration of 17 years (SD: ±10.27), and a median EDSS of 4 (range 1.5-7.5). The Cronbach's alpha for SDQ (to assess internal consistency) was 0.902, which increased to 0.908 after the elimination of item 15, resulting in the SDQ composed of 14 items. ROC analysis demonstrated good accuracy of the 14-item SDQ in pwMS (AUC: 0.811). By dividing the 14-item SDQ score into quartiles, three risk levels for dysphagia were identified: low (score 1-3), intermediate (score 4-8), and high (score ≥9). 14-item SDQ scores significantly correlated with DYMUS (r = 0.820; p<0.0001) and with EDSS (r = 0.541; p<0.0001). PwMS who reported dysphagia had a significantly higher mean 14-item SDQ score (8.27 ± SD 8.15) compared to those without swallowing problems (2.77 ± SD 4.25; p = 0.003). Additionally, pwMS with a positive WST had a significantly higher mean 14-item SDQ score (10.17 ± SD 8.96) than those with a negative WST (2.96 ± SD 3.93; p = 0.02). The Intraclass Correlation Coefficient for the retest, calculated on 48 pwMS in a stable phase of the disease, was 0.91 (95 % CI 0.84-0.95).
CONCLUSION
The 14-item SDQ has demonstrated high internal consistency, good accuracy, and reliability in pwMS, making it a readily applicable tool for investigating dysphagia in MS.
Topics: Humans; Female; Adult; Male; Multiple Sclerosis; Deglutition; Deglutition Disorders; Reproducibility of Results; Surveys and Questionnaires
PubMed: 38006849
DOI: 10.1016/j.msard.2023.105142 -
JAMA Network Open Nov 2023
Topics: Humans; Early Detection of Cancer; Cost-Benefit Analysis; Cost-Effectiveness Analysis; Colorectal Neoplasms
PubMed: 37971745
DOI: 10.1001/jamanetworkopen.2023.43346 -
Cureus Oct 2023Background In the field of aesthetic dermatology, there is currently very little data on affordability and cost analysis regarding cosmeceuticals as more demand from...
Background In the field of aesthetic dermatology, there is currently very little data on affordability and cost analysis regarding cosmeceuticals as more demand from patients showing interest in cosmeceutical products to reduce and prevent aging continues to grow. Photoaging, a form of extrinsic aging from sun exposure, can be ameliorated by applying sunscreen and retinol products. Topical ascorbic acid and niacinamide have been shown to target the oxidative stress process that contributes to photoaging. These four products have been identified as the cosmeceutical ingredients with the most evidence-based data on photoaging prevention and treatment. Objective Given the demand for effective skin care, the paucity of data on cost differentiation, and the availability of cosmeceutical products, we analyzed the unit cost of four anti-aging products from major online and physical retailers in the United States. Such a cost comparison may facilitate more economically appropriate recommendations on skin care to consumers. Methods and materials We analyzed sunscreen, topical vitamin C (ascorbic acid), topical vitamin B3 (niacinamide), and topical vitamin A (retinol) products sold by four major United States retailers: Walmart, Ulta, Walgreens, and Amazon. The average cost in dollars per ounce (dollar/oz) was calculated for each product category at each retailer. Statistical analyses were done to determine statistical significance for each product category between retailers as well as between each category of product. Results Between the four retailers, Walmart offered the lowest cost per ounce for every product. In contrast, Amazon offered the highest cost per ounce for every product except for sunscreen. We also found that sunscreen products are less expensive per ounce as compared to retinol, ascorbic acid, and niacinamide products. Conclusion Dermatologists should be knowledgeable of product costs when providing patients with anti-aging product recommendations. Our study provides data on the financial cost by retail location of evidence-based anti-aging cosmeceuticals to better guide physicians in patient consulting and economical resource sharing.
PubMed: 37933373
DOI: 10.7759/cureus.46596 -
Current Developments in Nutrition Oct 2023Tree nuts are nutrient dense, and their consumption has been associated with improvements in health outcomes.
BACKGROUND
Tree nuts are nutrient dense, and their consumption has been associated with improvements in health outcomes.
OBJECTIVE
To estimate the usual tree nut intake and examine the association between tree nut consumption and cardiometabolic (CM) health outcomes in a nationally representative sample of US adults.
METHODS
Cross-sectional data were analyzed from a sample of 18,150 adults aged ≥ 20y who provided at least one reliable 24-h dietary recall and had complete data for the variables of interest in the NHANES 2011-2018. Tree nut consumers were defined as those consuming ≥ ¼ ounce/d (7.09 g). The National Cancer Institute Method was used to estimate the usual tree nut intake among consumers. Measurement error calibrated regression models were used to assess the association between tree nut consumption and each health outcome of interest.
RESULTS
Approximately 8% of all participants ( = 1238) consumed tree nuts and had a mean ± SE usual intake of 39.5 ± 1.8 g/d. Tree nut consumers were less likely to have obesity (31% vs. 40%, < 0.001) and low high-density lipoprotein cholesterol (22% vs. 30%, < 0.001 compared with nonconsumers. Moreover, tree nut consumers had a lower mean waist circumference (WC) (97.1 ± 0.7 vs. 100.5 ± 0.3 cm, < 0.001) and apolipoprotein B (87.5 ± 1.2 vs. 91.8 ± 0.5 mg/dL, 0.004) than nonconsumers. After adjusting models for demographics and lifestyle covariates, the difference in WC between average intake (33.7 g/d) and low threshold intake (7.09/g) of tree nuts was -1.42 ± 0.58 cm ( = 0.005).
CONCLUSIONS
Most US adults do not consume tree nuts, yet modest consumption was associated with decreased prevalence of cardiovascular disease and CM risk factors and improvement for some health outcome measures.
PubMed: 37869524
DOI: 10.1016/j.cdnut.2023.102007 -
Journal of Chromatography. B,... Sep 2023The recent increase in peptidomimetic-based medications and the growing interest in peptide hormones has brought new attention to the quantification of peptides for...
The recent increase in peptidomimetic-based medications and the growing interest in peptide hormones has brought new attention to the quantification of peptides for diagnostic purposes. Indeed, the circulating concentrations of peptide hormones in the blood provide a snapshot of the state of the body and could eventually lead to detecting a particular health condition. Although extremely useful, the quantification of such molecules, preferably by liquid chromatography coupled to mass spectrometry, might be quite tricky. First, peptides are subjected to hydrolysis, oxidation, and other post-translational modifications, and, most importantly, they are substrates of specific and nonspecific proteases in biological matrixes. All these events might continue after sampling, changing the peptide hormone concentrations. Second, because they include positively and negatively charged groups and hydrophilic and hydrophobic residues, they interact with their environment; these interactions might lead to a local change in the measured concentrations. A phenomenon such as nonspecific adsorption to lab glassware or materials has often a tremendous effect on the concentration and needs to be controlled with particular care. Finally, the circulating levels of peptides might be low (pico- or femtomolar range), increasing the impact of the aforementioned effects and inducing the need for highly sensitive instruments and well-optimized methods. Thus, despite the extreme diversity of these peptides and their matrixes, there is a common challenge for all the assays: the need to keep concentrations unchanged from sampling to analysis. While significant efforts are often placed on optimizing the analysis, few studies consider in depth the impact of pre-analytical steps on the results. By working through practical examples, this solution-oriented tutorial review addresses typical pre-analytical challenges encountered during the development of a peptide assay from the standpoint of a clinical laboratory. We provide tips and tricks to avoid pitfalls as well as strategies to guide all new developments. Our ultimate goal is to increase pre-analytical awareness to ensure that newly developed peptide assays produce robust and accurate results.
Topics: Chromatography, Liquid; Mass Spectrometry; Peptide Hormones
PubMed: 37832388
DOI: 10.1016/j.jchromb.2023.123904 -
PloS One 2023There are oral health disparities in the U.S. and children in food-insecure households have a higher burden of tooth decay. Identifying the mechanisms underlying the...
INTRODUCTION
There are oral health disparities in the U.S. and children in food-insecure households have a higher burden of tooth decay. Identifying the mechanisms underlying the food insecurity-tooth decay relationship could inform public health interventions. This study examined how sugar-sweetened beverage (SSB) intake and frequent convenience store shopping mediated the food insecurity-tooth decay relationship for lower-income children.
MATERIALS AND METHODS
Cross-sectional study data included a household survey, beverage questionnaire, and dental examination. The sample included 452 lower-income, racially-diverse, child-caregiver dyads in 2018 from King County in Washington state. The exposure was household food insecurity, the outcome was untreated decayed tooth surfaces, and the proposed mediators were SSB intake and frequent convenience store shopping (≥2 times/week). Causal mediation analyses via the potential outcomes framework was used to estimate natural indirect and direct effects.
RESULTS
Fifty-five percent of participants were in food-insecure households, the mean number of decayed tooth surfaces among children was 0.87 (standard deviation [SD] = 1.99), the mean SSB intake was 17 fluid ounces (fl/oz)/day (SD = 35), and 18% of households frequently shopped at a convenience store. After adjusting for confounders, household food insecurity and log-transformed SSB intake (fluid ounces/day) were positively associated with decayed tooth surfaces, but not at the a α = 0.05 level (mean ratio [MR] 1.60; 95% confidence interval [CI] 0.89, 2.88; p = .12 and MR 1.16; 95% CI 0.93, 1.46; p = .19, respectively). Frequent convenience store shopping was associated with 2.75 times more decayed tooth surfaces (95% CI 1.61, 4.67; p < .001). SSB intake mediated 10% of the food insecurity-tooth decay relationship (p = .35) and frequent convenience store shopping mediated 22% (p = .33).
CONCLUSIONS
Interventions aimed at addressing oral health disparities in children in food-insecure households could potentially focus on reducing intake of SSBs and improving access to healthful foods in lower-income communities.
Topics: Humans; Sugar-Sweetened Beverages; Washington; Cross-Sectional Studies; Poverty; Commerce
PubMed: 37699013
DOI: 10.1371/journal.pone.0290287 -
Nutrients Aug 2023Concern for the environment when making dietary choices has grown as the contribution of the food sector to global greenhouse gas emissions becomes more widely known....
Concern for the environment when making dietary choices has grown as the contribution of the food sector to global greenhouse gas emissions becomes more widely known. Understanding the correlates of beef eating could assist in the targeting of campaigns to reduce the consumption of high-impact foods. The objective of this study was to identify the demographic, socioeconomic, and behavioral correlates of disproportionate beef consumption in the United States. We analyzed 24-h dietary recall data from adults ( = 10,248) in the 2015-2018 National Health and Nutrition Examination Survey (NHANES). Disproportionate beef consumption was defined as an intake greater than four ounce-equivalents per 2200 kcal. Associations of this indicator variable with gender, age, race/ethnicity, education, family income, diet knowledge, and away-from-home meals were assessed using logistic regression, incorporating survey design and weighting. Disproportionate beef diets were consumed by 12% of individuals, but accounted for half of all beef consumed. Males were more likely than females ( < 0.001) to consume these diets. This relationship was seen in all bivariate and multivariable models. Older adults, college graduates, and those who looked up the MyPlate educational campaign online were less likely ( < 0.01) to consume a disproportionate beef diet. While almost one-third of reported consumption came from cuts of beef (e.g., steak or brisket), six of the top ten beef sources were mixed dishes: burgers, meat mixed dishes, burritos and tacos, frankfurters, soups, and pasta. Efforts to address climate change through diet modification could benefit from targeting campaigns to the highest consumers of beef, as their consumption accounts for half of all beef consumed.
Topics: Animals; Female; Male; Humans; Cattle; Aged; Global Warming; Nutrition Surveys; Educational Status; Ethnicity; Meals
PubMed: 37686827
DOI: 10.3390/nu15173795 -
Nutrients Aug 2023Parents play a significant role in adolescent health behaviors; however, few nutrition interventions for Hispanic adolescents involve parents. This study assessed the... (Randomized Controlled Trial)
Randomized Controlled Trial
Diet Outcomes from a Randomized Controlled Trial Assessing a Parenting Intervention Simultaneously Targeting Healthy Eating and Substance Use Prevention among Hispanic Middle-School Adolescents.
Parents play a significant role in adolescent health behaviors; however, few nutrition interventions for Hispanic adolescents involve parents. This study assessed the effects of a 10-week parenting intervention simultaneously targeting nutrition and substance use prevention. Hispanic parent/6th-8th-grade adolescent dyads (n = 239) were randomized to Families Preparing the New Generation Plus (FPNG+; nutrition/substance use prevention), FPNG (substance use prevention only), or Realizing the American Dream (RAD; academic success control). Surveys assessed diet, alcohol use, substance use intentions, and substance use norms at baseline (T1), immediately post-intervention (T2), and at 16 weeks post-intervention (T3). Latent change modeling assessed diet changes; adolescent substance use outcomes were assessed using effect sizes. Among adolescents, those in FPNG+ increased fruit (+0.32 cup equivalents, = 0.022) and fiber intake (+1.06 g, = 0.048) and did not change added sugars intake at T2; those in FPNG and RAD reduced their intake of fruit and fiber ( < 0.05 for both). FPNG+ parents marginally increased fruit/vegetable intake (+0.17 cup equivalents, = 0.054) and increased whole grains intake (+0.25-ounce equivalents, < 0.05), in contrast to the reduction among RAD and FPNG parents ( < 0.05). Reductions in added sugar intake at T2 were greater among FPNG and FPNG+ parents relative to RAD parents ( < 0.05). FPNG+ and FPNG had comparable substance use outcomes (i.e., both had lower alcohol use and intentions to use substances relative to RAD). Engaging parents in a nutrition and substance use prevention parenting intervention yielded positive changes in dietary intake and maintained substance use prevention outcomes among their adolescent children.
Topics: Adolescent; Humans; Diet; Diet, Healthy; Hispanic or Latino; Parenting; Parents
PubMed: 37686822
DOI: 10.3390/nu15173790 -
Public Health Nutrition Oct 2023To examine the effectiveness of a workplace sugar-sweetened beverage (SSB) sales ban on reducing SSB consumption in employees, including those with cardiometabolic... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
To examine the effectiveness of a workplace sugar-sweetened beverage (SSB) sales ban on reducing SSB consumption in employees, including those with cardiometabolic disease risk factors.
DESIGN
A controlled trial of ethnically diverse, full-time employees who consumed SSB heavily (sales ban 315; control 342). Outcomes included standardised measures of change in SSB consumption in the workplace (primary) and at home between baseline and 6 months post-sales ban.
SETTING
Sutter Health, a large non-profit healthcare delivery system in Northern California.
PARTICIPANTS
Full-time employees at Sutter Health screened for heavy SSB consumption.
RESULTS
Participants were 66·1 % non-White. On average, participants consumed 34·7 ounces (about 1 litre) of SSB per d, and the majority had an elevated baseline BMI (mean = 29·5). In adjusted regression analyses, those exposed to a workplace SSB sales ban for 6 months consumed 2·7 (95 % CI -4·9, -0·5) fewer ounces of SSB per d while at work, and 4·3 (95 % CI -8·4, -0·2) fewer total ounces per d, compared to controls. Sales ban participants with an elevated BMI or waist circumference had greater post-intervention reductions in workplace SSB consumption.
CONCLUSIONS
Workplace sales bans can reduce SSB consumption in ethnically diverse employee populations, including those at higher risk for cardiometabolic disease.
Topics: Humans; Sugar-Sweetened Beverages; Beverages; Workplace; Cardiovascular Diseases
PubMed: 37465952
DOI: 10.1017/S1368980023001386