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PEC Innovation Dec 2024Health misinformation is common and can lead to harmful behaviors such as medication non-adherence. We assessed the impact of a novel patient educational tool focused on...
OBJECTIVE
Health misinformation is common and can lead to harmful behaviors such as medication non-adherence. We assessed the impact of a novel patient educational tool focused on overcoming misconceptions among patients with coronary artery disease (CAD).
METHODS
We developed the CAD Roadmap, an educational tool aimed at explaining the disease trajectory and overcoming common disease misconceptions (such as that statin medications are not beneficial). We designed a pilot survey to assess patients' 1) CAD-related knowledge, 2) medication-taking behavior, and 3) acceptability of the Roadmap. Survey participants were recruited online. CAD knowledge scores were compared with repeated measures -tests.
RESULTS
Among 114 patients with CAD (mean age 67 years, 63% male), average CAD-related knowledge was 79.0% pre-test and 89.7% after review of the CAD Roadmap ( < .001). After review of the Roadmap, 24% indicated they planned to take their medications more regularly, 93% agreed it was helpful in understanding medication benefits, and 77% felt more empowered to participate in medical decisions.
CONCLUSION
The CAD Roadmap was evaluated positively, improved disease-related knowledge, and has the potential to improve adherence to treatments.
INNOVATION
Unlike many other interventions, the CAD Roadmap is specifically designed to overcome common misconceptions to improve health behaviors.
PubMed: 38911020
DOI: 10.1016/j.pecinn.2024.100303 -
Current Research in Immunology 2024Lymphoblastoid cell lines (LCLs) are immortalised peripheral B lymphocytes, transformed via infection with Epstein Barr virus (EBV). The use of LCLs to study B cell...
Lymphoblastoid cell lines (LCLs) are immortalised peripheral B lymphocytes, transformed via infection with Epstein Barr virus (EBV). The use of LCLs to study B cell function remains controversial and core markers to define physiological B cell populations are not consistent between studies of physiological B cells and LCLs. A consensus on the nature of these commonly used cell lines has not been reached. Recently, a core set of markers to subtype peripheral B cells was proposed, addressing the lack of agreed markers for B cell characterisation. In this present study, the consensus panel was applied to describe the B cell subtypes in LCLs. We found that LCLs were generally not physiologically representative of B cells, with most cells harbouring marker combinations absent on peripheral B cells. Some B cell subtyping markers were fundamentally altered during EBV transformation to LCLs (e.g. CD19, CD21). Notably, most LCLs secreted IgG but the associated marker combinations were predominantly only present following EBV transformation. This study therefore informs interpretation of past investigations, and planning of future studies using LCLs, as these cells are unlikely to behave like their pre-transformed B cell subtype.
PubMed: 38910966
DOI: 10.1016/j.crimmu.2024.100079 -
Frontiers in Pediatrics 2024Multiple-breath washout (MBW) is a sensitive method for assessing lung volumes and ventilation inhomogeneity in infants, but remains prone to artefacts (e.g., sighs)....
BACKGROUND
Multiple-breath washout (MBW) is a sensitive method for assessing lung volumes and ventilation inhomogeneity in infants, but remains prone to artefacts (e.g., sighs). There is a lack of tools for systematic retrospective analysis of existing datasets, and unlike N-MBW in older children, there are few specific quality control (QC) criteria for artefacts in infant SF-MBW.
AIM
We aimed to develop a computer-based tool for systematic evaluation of visual QC criteria of SF-MBW measurements and to investigate interrater agreement and effects on MBW outcomes among three independent examiners.
METHODS
We developed a software package for visualization of raw Spiroware (Eco Medics AG, Switzerland) and signal processed WBreath (ndd Medizintechnik AG, Switzerland) SF-MBW signal traces. Interrater agreement among three independent examiners (two experienced, one novice) who systematically reviewed 400 MBW trials for visual artefacts and the decision to accept/reject the washin and washout were assessed.
RESULTS
Our tool visualizes MBW signals and provides the user with (i) display options (e.g., zoom), (ii) options for a systematic QC assessment [e.g., decision to accept or reject, identification of artefacts (leak, sigh, irregular breathing pattern, breath hold), and comments], and (iii) additional information (e.g., automatic identification of sighs). Reviewer agreement was good using pre-defined QC criteria (κ 0.637-0.725). Differences in the decision to accept/reject had no substantial effect on MBW outcomes.
CONCLUSION
Our visual quality control tool supports a systematic retrospective analysis of existing data sets. Based on predefined QC criteria, even inexperienced users can achieve comparable MBW results.
PubMed: 38910962
DOI: 10.3389/fped.2024.1393291 -
Scientific Reports Jun 2024Peripheral neuropathy and amputation are common complications of diabetes mellitus (DM) that significantly impact the quality of life of the affected individuals. This...
Peripheral neuropathy and amputation are common complications of diabetes mellitus (DM) that significantly impact the quality of life of the affected individuals. This study aims to investigate the prevalence of peripheral neuropathy, the level of amputation, and the quality of life in patients with DM. This cross-sectional study was conducted after approval of the synopsis involving 225 diagnosed patients with DM on pre-defined eligibility criteria, selected from public sector OPDs, specialized diabetes centres, and centres manufacturing orthotics and prosthetics. Data were collected through interviews, observations, and the administration of the Michigan Neuropathy Screening Instrument and the Asian Diabetes Quality of Life Questionnaire. The level of amputation was recorded for each participant. Data was entered into SPSS, and results were synthesized. Pearson correlation is applied to find an association between gender and the quality of life of the participants, while P ≤ 0.05 will be considered significant. The prevalence of peripheral neuropathy in a sample of 225, based on a self-administered questionnaire, was (44.4%), and in terms of foot examination was (51.1%). As people progressed in age, the prevalence increased to 20.0% in patients above 60 years and 8.9% in ≤ 35 years of age. The majority of participants (56.0%) have had DM for less than five years. Females were 57.8% of the study population, while 97.8% of participants had type II DM. Below-knee amputation of the right limb was observed in 22(9.8%) of the participants. The QoL was poor in the majority of the participants (96.9%) patients with DM (P = 0.638 and T = -0.471). This cross-sectional study highlights a high prevalence of peripheral neuropathy and amputation and poor QoL in patients with diabetic mellitus.
Topics: Humans; Quality of Life; Male; Female; Middle Aged; Amputation, Surgical; Prevalence; Cross-Sectional Studies; Adult; Aged; Diabetic Neuropathies; Surveys and Questionnaires; Peripheral Nervous System Diseases; Diabetes Mellitus
PubMed: 38910161
DOI: 10.1038/s41598-024-65495-2 -
The International Journal on Drug Policy Jun 2024Young adult (18-30 years) people who inject drugs (PWID) face high hepatitis C virus (HCV) prevalence. In San Francisco, where >60% of PWID lack stable housing, barriers...
BACKGROUND
Young adult (18-30 years) people who inject drugs (PWID) face high hepatitis C virus (HCV) prevalence. In San Francisco, where >60% of PWID lack stable housing, barriers hinder HCV treatment access. We assessed progress towards the World Health Organization's (WHO) HCV elimination goal of an 80% reduction in incidence over 2015-2030, focusing on young (YPWID) and unstably housed PWID in San Francisco.
METHODS
We developed a dynamic HCV transmission model among PWID, parameterized and calibrated using bio-behavioural survey datasets from San Francisco. This included 2018 estimates for the antibody-prevalence among PWID (77%) and care cascade estimates for HCV for YPWID (72% aware of their status and 33% ever initiating treatment). Based on programmatic data, we assumed a 53.8% reduction in testing and 40.7% decrease in treatment from 2020 due to the COVID-19 pandemic, which partially rebounded from April 2021 with testing rates then being 31.1% lower than pre-pandemic rates and treatment numbers being 19.5% lower. We simulated different scenarios of how services changed after the pandemic to project whether elimination goals would be met.
RESULTS
Continuing post-pandemic rates of testing and treatment, the model projects an 83.3% (95% credibility interval [95% CrI]:60.6-96.9%) decrease in incidence among PWID over 2015-2030 to 1.5/100pyrs (95% CrI:0.3-4.4) in 2030. The probability of achieving the elimination goal by 2030 is 62.0%. Among YPWID and unstably housed PWID, the probability of achieving the elimination goal by 2030 is 54.8 and 67.6%, respectively. Importantly, further increasing testing and treatment rates to pre-pandemic levels by 2025 only results in a small increase in the probability (67.5%) of the elimination goal being achieved among all PWID by 2030, while increased coverage of medication for opioid use disorder among YPWID and/or housing interventions results in the probability of achieving elimination increasing to over 75%.
CONCLUSION
The COVID-19 pandemic impeded progress toward achieving HCV elimination. Our findings indicate that existing partial rebounds in HCV testing and treatment may achieve the elimination goal by 2030, with an additional scale-up of interventions aimed at YPWID or unstably housed PWID ensuring San Francisco is likely to achieve elimination by 2030.
PubMed: 38910096
DOI: 10.1016/j.drugpo.2024.104452 -
Rural and Remote Health Jun 2024Physical activity and lifestyle programs are scarce for people with hereditary ataxias and neurodegenerative diseases. Aboriginal families in the Top End of Australia...
INTRODUCTION
Physical activity and lifestyle programs are scarce for people with hereditary ataxias and neurodegenerative diseases. Aboriginal families in the Top End of Australia who have lived with Machado-Joseph disease (MJD) for generations co-designed a physical activity and lifestyle program called the Staying Strong Toolbox. The aim of the present study was to explore feasibility and impact of the program on walking and moving around.
METHODS
A mixed-methods, multiple case study design was used to pilot the Staying Strong Toolbox. Eight individuals with MJD participated in the program for 4 weeks. Participants tailored their own program using the Toolbox workbook. Families, support workers and researchers facilitated each individual's program. Feasibility was determined through program participation, adherence, coinciding or serious adverse events, participant acceptability and cost. Impact was determined through measures of mobility, ataxia, steps, quality of life, wellbeing and goal attainment, assessed before and after the program.
RESULTS
All participants completed the program, averaging five activity sessions per week, 66 minutes per session, of walking (63.5%), strengthening/balance-based activities (16%), cycling (11.4%) and activities of daily living, cultural and lifestyle activities (10.5%). Seven participants were assessed on all measures on three occasions (baseline, pre-program and post-program), while one participant could not complete post-program measures due to ceremonial responsibilities. All had significant improvements in mobility, steps taken and ataxia severity (p<0.05) after the program. Quality of life and wellbeing were maintained.
CONCLUSION
The program helped participants remain 'strong on the inside and outside'. Participants recommended implementation in 4-week blocks and for the program to be shared internationally. The Staying Strong Toolbox program was feasible for families with MJD. The program had a positive impact on walking and moving around, with participants feeling stronger on the outside (physically) and inside (emotionally, spiritually, psychosocially). The program could be adapted for use by other families with MJD.
Topics: Humans; Machado-Joseph Disease; Male; Female; Native Hawaiian or Other Pacific Islander; Adult; Exercise; Australia; Middle Aged; Life Style; Feasibility Studies; Quality of Life; Walking; Activities of Daily Living
PubMed: 38909987
DOI: 10.22605/RRH8376 -
Cellular Signalling Jun 2024Glutamatergic neurotransmission, important for learning and memory, is disrupted in different ways in patients with Alzheimer's disease (AD) and frontotemporal dementia...
Glutamatergic neurotransmission, important for learning and memory, is disrupted in different ways in patients with Alzheimer's disease (AD) and frontotemporal dementia (FTD) tauopathies. We have previously reported that two tau transgenic mouse models, L1 and L66, produce different phenotypes resembling AD and FTD, respectively. The AD-like L1 model expresses the truncated core aggregation domain of the AD paired helical filament (PHF) form of tau (tau296-390) whereas the FTD-like L66 model expresses full-length tau carrying two mutations at P301S/G335D. We have used synaptosomes isolated from these mice to investigate K-evoked glutamate release and, if abnormal, to determine responsiveness to hydromethylthionine, a tau aggregation inhibitor previously shown to reduce tau pathology in these models. We report that the transgenes in these two mouse lines cause opposite abnormalities in glutamate release. Over-expression of the core tau unit in L1 produces a significant reduction in glutamate release and a loss of Ca-dependency compared with wild-type control mice. Full-length mutant tau produces an increase in glutamate release that retains normal Ca-dependency. Chronic pre-treatment with hydromethylthionine normalises both reduced (L1) and excessive glutamate (L66) and restores normal Ca-dependency in L1 mice. This implies that both patterns of impairment are the result of tau aggregation, but that the direction and Ca-dependency of the abnormality is determined by expression of the disease-specific transgene. Our results lead to the conclusion that the tauopathies need not be considered a single entity in terms of the downstream effects of pathological aggregation of tau protein. In this case, directionally opposite abnormalities in glutamate release resulting from different types of tau aggregation in the two mouse models can be corrected by hydromethylthionine. This may help to explain the activity of hydromethylthionine on cognitive decline and brain atrophy in both AD and behavioural-variant FTD.
PubMed: 38909930
DOI: 10.1016/j.cellsig.2024.111269 -
Journal of ISAKOS : Joint Disorders &... Jun 2024Robotic-tools have been developed to improve planning, accuracy and outcomes in total knee arthroplasty (TKA). The purpose of this study was to describe and illustrate a...
OBJECTIVES
Robotic-tools have been developed to improve planning, accuracy and outcomes in total knee arthroplasty (TKA). The purpose of this study was to describe and illustrate a novel technique for assessing the patellofemoral (PFJ) in TKA using an imageless robotic platform.
METHODS
A consecutive series of 30 R-TKA were undertaken by a single-surgeon utilising the described technique. A technique to dynamically assess the PFJ intra-operatively, pre and post implantation was developed. A full set of data from 9 cases was then collected and reviewed for analysis. A series of dynamic PFJ tracks collected intra-operatively pre and post implantation are presented. Furthermore, a full assessment of PFJ over and under-stuffing through a 90° arc of flexion is illustrated. Finally, a pre and post centre of rotation for the PFJ was defined and measured.
RESULTS
The described technique was defined over a series of 30 R-TKA using the described robotic platform. Nine cases were analysed to determine what data could be measured using the robotic platform. Intra-operative real-time data allowed a visual assessment of PFJ tracking through a range of motion of 0° to 90° flexion pre and post-implantation. PFJ over and under-stuffing was also assessed intra-operatively through a range of motion of 0° to 90° flexion. Post operative analysis allowed a more detailed study to be performed, including defining a pre and post implantation centre of rotation (COR) for the patella. Defining the COR allowed the definition of a patella plane. Furthermore, patella mediolateral shift in full extension, and end flexion could be measured.
CONCLUSION
Intra-operative assessment of the PFJ in TKA is challenging. Robotic tools have been developed to improve measurement, accuracy of delivery and outcomes in TKA. These tools can be adapted in novel ways to assess the PFJ, which may lead to further refinements in TKA techniques.
PubMed: 38909904
DOI: 10.1016/j.jisako.2024.06.006 -
Reproductive Toxicology (Elmsford, N.Y.) Jun 2024Previous retrospective cohort studies have found that, compared with oxygen tension in the uterus and fallopian tubes (2%-8%), exposure of pre-implantation embryos to...
Previous retrospective cohort studies have found that, compared with oxygen tension in the uterus and fallopian tubes (2%-8%), exposure of pre-implantation embryos to atmospheric oxygen tension (AtmO, 20%) during assisted reproductive technology(ART) can affect embryo quality, pregnancy outcomes and offspring health. However, current research on the effects and mechanisms of AtmO on the development of embryos and offspring is mainly limited to animal experiments. Human embryonic stem cells (hESCs) play a special and irreplaceable role in the study of early human embryonic development. In this study, we used hESCs as a model to elucidate the possible effects and mechanisms of AtmO exposure on human embryonic development. We found that exposure to AtmO can reduce cell viability, produce oxidative stress, increase DNA damage, initiate DNA repair, activate autophagy, and increase cell apoptosis. We also noticed that approximately 50% of hESCs survived, adapted and proliferated through high expression of self-renewal and pluripotency regulatory factors, and affected embryoid body differentiation. These data indicate that hESCs experience oxidative stress, accumulation of DNA damage, and activate DNA damage response under the selective pressure of AtmO.Some hESCs undergo cell death, whereas other hESCs adapt and proliferate through increased expression of self-renewal genes. The current findings provide in vitro evidence that exposure to AtmO during the early preimplantation stage negatively affects hESCs.
PubMed: 38909692
DOI: 10.1016/j.reprotox.2024.108648 -
Clinical Microbiology and Infection :... Jun 2024Tuberculosis (TB) is the leading cause of mortality by an infectious disease world-wide. Despite national and international efforts, the world is not on track to end TB... (Review)
Review
BACKGROUND
Tuberculosis (TB) is the leading cause of mortality by an infectious disease world-wide. Despite national and international efforts, the world is not on track to end TB by 2030. Antibiotic treatment of TB is longer than for most infectious diseases and complicated by frequent adverse events. To counter emerging Mycobacterium tuberculosis drug resistance and provide effective, safe drug treatments of shorter duration, novel anti-TB medicines and treatment regimens are needed. Through a joint global effort, more candidate medicines are in the clinical phases of drug development than ever before.
OBJECTIVES
To review anti-TB medicines and treatment regimens under clinical evaluation for the future treatment of drug-susceptible and drug-resistant TB.
SOURCES
Pre-clinical and clinical studies on novel anti-TB drugs.
CONTENT
Description of novel protein synthesis inhibitors (oxazolidinones and oxaboroles), respiratory chain inhibitors (diarylquinolines and cytochrome bc1 complex inhibitor), cell wall inhibitors (DprE1 inhibitors, thioamides and carbapenems) and cholesterol metabolism inhibitor currently evaluated in clinical trials and novel clinical trial platforms for the evaluation of treatment regimens, rather than single entities.
IMPLICATIONS
A large number of potential anti-TB candidate medicines and innovations in clinical trial design for the evaluation of regimens, rather than single medicines, provide hope for improvements in the treatment of TB.
PubMed: 38909687
DOI: 10.1016/j.cmi.2024.06.016