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Background: Electronic cigarettes or e-cigarettes have gained significant popularity as an alternative to traditional combustible tobacco smoking particularly among the youth. Although there is a growing prevalence of e-cigarette usage, the effects on cardiovascular function and physical capacity have not been adequately studied. The toxic products in combustible tobacco cigarettes negatively impact functional exercise capacity. However, the available data regarding the effect of e-cigarette use on functional exercise capacity are scarce. Thus, in the current study, we aimed to evaluate the functional aerobic exercise capacity among chronic e-cigarette users compared to combustible cigarette smokers and non-smokers. Results: This comparative, cross-sectional study was conducted on 105 healthy volunteers. Participants were assigned into three study groups each consisting of 35 participants: chronic e-cigarette users, combustible cigarette smokers, and a non-smoker control group. Basal demographic and clinical data were similar in all groups. Mean heart rates and respiratory rates were significantly higher among e-cigarette smokers and combustible cigarette smokers compared to non-smoker controls (p < 0.001). Chronic e-cigarette users and combustible cigarette smokers had shorter 6-MWT distances compared to non-smokers (508.3, 488, and 616.6 m, respectively, p < 0.001). Borg scale scores after performing the six-minute walking test were significantly higher in chronic e-cigarette users and combustible cigarette smokers groups compared to non-smokers, where perceived exertion (4.9, 5.5, 2.1, respectively, p < 0.001), dyspnea (5.7, 6.5, 0.1, respectively, p < 0.001) and leg fatigue (4.2, 5.4, 1.4, respectively, p < 0.001). Conclusion: In this cross-sectional study, significant evidence demonstrates that e-cigarette use is not harmless. This was particularly presented in apparently healthy e-cigarette users in comparison to the healthy non-smoker control group. Chronic e-cigarette use is associated with reduced functional capacity compared to non-smoker controls. This was signified by decreased 6MWT walking distances, higher Borg scale scores, and lower oxygen saturation percentages among the chronic electronic cigarette users as compared to non-smoker controls after performing the six-minute walking test. All the evaluated parameters in the current study were similarly reduced among both the e-cigarette users group and the combustible cigarette smokers group compared to non-smokers with no statistically significant differences between both smoker groups. [ABSTRACT FROM AUTHOR]

Background: Radiological diagnosis of cervical spondylotic myelopathy should be made as early as possible to obtain favourable clinical outcomes when compared with later stages. Diffusion tensor imaging can reveal early structural changes of the cord in patients with cervical compressive myelopathy. Aim: This study aimed to assess the role of magnetic resonance diffusion tensor imaging in the accurate evaluation of cervical spondylotic myelopathy. Patients and methods: This prospective study included a group of 60 patients with neurological symptoms suggestive for cervical spondylotic myelopathy and a control group of 30 healthy subjects. The clinical severity of compressive myelopathy was assessed based on the European myelopathy score. Magnetic resonance diffusion tensor imaging and tractography were done for all patients and controls. Results: Fractional anisotropy values at the most compressed segments of spinal cord are lower while apparent diffusion coefficient values of the same segments are higher than healthy segments in controls. Fractional anisotropy and apparent diffusion coefficient parameters had higher sensitivity (97.0% and 88.1%, respectively) than conventional T2 WIs (13.4%) and fibre tractography (10%) for the detection of early compressive myelopathy with cutoff values ≤ 0.56 and > 1.23, respectively, in differentiating between patients and control groups. Conclusion: Diffusion tensor imaging indices are valuable tools for quantitative assessment of degenerative cervical spondylotic myelopathy in addition to routine cervical spine magnetic resonance. [ABSTRACT FROM AUTHOR]

Background: Lung cancer is the leading cause of cancer death in the world. Non-small-cell lung cancer (NSCLC) accounts for 85% of primary lung tumors. Epidermal growth factor receptors (EGFRs) are found on the surface of tumor cells, and their role is to send a growth signal to the cell nucleus. Tumor cells with EGFR mutations are very sensitive to cancer treatments called "Targeted Therapies." The search for EGFR mutations requires lung biopsies. Some studies have shown a correlation between clinico-radiological characteristics and the EGFR mutation. In this study, an attempt was made to identify the relevant clinico-radiological characteristics associated with the EGFR mutation in patients with NSCLC. Objectives: The main objective of this study was to evaluate the clinico-radiological characteristics useful for predicting the risk of EGFR mutation in patients with NSCLC. Materials and methods: This is a retrospective cross-sectional study, carried out in 149 patients followed up for lung adenocarcinoma who benefited from an EGFR mutation study at the anatomopathology department of the University Hospital of Fez, spread over a period of 4 years (between January 2018 and December 2021). A database was compiled from this study, including sociodemographic, clinical, anatomopathological and radiological data. A statistical analysis was carried out in order to identify the factors associated with EGFR mutation. Results: According to the inclusion and exclusion criteria, of the 149 patients included, the mean age was 61.05 + / − 11.095 years. Males predominated with a percentage of 70.5% (n = 105). Fifty-seven point seven percent of patients were smokers or ex-smokers. Forty-one patients had an EGFR mutation, representing a percentage of 27.5%. Multivariate analysis by logistic regression revealed an association of the EGFR mutation with irregular contours (ORA = 6.43; CI95% 1.26;32.78), with the presence of spiculations (ORA = 5.81; CI95% 1.96;17.22), with pleural attachment (ORA = 3.53; CI95% 1.32;9.42), with heterogeneous enhancement (ORA = 30.679; CI95% 5.149;182.778), with absence of emphysema (ORA = 4.815; CI95% 1.966;17.220) and with presence of distant metastasis (ORA = 4.123; CI95% 1.373;12.383). Conclusions: This study provides substantial evidence to support the assertion that irregular contours, the presence of spiculations, pleural attachment, heterogeneous enhancement, the absence of emphysema and the presence of distant metastasis are statistically correlated with EGFR mutations. The model developed within this study, encompassing all relevant clinical and CT characteristics, has demonstrated its effectiveness as a reliable predictor for EGFR mutations (AUC: 0.7659) and consequently as a key determinant of EGFR-TKI treatment response. [ABSTRACT FROM AUTHOR]

Background: The universal newborn hearing screening (UNHS) has effectively allowed babies with hearing loss to be detected early. However, findings from previous studies indicate that this procedure may adversely induce anxiety among mothers. Therefore, this study aimed to investigate anxiety among mothers whose babies received a hearing screening at a tertiary hospital in Malaysia. A cross-sectional study was conducted on 105 mothers from a tertiary hospital in Kuala Lumpur, Malaysia. Two questionnaires, the Infant Health Concern Scale (IHCS) and State-Trait Anxiety Inventory (STAI), were used to measure the mothers' worry level on a 4-point Likert scale. Mothers were required to complete the questionnaires twice, before and 4 weeks after discharge, regardless of the hearing screening results. Results: The STAI scores obtained from mothers whose babies failed the initial screening were significantly higher than mothers whose babies passed. During the initial screening, all mothers rated hearing as the sixth health aspect causing anxiety using the IHCS. However, the ranking fell to 15th place after the second screening. Similarly, mothers whose babies had false positive results also exhibited significantly higher STAI scores and a dropped hearing ranking during rescreening than the initial screening. In addition, mother's anxiety was not significantly correlated with their education level, family income, or number of births. Conclusion: Mothers who participated in this study experienced anxiety regardless of their babies hearing screening results. Therefore, the UNHS program must be reviewed to identify appropriate strategies to minimize this negative emotion among mothers. [ABSTRACT FROM AUTHOR]

Introduction: The performance of total hip arthroplasty in elderly patients, especially nonagenarians, is challenging due to higher patient frailty and medical comorbidities. We compared 90-day postoperative complications and unplanned readmissions between nonagenarians and octogenarians undergoing elective THA. Methods: One hundred and eleven patients undergoing elective, unilateral THA were retrospectively analyzed. Forty-four patients were nonagenarians (Group A), and 67 patients were octogenarians (Group B). Demographic data included age, gender, body mass index (BMI), ASA score and Charlson Comorbidity Index (CCI). Frailty was defined according to the Rockwood Frailty Index. All patients underwent a thorough preoperative assessment through a specific institutional clinical pathway created for this matter. Postoperative adverse events were grouped into major or minor. A regression model was used to evaluate independent risk factors for the development of complications. Results: There were no differences in the ASA score (65.9% vs. 53.7% ASA III-IV), prevalence of frailty (1% vs. 9%) and comorbidities between both groups (p >.05). The CCI was higher in nonagenarians (p = 0.007). Nonagenarians had more in-hospital complications, although most were minor (p = 0.002), none of which resulted in mortality. Ninety-day unplanned readmissions were similar between groups, with 4 (9.1%) and 6 (9%) in groups A and B, respectively (p = 1). Although age was a factor associated with the development of postoperative complications in the univariate regression model (OR 3.81, 95% CI 1.31 to 11.11, p = 0.014), it lost significance after performing the multivariate analysis (OR 2.48, 95% CI 0.78 to 7.90, p = 0.125). Conclusion: The age of 90 years old was not a barrier to perform elective THA safely. Nonagenarians had higher in-hospital minor complications when compared to the younger cohort. However, age over 90 years was not an independent risk factor for unplanned readmissions or mortality. Multimodal protocols of perioperative care are paramount for improving outcomes after THA in very old patients. [ABSTRACT FROM AUTHOR]

The font size effect refers to the metacognitive illusion that larger fonts lead to higher judgments of learning (JOLs) but not better recall. Prior studies demonstrated robust JOL effects of font size under conditions of intra-item relation (i.e., cue–target relatedness within a word pair), even though intra-item relation is a more diagnostic cue than font size. However, it remains an open question whether the JOL effects of font size persist under conditions of inter-item relation (i.e., relations across items on a single-word list). In the current study, we examined the JOL and recall effects of font size when font size and inter-item relation were factorially manipulated in three JOL-recall experiments. Additionally, to manipulate the salience of inter-item relation, we presented related and unrelated lists in a blocked manner in Experiment 1 but in a mixed manner in Experiments 2 and 3. Our results showed that the JOL effects of font size are moderated or eliminated when inter-item relation is manipulated simultaneously with font size. Moreover, the smaller font led to better recall for related lists but not for unrelated lists across all three experiments. Therefore, our results demonstrate that individual cues may not be integrated with equal weight, and there can be a trade-off between item-specific and relational processing during the JOL process. Additionally, highlighting key information with larger fonts may not be optimal with related items. [ABSTRACT FROM AUTHOR]

Background: Growing evidence indicates early exercise may improve symptoms and reduce clinical recovery time after concussion, but research examining collegiate student-athletes is scarce. Objective: The aim of this study was to compare symptom recovery time, clinical recovery time, and persisting post-concussion symptom (i.e., symptoms ≥ 28 days) prevalence by the timing of light exercise initiation before the graded return to play (RTP) protocol among concussed participants. Methods: Collegiate student-athletes (n = 1228; age 18.4 ± 0.9 years; 56.5% male, 76.3% division I; 33.7% ≥ 1 prior concussion) across 30 institutions enrolled in the CARE Consortium completed post-concussion assessments and were monitored over time. Symptom recovery (days from injury to symptom resolution) and clinical recovery (days from injury to return to play protocol completion) was determined by the student-athletes' clinicians. Student-athletes were categorized by timing of light exercise initiation. Early (< 2 days post-concussion; n = 161), typical (3–7 days post-concussion; n = 281), and late exercise (≥ 8 days post-concussion; n = 169) groups were compared with the no-exercise group (n = 617; i.e., did not exercise prior to beginning the RTP protocol) for all analyses. Multivariable Cox regression models with hazard ratios (HR) and survival curves and a multivariable binomial regression model with prevalence ratios (PR) compared recovery outcomes between exercise groups while accounting for covariates. Results: Compared to the no-exercise group, the early exercise group was 92% more probable to experience symptom recovery (HR 1.92; 95% CI 1.57–2.36), 88% more probable to reach clinical recovery (HR 1.88; 95% CI 1.55–2.28) and took a median of 2.4 and 3.2 days less to recover, respectively. The late exercise group relative to the no-exercise group was 57% less probable to reach symptom recovery (HR 0.43; 95% CI 0.35–0.53), 46% less probable to achieve clinical recovery (HR 0.54; 95% CI 0.45–0.66) and took 5.3 days and 5.7 days more to recover, respectively. The typical exercise group did not differ in hazard for symptom or clinical recovery (p ≥ 0.329) compared with the no-exercise group. The prevalence of persisting post-concussion symptoms in the combined sample was 6.6%. Early exercise had 4% lower prevalence (PR 0.96, 95% CI 0.94–0.99) and typical exercise had 3% lower prevalence (PR 0.97, 95% CI 0.94–0.99) of persisting post-concussion symptoms, while the late exercise group had an elevated prevalence (PR 1.11, 95% CI 1.04–1.18) compared with the no-exercise group. Conclusion: Exercise < 2 days post-concussion was associated with more probable and faster symptom and clinical recovery, and lower persisting post-concussion symptom prevalence. When considering our findings and existing literature, qualified clinicians may implement early exercise into their clinical practice to provide therapeutic treatment and improve student-athlete recovery. [ABSTRACT FROM AUTHOR]

Individuals with serious mental illness are vulnerable to extreme heat due to biological, social, and place-based factors. We examine the spatial correlation of prevalence of individuals treated at a community mental health center to heat vulnerability. We applied a heat vulnerability index (HVI) to the catchment of the Connecticut Mental Health Center in New Haven, Connecticut. Geocoded addresses were mapped to correlate patient prevalence with heat vulnerability of census tracts. Census tracts closer to the city center had elevated vulnerability scores. Patient prevalence was positively correlated with HVI score (Pearson's r(44) = 0.67, p < 0.01). Statistical significance persists after correction for spatial autocorrelation (modified t-test p < 0.01). The study indicates that individuals treated at this community mental health center are more likely to live in census tracts with high heat vulnerability. Heat mapping strategies can help communicate risk and target resources at the local scale. [ABSTRACT FROM AUTHOR]

Maternal psychological distress is often associated with domestic violence. Spiritual well-being can affect the psychological capacity to deal with distress. This study aimed to investigate the relationship between psychological distress and spiritual well-being in pregnant women exposed to domestic violence. This cross-sectional study was conducted on 305 pregnant women subjected to domestic violence in southern Iran. The participants were selected using the census method. Data were collected using the Spiritual Well-being Scale (SWB), the Kessler Psychological Distress Scale (K10), and the Hurt, Insult, Threaten, Scream (HITS) screening tool (short form) and were analyzed with descriptive and inferential statistics (t-test, ANOVA, the Spearman correlation coefficient, and multiple linear regression) in SPSS software version 24. The mean scores ± standard deviation of the participants' psychological distress, spiritual well-being, and domestic violence were 24.68 ± 6.43, 79.89 ± 18.98, and 11.24 ± 1.5, respectively. The results showed that psychological distress had a significant negative correlation with spiritual well-being (ρ = − 0.84, P < 0.001) and domestic violence (ρ = − 0.73, P < 0.001). The results of the multiple linear regression analysis also showed that spiritual well-being and domestic violence could predict the psychological distress of pregnant women who were exposed to domestic violence, which explained 73% of the psychological distress in the participants. According to the study results, spiritually oriented education can be provided for women to reduce their psychological distress. Also, it is recommended that necessary interventions be used to reduce domestic violence and empower women to prevent it. [ABSTRACT FROM AUTHOR]

Objectives: To identify a normal pattern of mandibular trabecular bone in children based on the fractal dimension (FD), and its possible correlation with pixel intensity (PI) values, to facilitate the early diagnosis of possible diseases and/or future bone alterations. Materials and methods: The 50 panoramic images were selected and divided into two groups, according to the children's age: 8–9 (Group 1; n = 25) and 6–7 (Group 2; n = 25). For FD and PI analyses, three regions of interest (ROIs) were selected, and their mean values were evaluated for each ROI, according to each group, using the t test for independent samples and the model of generalized estimation equations (GEE). Subsequently, these mean values were correlated by the Pearson test. Results: Comparing the groups, FD and PI did not differ from each other for any of the measured regions (p > 0.00). It was observed that in the mandible branch (ROI1), FD and PI means were 1.26 ± 0.01 and 81.0 ± 2.50, respectively. In the mandible angle (ROI2), the means were 1.21 ± 0.02 (FD) and 72.8 ± 2.13 (PI); and in the mandible, cortical (ROI3) values of FD = 1.03 ± 0.01 and PI = 91.3 ± 1.75 were obtained. There was no correlation between FD and PI in any of the analyzed ROI (r < 0.285). The FD means of ROI1 and ROI2 did not differ from each other (p = 0.053), but both were different from ROI3 (p < 0.00). All PI values differed from each other (p < 0.00). Conclusion: The bone trabeculate pattern in 6–9-year-old children presented FD between 1.01 and 1.29. Besides that, there was no significant correlation between FD and PI. [ABSTRACT FROM AUTHOR]

Objective: To investigate the molecular mechanisms underlying the effect of baicalin on prostate cancer (PCa) progression both in vivo and in vitro. Methods: The in situ PCa stem cells (PCSCs)-injected xenograft tumor models were established in BALB/c nude mice. Tumor volume and weight were respectively checked after baicalin (100 mg/kg) treatment. Hematoxylin-eosin (HE) staining was used to observe the growth arrest and cell necrosis. mRNA expression levels of acetaldehyde dehydrogenase 1 (ALDH1), CD44, CD133 and Notch1 were determined by reverse transcription-polymerase chain reaction. Protein expression levels of ALDH1, CD44, CD133, Notch1, nuclear factor κB (NF-κB) P65 and NF-κB p-P65 were detected by Western blot. Expression and subcellular location of ALDH1, CD44, CD133, Notch1 and NF-κB p65 were detected by immunofluorescence analysis. In vitro, cell cycle distribution and cell apoptosis of PC3 PCSCs was assessed by flow cytometry after baicalin (125 µmol/L) treatment. The migration and invasion abilities of PCSCs were assessed using Transwell assays. Transmission electron microscopy scanning was utilized to observe the structure and autophagosome formation of baicalin-treated PCSCs. In addition, PCSCs were infected with lentiviruses expressing human Notch1. Results: Compared with the control group, the tumor volume and weight were notably reduced in mice treated with 100 mg/kg baicalin (P<0.05 or P<0.01). Histopathological analysis showed that baicalin treatment significantly inhibited cell proliferation and promoted cell apoptosis. Furthermore, baicalin treatment reduced mRNA and protein expression levels of CD44, CD133, ALDH1, and Notch1 as well as the protein expression of NF-κB p-P65 in the xenograft tumor (P<0.01). In vitro, the cell proliferation of PCSCs was significantly attenuated after treatment with 125 µmol/L baicalin for 72 h (P<0.01). The cell migration and invasion rates were decreased following treatment with baicalin for 48 and 72 h (P<0.01). Baicalin notably induced cell apoptosis and seriously damaged the structure of PCSCs. The mRNA and protein expressions of CD133, CD44, ALDH1 and Notch1 in PCSCs were significantly downregulated following baicalin treatment (P<0.01). Importantly, the inhibitory effects of baicalin on PCa progression and stemness were reversed by Notch1 overexpression (P<0.05 or P<0.01). Conclusion: Mechanistically, baicalin exhibited a potential therapeutic effect on PCa via inhibiting the Notch1/NF-κB signaling pathway and its mediated cancer stemness. [ABSTRACT FROM AUTHOR]

Chronic pain is common in people living with HIV (PLWH), causes substantial disability and is associated with limitations in daily activities. Opioids are commonly prescribed for pain treatment among PLWH, but evidence of sustained efficacy is mixed. There is little information available on how PLWH who have chronic pain use multimodal strategies in pain management. The current cross-sectional study examined background characteristics, self-reported pain, and the use of other pain treatments among 187 PLWH with chronic pain and depressive symptoms who were and were not prescribed opioids. Approximately 20.9% of participants reported using prescription opioids at the time of the study interview. These individuals were significantly more likely to report having engaged in physical therapy or stretching, strengthening or aerobic exercises in the previous 3 months, recent benzodiazepine use, and receiving disability payments. There were no significant differences in pain characteristics (pain-related interference, average pain severity, and worst pain severity) between the two groups. Those not prescribed opioids were more likely to report better concurrent physical functioning and general health, and fewer physical role limitations, but higher depression symptom severity. Our findings suggest that many PLWH with chronic pain and depressive symptoms express high levels of pain with deficits in physical function or quality of life despite their use of opioids. The high rate of co-use of opioids and benzodiazepines (30.8%) is a concern because it may increase risk of overdose. An integrated care approach that includes a variety of effective non-pharmacologic treatment strategies such as physical therapy may be beneficial in reducing the reliance on opioids for pain management. [ABSTRACT FROM AUTHOR]

Purpose: The present study examines differences in the characteristics and recidivism risk of young people reported to police for family violence (FV) with a history of prior offending (generalists) and those only known to police for using FV (family-only). Method: A population-based cohort of youth aged 10–24 years (N = 5014) who were reported to police for using FV over a four-month period in 2019 was examined and FV-related risk and need data extracted, with a six-month follow-up period for further police-reported FV. All data was extracted from police databases. Logistic regression with odds ratios as a measure of effect size were used to compare generalist and family-only cohorts. Cox proportional hazards were used to assess time to FV recidivism among the two cohorts, and to assess whether diversity of prior offending was associated with risk of FV recidivism among generalist youth. Results: Generalists were more likely than family-only youth to be recorded as using FV in a high severity FV incident, be abusive across multiple relationships, and breach court orders. Generalists experienced a greater level of need and were more likely to engage in FV recidivism, and do so more quickly, than family-only youth. Diversity of prior offending among generalists was positively associated with risk of FV recidivism. Conclusion: Compared to family-only youth, generalists represent a higher risk cohort with a greater level of need. History of prior offending among young people may be a simple and efficacious means of prioritising higher risk youth who use FV. [ABSTRACT FROM AUTHOR]

Using the Mimics software to assess the maxillary and mandibular donor sites on cone-beam computed tomography (CBCT) images. This cross-sectional study was conducted on 80 CBCT scans. Data in DICOM format were transferred to the Mimics software version 21, and a maxillary and a mandibular mask according to cortical and cancellous bones were virtually created for each patient based on Hounsfield units (HUs). Three-dimensional models were reconstructed, and boundaries of donor sites, including mandibular symphysis, ramus, coronoid process, zygomatic buttress, and maxillary tuberosity, were defined. Virtual osteotomy was conducted on the 3D models to harvest bone. The volume, thickness, width, and length of harvestable bone from each site were quantified by the software. Data were analyzed by independent t-test, one-way ANOVA, and Tukey's test (alpha = 0.05). The greatest harvestable bone volume and length differences were observed between ramus and tuberosity (P < 0.001). The maximum and minimum harvestable bone volumes were found in symphysis (1753.54 mm3) and tuberosity (84.99 mm3). The greatest difference in width and thickness was noted between the coronoid process and tuberosity (P < 0.001) and symphysis and buttress (P < 0.001), respectively. Harvestable bone volume from tuberosity, length, width, volume from symphysis, and volume and thickness from the coronoid process was significantly greater in males (P < 0.05). The harvestable bone volume was the highest in symphysis, followed by ramus, coronoid, buttress, and tuberosity. The harvestable bone length and width were the highest in the symphysis and coronoid process, respectively. Maximum harvestable bone thickness was found in symphysis. [ABSTRACT FROM AUTHOR]

Background: Pure-tone audiometry is the traditional gold standard for assessment and screening of hearing impairment, but it requires the use of calibrated devices and soundproof booth. Mobile apps can offer a good alternative to traditional methods in limited circumstances and in some emergency situations, especially when traditional methods are not available. The aim of the study was to develop an easily accessible mobile-based Turkish Digit in Noise Test screening test for the assessment of hearing. Methods: The digits were read by a male speaker whose native language is Turkish. A mobile application was developed in accordance with the Android operating system. Twenty-five individuals with normal hearing, 25 individuals with bilateral mild sensorineural hearing loss, 25 with bilateral mild mixed hearing loss, and 25 with bilateral mild conductive hearing loss total of 100 participated in the study. All participants were between the ages of 18–60. The Turkish Digit in Noise Test mobile application was applied to the participants and the test scores were compared among the types of hearing loss. Results: The Turkish Digit in Noise Test scores of participants with bilateral mild sensorineural hearing loss (19.4 ± 5.39) and mixed hearing loss (22.96 ± 4.52) were lower than those of participants with normal hearing (39.68 ± 6.82) (p <.01). In addition, the results of participants with bilateral mild sensorineural hearing loss (19.4 ± 5.39) and mixed hearing loss (22.96 ± 4.52) were lower than those of participants with conductive hearing loss (36.88 ± 6.31) (p <.01). Conclusion: An easy and accessible Turkish Digit in Noise Test mobile application has been developed using which one can assess his/her hearing. [ABSTRACT FROM AUTHOR]

Background: In SLE patients, cytokines are linked to endothelial cell damage. Nailfold capillaroscopy (NFC) is a simple method for evaluating micro-vascular abnormalities in different connective tissue diseases (CTDs). The study aimed to detect the levels of interleukin 17A (IL 17A), type I interferons (IFNs I) in the serum, and NFC changes in Egyptian SLE patients compared to a control group and to correlate NFC findings with patients' demographic features and serum levels of IL 17A and IFNs I. Results: Serum levels of IL 17A, IFN α, and IFN β were significantly higher in SLE patients than in control group (P < 0.0001). About thirty nine patients (73.6%) of the 53 SLE patients showed abnormal NFC changes. Egyptian SLE patients had a high prevalence of the NFC non-specific pattern, with 32 (60.4%) patients showing non-specific changes and 7 (13.2%) patients showing scleroderma pattern, including 3 (5.6%) patients with active scleroderma pattern and 4 (7.55%) patients with late scleroderma pattern. Furthermore, Raynaud's phenomenon (RP) was observed in 8 (15.1%) SLE patients, with 3 (5.6%) having normal NFC pattern and 5 (9.4%) having scleroderma pattern. All controls (n = 20) showed normal hairpin shape capillaries. Except for SLEDAI (P = 0.03) and the presence of RP (P < 0.0001), there were no significant differences in demographic and laboratory parameters between the three NFC patterns (normal, non-specific, and scleroderma); additionally, NFC score correlated significantly with SLEDAI (P = 0.021). Conclusion: As a result of the high disease activity, Egyptian SLE patients had elevated serum levels of IL 17A and IFNs I. The most common NFC pattern in Egyptian SLE patients was a non-specific pattern. NFC abnormalities in Egyptian SLE patients were correlated with disease activity but not with patients' ages, disease duration, or serum levels of IL 17A and IFNs I. SLE patients with scleroderma NFC pattern and RP should be closely followed for the possibility of appearance of anti-U1 RNP antibodies and MCTDS. [ABSTRACT FROM AUTHOR]

Objective: We aimed to compare maternal and fetal cardiovascular responses to an acute bout of high-intensity interval training (HIIT) versus moderate-intensity continuous training (MICT) during pregnancy. Methods: Fifteen women with a singleton pregnancy (27.3 ± 3.5 weeks of gestation, 33 ± 4 years of age) were recruited. Following a peak fitness test, participants engaged in a session of HIIT (10 × 1-min intervals ≥ 90% maximum heart rate [HRmax]) interspersed with 1 min of active recovery) and MICT (30 min at 64–76% HRmax) 48 h apart in random order. Maternal HR, blood pressure, middle (MCAv), and posterior cerebral artery blood velocity (PCAv), as well as respiratory measures were monitored continuously throughout HIIT/MICT. Fetal heart rate, as well as umbilical systolic/diastolic (S/D) ratio, resistive index (RI), and pulsatility index (PI) were assessed immediately before and after exercise. Results: Average maternal heart rate was higher for HIIT (82 ± 5% HRmax) compared with MICT (74 ± 4% HRmax; p < 0.001). During the HIIT session, participants achieved a peak heart rate of 96 ± 5% HRmax (range of 87–105% HRmax). Maternal cerebral blood velocities increased with exercise but was not different between HIIT and MICT for MCAv (p = 0.340) and PCAv (p = 0.142). Fetal heart rate increased during exercise (p = 0.244) but was not different between sessions (HIIT: Δ + 14 ± 7 bpm; MICT: Δ + 10 ± 10 bpm). Metrics of umbilical blood flow decreased with exercise and were not different between exercise sessions (PI: p = 0.707; S/D ratio: p = 0.671; RI: p = 0.792). Fetal bradycardia was not observed, and S/D ratio, RI, and PI remained within normal ranges both before and immediately after all exercise sessions. Conclusions: An acute bout of HIIT exercise consisting of repeated 1-min near-maximal to maximal exertions, as well as MICT exercise is well tolerated by both mother and fetus. Clinical Trial Registration: NCT05369247. [ABSTRACT FROM AUTHOR]

This study sought to provide prevalence data for mental health (MH) diagnoses and psychotropic medication prescriptions among individuals in foster care and to examine their relationships with physical health status, maltreatment type, placement type, and demographic variables. Data were retrieved from electronic health records for 3,067 patients seen at integrated pediatric primary care clinics serving individuals in care. Descriptive and bivariate statistics for presence of MH diagnoses and psychotropic medication prescription were calculated. Multivariable zero-inflated negative binomial regressions were used to assess relationships. Half (50.0%) of patients had at least one MH diagnosis; trauma and stressor-related (31.5%) and attention deficit hyperactivity (22.6%) disorders were most common. 27.8% of patients were prescribed at least 1 psychotropic medication. Complex chronic physical health, having 1 and 2 or more maltreatment exposures, and being 6–11 and 12–20 years of age had significantly higher rates of having a MH diagnosis while being female, Black, Hispanic, and other race were significantly associated with lower rates. Patients with at least 1 MH diagnosis that had complex chronic physical health status, experienced sexual abuse, and were 6–11 and 12–20 years of age had significantly higher rates of psychotropic medication prescription while shelter and kinship placement and female gender were significantly associated with lower rates. Findings suggest that initial and ongoing MH screening is vital for individuals in care so that appropriate interventions can be offered. Results support implementing strategies designed to increase access to MH services for this population, such as integrated care and child psychiatry consult programs. [ABSTRACT FROM AUTHOR]

Background: Continuous kidney replacement therapy (CKRT) has been expanded from simple kidney replacement therapy to the field of critical illness in children. However, CKRT is rarely used in critically ill neonates in the neonatal intensive care unit (NICU). This study aimed to describe patients' clinical characteristics at admission and CKRT initiation, CKRT effects, short-term outcomes, and predictors of death in critically ill neonates. Methods: A 7-year single-center retrospective study in a tertiary NICU. Results: Thirty-nine critically ill neonates received CKRT between May 2015 and April 2022 with a mortality rate of 35.9%. The most common primary diagnosis was neonatal sepsis in 15 cases (38.5%). Continuous veno-venous hemodiafiltration and continuous veno-venous hemofiltration were applied in 43.6% and 56.4% of neonates, respectively. The duration of CKRT was 44 (18, 72) h. Thirty-one patients (79.5%) had complications due to CKRT-related adverse events, and the most common complication was thrombocytopenia. Approximately 12 h after the CKRT initiation, urine volume, mean arterial pressure, and pH were increased, and serum creatinine, blood urea nitrogen, and blood lactate were decreased. In the multivariate logistic regression analysis, neonatal critical illness score [odds ratio 0.886 (0.786 ~ 0.998), P = 0.046] was an independent risk factor for death in critically ill neonates who received CKRT. Conclusions: CKRT can be an effective and feasible technique in critically ill neonates, but the overall mortality and CKRT-related complications are relatively high. Furthermore, the probability of death is greater among neonates with greater severity of illness at CKRT initiation. [ABSTRACT FROM AUTHOR]

The link between memory and comorbid depression in persons with HIV (PWH) is unclear based on evidence from published cohorts. We compared verbal memory in the HVLT-R in a well-characterized HIV cohort (n = 354) with (n = 102) or without (n = 252) comorbid depressive symptoms, and examined memory correlates in both scenarios. Memory fell within unimpaired ranges, but was lower in depressed than non-depressed PWH. Memory was related to quality of life, sociodemographic, and mental health factors, but not to assessed HIV-related or antiretroviral factors. However, longitudinally (n = 52) memory declined with presence and severity of depressive symptoms. In this treated cohort, verbal memory was unrelated to HIV-related variables but to quality of life and depressive symptoms. Greater performance decline over time also related to acute or ongoing depressive symptoms. These findings highlight the importance of addressing comorbid depressive symptoms to improve quality of life in persons with treated HIV. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to predict the probability of postoperative pulmonary infection in elderly patients with hip fractures by developing and validating a precise model. Methods: The clinical data of 1008 elderly hip fracture patients undergoing surgical treatment in Shanghai Tenth Peoples' Hospital were retrospectively selected. A univariate analysis and multivariate regression were used to analyze the independent risk factors for postoperative pulmonary infection in elderly patients with hip fractures. A risk prediction model was established, and a nomogram was drawn. The area under the ROC curve and Hosmer‒Lemeshow test were used to evaluate the predictive effect of the model. Results: The multivariate regression analysis indicated that age > 73, time from fracture to surgery (d) > 4 days, smoking, ASA ≥ III level, COPD, hypoproteinemia, red cell distribution width > 14.8%, mechanical ventilation time > 180 min, and stay in the ICU were independent risk factors for postoperative pulmonary infection in elderly patients. The AUCs of the model were 0.891 and 0.881, 0.843, respectively, in the two verification groups. For the Hosmer‒Lemeshow test, the P values were 0.726 in the modeling group and 0.497 and 0.231 in the verification group (P > 0.05). Conclusion: Overall, this study uncovered different independent risk factors for postoperative pulmonary infection in patients with hip fractures. The nomogram can effectively predict the occurrence of postoperative pulmonary infection. [ABSTRACT FROM AUTHOR]

Background: Migraine is a cyclic, neurosensory disorder characterized by recurrent headaches and altered sensory processing. The latter is manifested in hypersensitivity to visual stimuli, measured with questionnaires and sensory thresholds, as well as in abnormal cortical excitability and a lack of habituation, assessed with visual evoked potentials elicited by pattern-reversal stimulation. Here, the goal was to determine whether factors such as age and/or disease severity may exert a modulatory influence on sensory sensitivity, cortical excitability, and habituation. Methods: Two similar experiments were carried out, the first comparing 24 young, episodic migraine patients and 28 healthy age- and gender-matched controls and the second 36 middle-aged, episodic migraine patients and 30 healthy age- and gender-matched controls. A neurologist confirmed the diagnoses. Migraine phases were obtained using eDiaries. Sensory sensitivity was assessed with the Sensory Perception Quotient and group comparisons were carried out. We obtained pattern-reversal visual evoked potentials and calculated the N1-P1 Peak-to-Peak amplitude. Two linear mixed-effects models were fitted to these data. The first model had Block (first block, last block) and Group (patients, controls) as fixed factors, whereas the second model had Trial (all trials) and Group as fixed factors. Participant was included as a random factor in both. N1-P1 first block amplitude was used to assess cortical excitability and habituation was defined as a decrease of N1-P1 amplitude across Blocks/Trials. Both experiments were performed interictally. Results: The final samples consisted of 18 patients with episodic migraine and 27 headache-free controls (first experiment) and 19 patients and 29 controls (second experiment). In both experiments, patients reported increased visual hypersensitivity on the Sensory Perception Quotient as compared to controls. Regarding N1-P1 peak-to-peak data, there was no main effect of Group, indicating no differences in cortical excitability between groups. Finally, significant main effects of both Block and Trial were found indicating habituation in both groups, regardless of age and headache frequency. Conclusions: The results of this study yielded evidence for significant hypersensitivity in patients but no significant differences in either habituation or cortical excitability, as compared to headache-free controls. Although the alterations in patients may be less pronounced than originally anticipated they demonstrate the need for the definition and standardization of optimal methodological parameters. [ABSTRACT FROM AUTHOR]

In the Open Dialogue (OD) based psychiatric services adolescent patients receive less medication and are more often treated within an outpatient setting as compared to standard services. An evaluation of the possible risks of implementing OD are required. The aim of this longitudinal register-based study was to evaluate how treatment under OD is associated with the probability of suicide as compared standard psychiatric care. Study included all 13- to 20-year-old adolescents who enrolled to a psychiatric service in Finland in 2003–2013. The OD-group included adolescents whose treatment commenced in the Western Lapland area (n = 2107), this being the only region where OD covered all psychiatric services. The comparison group (CG) included rest of Finland (n = 121,658). Information was gathered from onset of treatment to the end of the 5-year follow-up or death. In a multivariate Cox regression there were no statistically significant differences in 5-year suicide hazard ratios between OD and CG. [ABSTRACT FROM AUTHOR]

Background: Medical personnel have reported increases in psychological distress and depression during the COVID-19 pandemic. Additionally, many providers, including primary care providers (PCPs), face significant stigma related to personal mental healthcare. However, the process by which stigma affects help-seeking among PCPs is unclear. Method: Between January and May 2020, 112 PCPs completed a survey of perceived public stigma, self-stigma, attitudes, intentions to seek psychotherapy for depression, and a clinical vignette on patient referrals to psychotherapy. Results: Self-stigma and attitudes toward psychotherapy sequentially mediated the relationship between perceived public stigma and intentions to seek psychotherapy. PCPs were more likely to refer a depressed patient to psychotherapy than seek personal psychotherapy, but lower personal help-seeking intentions were associated with lower referral intentions. Conclusion: These results clarify processes by which stigma hinders PCPs' psychotherapy use and highlight interventions to encourage their help-seeking. Addressing cultural and practical barriers in the medical field is needed to reduce stigma. [ABSTRACT FROM AUTHOR]

Objectives: We aimed to assess atrial conduction time and P-wave dispersion (PWD) in gestational diabetes mellitus (GDM) patients. Methods: Thirty patients with GDM and 30 healthy pregnant women were included to the study. Atrial conduction times (PA) were calculated by the time interval from the onset of the P wave on the electrocardiography (ECG) to the onset of the late diastolic flow (Am wave) on echocardiography and from the lateral mitral annulus (PA lateral), septal mitral annulus (PA septum), and right ventricular tricuspid annulus (PA tricuspid). The difference between (PA lateral-PA tricuspid) was defined as interatrial electromechanical delay (EMD); the difference between (PA septum-PA tricuspid) as intra-atrial EMD; and the difference between (PA lateral-PA septal) as intraleft atrial EMD. Results: Mean PWD was higher in GDM (52.7 ± 5.1 ms vs. 28.9 ± 4.2 ms, p < 0.001). PA lateral, PA septal and PA tricuspid were significantly higher in the GDM patients compared to the control group (65.7 ± 4.2 ms vs. 47.7 ± 4.7 ms, p < 0.001; 56.1 ± 3.4 ms vs. 40.8 ± 3.7 ms, p < 0.001 and 48.4 ± 3.9 ms vs. 36.0 ± 3.6 ms, p < 0.001, respectively). Interatrial, intra-atrial, and intraleft atrial EMDs were also significantly higher in the GDM group (median values: 18 ms vs. 12 ms; 10 ms vs 7.5 ms; 8 ms vs. 4 ms, respectively, p < 0.001 for all). There was a positive correlation between intra-atrial delay time and PWD in GDM group (r = 0.39, p = 0.033). Conclusion: We suggest that patients with GDM have higher PWD and higher atrial conduction and EMD times compared to otherwise healthy pregnant control group. [ABSTRACT FROM AUTHOR]

Background and aims: Zonulin, carnitine, choline, γ-butyrobetaine (γ-BB), and trimethylamine-N-oxide (TMAO) are intricately involved in metabolic anomalies and type 2 diabetes mellitus (T2D). This study aimed to compare and correlate the plasma levels of zonulin, carnitine, choline, γ-butyrobetaine, and TMAO, along with the adiposity, atherogenicity, surrogate insulin resistance (sIR), and proinflammatory hematological indices of newly diagnosed drug-naive prediabetic and diabetic patients vs. apparently healthy normoglycemic controls. Methods: In a cross-sectional study, 30 normoglycemic subjects (controls) and 16 prediabetic (preDM) and 14 type 2 diabetes (T2D) cases, that were gender and age-matched, were enrolled. Zonulin, carnitine, choline, γ-BB, and TMAO plasma levels were appraised using colorimetric assays. A comparison between the study groups was conducted by ANOVA while Spearman rank correlations between the metabolic risk biomarkers and between the risk markers and adiposity, sIR, atherogenicity, and proinflammatory hematological indices were also examined. Results: Significant intergroup discrepancies in plasma carnitine, choline, γ-BB, and TMAO (but not zonulin) could be recognized in the cases vs. controls. Fasting blood glucose (FPG), glycated hemoglobin (A1C), triglycerides (TGs), body mass index (BMI), lipid accumulation product (LAP), visceral adiposity index (VAI), atherogenic index of plasma (AIP), and all sIR were outstandingly higher in the cases vs. controls. Blood indices lacked a scoring value to discriminate cases from controls. Inadvertently, no relation was found between plasma carnitine, choline, γ-BB, TMAO, or zonulin in cases. Among the rest of the markers and sIR indices, the triglyceride glucose-body mass index (TyG*BMI) related reciprocally to zonulin. Noticeably, among adiposity indices, TyG*BMI, triglyceride glucose-waist circumference (TyG*WC), and metabolic score for insulin resistance (MetS-IR) positively associated with waist circumference (WC), hip circumference (HC), BMI, body adiposity index (BAI), and waist-to-height ratio (WHtR). Exceptionally, LAP proportionally correlated with all sIR. TyG*WC and MetS-IR correlated directly with the conicity index (CI). WHR directly associated with triglyceride glucose (TyG) index and TyG*WC. Remarkably, the TyG index (but not TyG*BMI, TyG*WC, or MetS-IR) positively associated with all atherogenicity indices and RDW (but none of other blood indices). TMAO correlated inversely (p < 0.05) and moderately with choline. Distinctively, carnitine associated negatively with TC (p < 0.05). Both choline and carnitine related similarly and directly with PLR but inversely with lymphocytes (p<.05). Effectively, γ-butyrobetaine associated with both WC and the TyG-WC index equally negatively (p < 0.05). Substantially, γ-butyrobetaine correlated inversely with both atherogenic LDL-C/HDL-C ratio and MPV (p < 0.05). No pronounced relations were detected between the five microbiome signature determinants and glycemic control parameters (FBG and A1C%), sIR (TyG, TyG-BMI, or MetS-IR), adiposity (WHR, WHtR, CI, BAI, LAP, or VAI), atherogenicity indices (TC/HDL-C ratio, non-HDL-C/HDL-C ratio, or AIP), or blood indices (NLR or MLR). Conclusion: Given the intergroup discrepancies in sIR, plasma zonulin, carnitine, choline, γ-BB, and TMAO along with their elective correlations with indices and clinical parameters of metabolic dysregulations, our study cannot rule out any possible molecular crosstalk and interplay of the biomarkers studied with the pathophysiology of prediabetes/diabetes. All in all, plasma zonulin, carnitine, choline, γ-BB, and TMAO with sIR can be putative surrogates for molecular cardiometabolic risk biomarkers to use as prognostic/predictive tools for the diagnosis/prevention and potential targets for prediabetes/diabetes management modalities. [ABSTRACT FROM AUTHOR]

Background: The study of the relationship between the presence of fibromyalgia (FM) with rheumatoid (RA) and psoriatic arthritis (PsA) patients can affect the main disease outcome and the treatment decision. The research aims to assess the associated fibromyalgia and vitamin D level in rheumatoid and psoriatic arthritis patients. Results: A cross-sectional study included 60 RA, 30 PsA, and 40 healthy controls, all of them were evaluated for the diagnosis of FM and serum vitamin D level, disease activity score 28 (DAS28), and health quality of life. The mean age of RA was 47.75 ± 11.11 SD, for PsA 44.17 ± 10.8 SD, and for the controls 44.35 ± 13.64 with no significant differences. FM was diagnosed in 21.7% of RA, 13.3% of PsA, and 2.5% of healthy controls with a significant difference among the three groups (P value = 0.025). RA and PsA patients with concomitant FM showed statistically significant higher disease activity scores, significantly worse quality of life than those without FM, and significantly lower serum vitamin D than those without FM. Conclusion: Vitamin D deficiency and the presence of FM can be related to higher disease activity and less response to treatment, early recognition and treatment of FM and vitamin D deficiency in RA and PsA patients could be important to obtain a good response to therapy and achieve remission. Key messages: • There is a strong association between FM and autoimmune diseases. • Vitamin D level plays an important role in the link between FM and RA or PsA disease activity. • Concomitant FM with PsA or RA affects the disease outcome and the treatment decision. • Type of drug therapy cs-DMARDs or b-DMARDs may affect the risk for the association of FM in these patients. [ABSTRACT FROM AUTHOR]

Purpose: The outcomes of anterior cruciate ligament reconstruction (ACLR) in patients with generalized joint laxity (GJL) are not clearly understood. In this study, we compared the outcomes of ACLR with quadruple hamstring autograft between GJL and non-GJL patients. Methods: In a retrospective case–control study, 36 patients with GJL, according to the Beighton and Horan Joint Mobility Index, who underwent ACLR surgery, were included. Forty-four group-matched non-GJL patients were included in the control group. The mean follow-up of the patients was 20.65 ± 6.93‏ months. The outcomes of ACLR were evaluated by the Lachman test, pivot shift test, anterior tibial translation and KT-1000 side-to-side difference, and International Knee Documentation Committee (IKDC) scale. Results: The results of the Lachman and pivot shift test were not significantly different between the GJL and non-GJL patients (P = 0.67 and P = 0.27, respectively). The mean anterior tibial translation was 7.06 ± 1.41 mm in the GJL group and 6.11 ± 1.53 mm in the non-GJL group (P = 0.006). The mean KT-1000 side-to-side difference was 2.25 ± 1.31 mm in the case and 2.5 ± 1.44 mm in the control group (P = 0.42). The mean IKDC score of the patients was not significantly different between the GJL and non-GJL groups (66.1 ± 20.6 vs. 69.9 ± 16.1, P = 0.35). ACLR failure occurred in 2 (5.5%) patients of the GJL group and no patients of the control group (P = 0.21). Conclusion: The present findings suggest ACLR with quadruple hamstring autograft as an adequate treatment for GJL patients, at least in short-term follow-up. [ABSTRACT FROM AUTHOR]

Background: Outcomes data of intramedullary nail fixation (IMN) constructs for complex Schatzker VI tibial plateau fractures are scant in the literature. This study compares the clinical and radiographic outcomes of IMN, dual plate, and single plate constructs for Schatzker IV tibial plateau fractures. Methods: Retrospective cohort study of sixty-two patients at a University-based Level 1 trauma center who underwent open reduction internal fixation for Schatzker VI tibial plateau fracture. Constructs evaluated were IMN (with or without raft screws), dual plating, and single plating. Demographic, clinical, and radiographic outcomes were recorded. All fractures were additionally classified based on the OTA classification for sub analyses. Mean follow-up was 13.2 (SD 13.3) months. Predictors of construct selection and outcomes were evaluated with bivariate logistic regression. Outcomes were compared between groups with independent samples t-tests and Chi Square tests. Results: No significant demographic differences were found between IMN, dual plate or single plate construct cohorts. There was a higher proportion of open fractures within the IMN construct group versus the dual plate cohort (21.1% vs 3.6%). No statistically significant differences in radiographic outcomes were observed between cohort groups except for small but statistically significant differences in condylar width (CW) ratio change and tibial slope; when fracture cohorts were sub analyzed by specific OTA classification, there were no significant differences in any radiographic outcomes. There was a significant difference between the ratio of OTA 41C1, C2 and C3 fractures regarding treatment allocation (p = 0.004), favoring dual plate fixation for OTA 41C3 fractures. There were no significant differences found between treatment cohorts in terms of all cause complications (p > 0.05). IMN and single plate constructs were utilized when posteromedial condyle fractures were nondisplaced or minimally displaced. Conclusion: Intramedullary nail fixation with or without supplemental raft screws produced similar short-term clinical and radiographic results compared to dual and single plate constructs among patients with Schatzker VI fracture types, regardless of OTA classification. Level of Evidence Level III retrospective cohort. [ABSTRACT FROM AUTHOR]

Adolescents with autism spectrum disorder (ASD) without an intellectual disability (ID) have daily living skills (DLS) that fall below their chronological age and affect their ability to achieve successful adult outcomes, but little is known about their specific DLS challenges. Utilizing the Vineland Adaptive Behavior Scales, 3rd Edition (VABS-3) in a sample of 151 adolescents with ASD without an ID, we explored the VABS-3 DLS domain, subdomains, interview topics, and individual items. Results indicated that Community DLS was a relative strength, followed by Domestic DLS, and then Personal DLS. Adolescents with ASD demonstrated significant challenges in many age appropriate DLS subdomain interview topics and individual items, indicating a need for interventions to increase acquisition of DLS to improve adult outcomes. [ABSTRACT FROM AUTHOR]

Background and aim: Early action is important for promoting newly arrived migrants' health. Politicians are major actors in decision-making that affects health outcomes in the population. Therefore, the aim of this study was to explore local and regional politicians' considerations of newly arrived migrants' health in political decision-making: whether politicians reflect on or discuss the effects of decision-making specifically on newly arrived migrants' health, whether considerations differ between municipality and regional politicians, and how knowledge and attitudes are associated with such considerations. Subject and methods: A cross-sectional quantitative study was conducted. A total of 667 municipality and regional politicians from northern Sweden responded to a questionnaire developed based on interviews with politicians. Bivariate analyses were performed using χ2 tests, the independent samples t-test, and the Wilcoxon signed-rank test. Multivariate analysis was performed using binary logistic regression. Results: Politicians considered the effects on newly arrived migrants' health significantly less frequently than those on the total population's health. Regional politicians discussed such effects more often than municipality politicians. Knowledge (odds ratio [OR] = 1.343), attitude (OR = 5.962), previous experience working on public health issues (OR = 1.784), and female gender (OR = 1.787) were positively associated with considering effects on newly arrived migrants' health in decision-making. Conclusion: Politicians play important roles in health promotion, and most consider health-related effects in their decision-making. However, about a third do not consider such effects. General health-related knowledge and attitude are important factors that could be affected or changed during political assignments. [ABSTRACT FROM AUTHOR]

Purpose: Diabetes remission is a phenomenon described in the context of drastic weight loss due to bariatric surgery or low-calorie diets. Evidence suggests that increasing the intake of plant protein could reduce the risk of type 2 diabetes. We sought for association between changes in plant protein intake in the context of 2 healthy diets without weight loss nor glucose-lowering medication, and diabetes remission in coronary heart disease patients from the CORDIOPREV study. Methods: Newly diagnosed type 2 diabetes participants without glucose-lowering treatment were randomized to consume a Mediterranean or a low-fat diet. Type 2 diabetes remission was assessed with a median follow-up of 60 months according to the ADA recommendation. Information on patient's dietary intake was collected using food-frequency questionnaires. At first year of intervention, 177 patients were classified according to changes in plant protein consumption into those who increased or decreased its intake, in order to perform an observational analysis on the association between protein intake and diabetes remission. Results: Cox regression showed that patients increasing plant protein intake were more likely to remit from diabetes than those who decreased its intake (HR = 1.71(1.05–2.77)). The remission occurred mainly at first and second year of follow-up with diminished number of patients achieving remission in the third year onwards. The increase in plant protein was associated with lower intake of animal protein, cholesterol, saturated fatty acids, and fat, and with higher intake of whole grains, fibre, carbohydrates, legumes, and tree nuts. Conclusion: These results support the need to increase protein intake of vegetal origin as dietary therapy to reverse type 2 diabetes in the context of healthy diets without weight loss. [ABSTRACT FROM AUTHOR]

Obesity and chronic disease are increasing problems in refugee populations. Afghani refugees undergoing hepatitis B vaccination between January 2015 and December 2017 at a general practice clinic received dietary counselling sessions in Dari by native speaking clinicians. Anthropometry, blood pressure, fasting lipids and liver function tests were measured at both visits with results compared over time. 110/119 refugees requiring hepatitis B vaccination were recruited into the study. Mean BMI was lower at follow up visits (25.4 vs 26.1 by wilcoxon signed rank test p 0.04) with 72 of 110 participants losing a median of 2 kg between visits (range 0.5–14 kg) a mean of 206 days after the initial consultation. Median triglyceride levels were lower at the second visit than the first (1.4 vs 1.3 mmol/L Wilcoxon signed rank test Z = 3.5, p 0.0004). This cohort of refugees lost weight and showed a small improvement in triglyceride levels between visits. [ABSTRACT FROM AUTHOR]

The high prevalence of sleep-related disorders is well documented in individuals with Down syndrome (DS). Given the association between physical activity (PA) and sleep in the typical populations, this study was the pilot study to examine this association through the parental report in this population. The total of forty-three individuals with DS (aged 14–55) participated in the present study. Parents reported on the questionnaires to measure different levels of PA and four factors of sleep-related disorders in adolescents and adults with DS. Our results indicate that age was positively associated with the frequency of "disorders of initiating and maintaining sleep". In addition, the levels of moderate-to-vigorous PA (MVPA) were negatively associated with the severity of "Features associated with obstructive sleep apnea (OSA)". Further, the active group had lower parental reports of features associated with OSA compared with the insufficiently active group after controlling for anthropometric measures. Our study suggests moderate-to-vigorous exercise may reduce OSA severity in individuals with DS. Therefore, future support for recreational services should be provided to promote physical leisure activity that may reduce the onset of sleep disorders in this population. [ABSTRACT FROM AUTHOR]

Purpose: Spinal injections are increasingly used for back pain treatment. Vertebral osteomyelitis (VO) after spinal injection (SIVO) is rare, but patient characteristics and outcome have not been well characterized. The aim of this study was to assess patient characteristics of SIVO in comparison to patients with native vertebral osteomyelitis (NVO) and to determine predictors for 1-year survival. Methods: This is a single-center cohort study from a tertiary referral hospital. This is a retrospective analysis of Patients with VO who were prospectively enrolled into a spine registry from 2008 to 2019. Student's t-test, Kruskal–Wallis test or Chi-square test were applied for group comparisons. Survival analysis was performed using a log-rank test and a multivariable Cox regression model. Results: 283 VO patients were enrolled in the study, of whom 44 (15.5%) had SIVO and 239 (84.5%) NVO. Patients with SIVO were significantly younger, had a lower Charlson comorbidity index and a shorter hospital stay compared to NVO. They also showed a higher rate of psoas abscesses and spinal empyema (38.6% [SIVO] vs. 20.9% [NVO]). Staphylococcus aureus (27%) and coagulase-negative staphylococci (CNS) (25%) were equally often detected in SIVO while S. aureus was more frequently than CNS in NVO (38.1% vs. 7.9%).Patients with SIVO (P = 0.04) had a higher 1-year survival rate (Fig. 1). After multivariate analysis, ASA score was associated with a lower 1-year survival in VO. Conclusion: The results from this study emphasize unique clinical features of SIVO, which warrant that SIVO should be estimated as a separate entity of VO. [ABSTRACT FROM AUTHOR]

Background: Immersion pulmonary edema (IPE) is a frequent diving accident, and it is the primary cause of hospitalization for young military divers during training. The objective of this study was to identify immersion-induced parameters predicting individual susceptibility to IPE. Methods: Eighteen experienced male divers having completed at least 100 dives were recruited. Eight divers had previously been hospitalized for IPE (IPE), and the other ten had never developed IPE (non-IPE). The two groups were matched for age, BMI, and number of dives performed. Ventilatory function and overall compliance of the respiratory system (Crs) were measured on land and during head-out-of-water immersion. Subjects also performed 30 min of fin swimming in a channel at 33 m min−1. Following this exercise, the presence of extravascular lung water, revealed by ultrasound lung comets (ULC), was assessed. Results: In the whole group, the decrease in Crs upon immersion correlated with the immersion-induced alterations to expiratory reserve volume, ERV (r2 = 0.91; p < 0.001), inspiratory reserve volume, IRV (r2 = 0.94; p < 0.001), and tidal volume, Vt, changes (r2 = 0.43; p < 0.003). The number of ULC correlated strongly with immersion-induced changes in ventilatory function (r2 = 0.818; p < 0.001 for ERV, r2 = 0.849; p < 0.001 for IRV, r2 = 0.304; p = 0.0164 for Vt) and reduced Crs (r2 = 0.19; p < 0.001). The variations of ERV, IRV, and Crs at rest induced by head-out-of-water immersion and the number of ULC measured after swimming for 30 min were significantly greater in IPE subjects. Conclusion: In the face of similar immersion stresses, the extent of alterations to ventilatory function and the number of ULCs were very different between individuals but remained statistically correlated. These parameters were significantly greater in divers with a history of IPE. Alterations to pulmonary function and, in particular, to pulmonary compliance induced by head-out-of-water immersion, through their effects on work of breathing appear to allow the identification of divers with a greater susceptibility to developing IPE. Measurement of these parameters could therefore be proposed as a predictive test for the risk of developing IPE. Key Points: Immersion Pulmonary Edema (IPE) can occur in highly fit individuals, such as military divers and triathletes, and is the leading cause of hospitalization among young military divers during training. To preserve the health of young divers, predictive tests of individual susceptibility to IPE should be proposed, similar to those proposed for High Altitude Pulmonary Edema (HAPE). Our findings confirm the fundamental role of immersion-induced changes in lung function in the development of IPE. Alterations in pulmonary function, particularly pulmonary compliance, appear to allow for identification of divers with a higher susceptibility to developing IPE. [ABSTRACT FROM AUTHOR]

Aim: Gender-related healthcare disparities persist. We sought to determine gender-related differences in rural healthcare. Subject and methods: Quality control assurance analysis utilizing an electronic medical record was used to determine gender-related differences in rural healthcare over a 3-year period (n = 78,814). Results: Compared to men, women tended to be older (69.4 ± 13.6 years vs 67.9 ± 12.5 years, p < 0.0001), have a higher BMI (30.8 ± 8.2 kg/m2 vs 30.5 ± 6.7 kg/m2, p < 0.0001), Caucasian (OR = 1.21; 95% CI: 1.13–1.29, p < 0.0001), reside in a rural county (OR = 1.03; 95% CI: 1.00–1.06, p = 0.03), have government pay or insurance (OR = 1.36; 95% CI: 1.32–1.41, p < 0.0001), shorter intervals between healthcare visits (158.9 ± 183.1 days vs 167.2 ± 189.7 days, p < 0.0001), more frequent number of emergency department visits (OR = 1.31; 95% CI: 1.26–1.35, p < 0.0001), and a higher number of inpatient hospital admissions (OR = 1.09; 95% CI: 1.05–1.12, p < 0.0001). With regard to cardiovascular disease, women had fewer markers as measured by a lower (Hb)A1c value (p < 0.001), tobacco use (51.3% vs 63.8%, p < 0.001), coronary artery disease diagnosis (38.2% vs 51.7%, p < 0.001), and taking a statin medication (40.4% vs 44.8%, p < 0.001). Conclusion: Gender-related healthcare differences occur in our rural population. Compared to men, women from both rural and non-rural locations tend to utilize the healthcare system more, which is associated with fewer markers of cardiovascular disease. [ABSTRACT FROM AUTHOR]

Aim: Electronic cigarette (e-cigarette) use among Irish teenagers has risen significantly. In 2019, prevalence of current use (last 30 days) among 15–17-year-olds was 17.3%. We examine social determinants of adolescent e-cigarette current use. Subject and methods: A stratified random sample of 50 schools in Ireland was surveyed in 2019, part of the European School Survey Project on Alcohol and other Drugs (ESPAD), with 3495 students aged 15, 16, and 17. Bivariate and multivariable logistic regression [providing adjusted odds ratios (AORs)] analyses were performed using Stata version 16. Results: Current e-cigarette users were more likely to be male (AOR = 0.55, 95% CI:0.32–0.96, p <.01), younger (AOR = 0.34, 95% CI: 0.17–0.67, p = <.05), to participate in sport (AOR = 2.21, 95% CI: 1.05–4.65, p <.05), to have higher-educated parents (maternal higher education: AOR = 27.54, 95% CI: 1.50–505.77, p = <.05, paternal higher education: AOR = 2.44, 95% CI: 1.00–5.91, p <.05), and less likely to consider their families better off (AOR = 0.29, 95% CI: 0.13–0.65, p <.01), or to report familial support (AOR = 0.78, 95% CI: 0.64–0.95, p <.05). They were more likely to be cigarette smokers (AOR = 7.22, 95% CI: 3.97–13.12, p <.001), to report problem cannabis use (AOR = 3.12, 95% CI: 1.40–6.93, p <.01), to be 'binge' drinkers (AOR = 1.81, 95% CI : 1.00–3.32, p =.054), and to have friends who get drunk (AOR = 5.30, 95% CI: 1.34–20.86, p <.05). Conclusion: Boys, smokers, binge drinkers, problem cannabis users, and sport-playing teenagers from higher-educated families, are at particular risk. As the number of young people using e-cigarettes continues to rise, including teenagers who have never smoked, improved regulation of e-cigarettes, similar to other tobacco-related products, is needed urgently to prevent this worrying new trend of initiation into nicotine addiction. [ABSTRACT FROM AUTHOR]

Purposes: External ventricular drainage (EVD) is frequently used to control raised intracranial pressure after traumatic brain injury. However, the available evidence about its effectiveness in this context is limited. The aim of this study is to evaluate the effectiveness of EVD to control intracranial pressure and to identify the clinical and radiological factors associated with its success. Methods: For this retrospective cohort study conducted in a Level 1 traumacenter in Paris area between May 2011 and March 2019, all patients with intracranial hypertension and treated with EVD were included. EVD success was defined as an efficient and continuous control of intracranial hypertension avoiding the use of third tier therapies (therapeutic hypothermia, decompressive craniectomy, and barbiturate coma) or avoiding a decision to withdraw life sustaining treatment due to both refractory intracranial hypertension and severity of brain injury lesions. Results: 83 patients with EVD were included. EVD was successful in 33 patients (40%). Thirty-two patients (39%) required a decompressive craniectomy, eight patients (9%) received barbiturate coma. In ten cases (12%) refractory intracranial hypertension prompted a protocolized withdrawal of care. Complications occurred in nine patients (11%) (three cases of ventriculitis, six cases of catheter occlusion). Multivariate analysis identified no independent factors associated with EVD success. Conclusion: In a protocol-based management for traumatic brain injury, EVD allowed intracranial pressure control and avoided third tier therapeutic measures in 40% of cases with a favorable risk–benefit ratio. [ABSTRACT FROM AUTHOR]

Background: Diabetic peripheral neuropathy (DPN) is one of the major diabetic complication and affects quality of life (QoL).This study aims at assessing the frequency of DPN among accidentally diagnosed diabetic patients, identifying risk factors linked to DPN in those patients, and determine the potential effect on QoL. Results: According to nerve conduction study (NCS), 32 patients (44.4%) had polyneuropathy. Polyneuropathy is significantly associated with older age, higher hip and waist measurements, higher weight, and body mass index (BMI). About 53% of patients with polyneuropathy were current smokers versus 25% of non-smokers. Longer duration since the first diagnosis, higher fasting blood sugar (FBG), 2-h post-prandial (2-hPP) glucose, and HbA1c are also associated with peripheral neuropathy (PN) (p < 0.001). Being on insulin was associated with PN (p = 0.002). Increasing BMI, current smoking, and increased HbA1c significantly increase the risk of PN by 1.314, 19.963, and 3.302-folds, respectively. An unhealthy diet is also associated with PN.Hyperlipidemia was also associated with PN (p = 0.028). A significant positive association was found between DQoL scores and symptom scores. Conclusion: A significant proportion of type 2 diabetic patients had DPN at the time of diagnosis, which adversely affects QoL. At the time of diagnosis, it is highly suggested that proper screening. procedures be used for DPN. Obesity, smoking, and elevated HbA1c significantly increase the risk of DPN. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to make a prospective evaluation of the effect on the clinical results of percutaneous iliotibial band partial tenotomy (PITP) applied to cases of genu valgum which developed following total hip prosthesis for Crowe Type IV dysplastic hip. Methods: The study consists of 33 patients with unilateral crowe type IV dysplastic hip osteoarthritis who developed iatrogenic ipsilateral genu valgum after total hip arthroplasty. The patients were randomly separated into 2 groups of Group 1 (n = 16) where percutaneous iliotibial band tricut partial tenotomy was applied (PITP) and Group 2 (n = 17) where no treatment was applied. Pre and postoperative measurements were taken of the Harris Hip Score (HHS), the Lysholm-Gilquist Knee Score (LGS), Visual Analog Score (VAS), ipsilateral knee Q angle, and the spina ilica anterior superior medial malleolus distance (SIAS-MM). Results: In both Group 1 and Group 2, a statistically significant increase was seen in the values of SIAS-MM (p < 0.001), Q angle (p < 0.001) and HSS (p < 0.001) from preoperative to postoperative. A statistically significant decrease was determined in LGS (p < 0.001, p < 0.003). In Group 1, a statistically significant decrease in the Q angle was determined at the final follow-up after PITP compared to the early postoperative period (p < 0.001). The HSS values for Group 1 were statistically significantly high in the early postoperative period and at the final follow-up (p < 0.001). Conclusion: PITP application improves knee and hip clinical scores in the early postoperative period and hip clinical scores in the mid-term follow-up. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to describe mothers' knowledge of infant fever management after birth and six months later and its association with sociodemographic characteristics, perceived support, sources of consultation and health education; and to assess determinants of change in mother's knowledge from birth to six months. Methods: Mothers (n = 2804) answered a self-reporting questionnaire after giving birth in maternity wards in six hospitals in Israel; six months later follow- up interviews were conducted by telephone. Results: The mothers' knowledge level of infant fever management was low after birth (mean = 50.5, range 0–100, SD = 16.1), and rose to a moderate level six months later (mean = 65.2, SD = 15.0). Mothers having their first born, with lower household income or education were less knowledgeable about infant fever management after birth. However, these mothers showed the largest improvement after six months. Mothers' perceived support or sources of consultation and health education (partner, family, friends, nurses, and physicians) were not associated with their knowledge at either time. Moreover, mothers stated self-learning from internet and other media as often as receiving health education by health professionals. Conclusions for Practice: Public health policy for health professionals in hospitals and community clinics is essential to promote clinical interventions promoting mothers' knowledge of infant fever management. Efforts should focus at first time mothers, those with non-academic education, and those with a moderate or low household income. Public health policy enhancing communication with mothers regarding fever management in hospitals and community health settings, as well as accessible means of self-learning is warranted. [ABSTRACT FROM AUTHOR]

Purpose: This study compares the performance of a 4-min multi-echo in steady-state acquisition (MENSA) with a 6-min fast spin echo with variable flip angle (CUBE) protocol for the assessment of lumbosacral plexus nerve root lesions. Methods: Seventy-two subjects underwent MENSA and CUBE sequences on a 3.0-T MRI scanner. Two musculoskeletal radiologists independently assessed the images for quality and diagnostic capability. A qualitative assessment scoring system for image quality and quantitative nerve signal-to-noise ratio (SNR) and iliac vein and muscle contrast-to-noise ratios (CNR) was applied. Using surgical reports as the reference, sensitivity, specificity, accuracy, and area under the receiver operating characteristic curves (AUC) were evaluated. Intraclass correlation coefficients (ICC) and weighted kappa were used to calculate reliability. Results: MENSA image quality rating (3.679 ± 0.47) was higher than for CUBE images (3.038 ± 0.68), and MENSA showed higher mean nerve root SNR (36.935 ± 8.33 vs. 27.777 ± 7.41), iliac vein CNR (24.678 ± 6.63 vs. 5.210 ± 3.93), and muscle CNR (19.414 ± 6.07 vs. 13.531 ± 0.65) than CUBE (P < 0.05). Weighted kappa and ICC values indicated good reliability. Sensitivity, specificity, and accuracy of diagnosis based on MENSA images were 96.23%, 89.47%, and 94.44%, respectively, and AUC was 0.929, compared with 92.45%, 84.21%, 90.28%, and 0.883 for CUBE images. The two correlated ROC curves were not significantly different. Weighted kappa values for intraobserver (0.758) and interobserver (0.768–0.818) reliability were substantial to perfect. Conclusion: A time-efficient 4-min MENSA protocol exhibits superior image quality and high vascular contrast with the potential to produce high-resolution lumbosacral nerve root images. [ABSTRACT FROM AUTHOR]

Objective: To examine the anti-inflammatory effect of grape seed extract (GSE) in animal and cellular models and explore its mechanism of action. Methods: This study determined the inhibitory effect of GSE on macrophage inflammation and Th1 and Th17 polarization in vitro. Based on the in vitro results, the effects and mechanisms of GSE on multiple sclerosis (MS)-experimental autoimmune encephalomyelitis (EAE) mice model were further explored. The C57BL/6 mice were intragastrically administered with 50 mg/kg of GSE once a day from the 3rd day to the 27th day after immunization. The activation of microglia, the polarization of Th1 and Th17 and the inflammatory factors such as tumor necrosis factor- α (TNF- α), interleukin-1 β (IL-1 β), IL-6, IL-12, IL-17 and interferon-γ (IFN-γ) secreted by them were detected in vitro and in vivo by flow cytometry, enzyme linked immunosorbent assay (ELISA), immunofluorescence staining and Western blot, respectively. Results: GSE reduced the secretion of TNF-α, IL-1 β and IL-6 in bone marrow-derived macrophages stimulated by lipopolysaccharide (P<0.01), inhibited the secretion of TNF-α, IL-1 β, IL-6, IL-12, IL-17 and IFN-γ in spleen cells of EAE mice immunized for 9 days (P<0.05 or P<0.01), and reduced the differentiation of Th1 and Th17 mediated by CD3 and CD28 factors (P<0.01). GSE significantly improved the clinical symptoms of EAE mice, and inhibited spinal cord demyelination and inflammatory cell infiltration. Peripherally, GSE downregulated the expression of toll-like-receptor 4 (TLR4) and Rho-associated kinase (ROCKII, P<0.05 or P<0.01), and inhibited the secretion of inflammatory factors (P<0.01 or P<0.05). In the central nervous system, GSE inhibited the infiltration of CD45+CD11b+ and CD45+CD4+ cells, and weakened the differentiation of Th1 and Th17 (P<0.05). Moreover, it reduced the secretion of inflammatory factors (P<0.01), and prevented the activation of microglia (P<0.05). Conclusion: GSE had a beneficial effect on the pathogenesis and progression of EAE by inhibiting inflammatory response as a potential drug and strategy for the treatment of MS. [ABSTRACT FROM AUTHOR]

Research indicates many children who experience maltreatment are also exposed to intimate partner violence (IPV). Some studies find that children with child protective services (CPS) history have higher risk of preventable child fatality (CF). It is not known if there are unique characteristics of families with combined CPS and IPV histories that could inform service plans to reduce risk of later CF. Information from documents published in the Innocents Lost Database was extracted and analyzed, and linked to county level census data. The sample includes CFs from 501 Florida families that occurred from 2008 to 2015. Families had a history of CPS contact, but cause of death varied. Bivariate (t-test, chi-square, correlation) and logistic regression analyses compared CF cases with and without IPV mentioned in the full sample (n = 501) and the reduced sample (n = 155 with in-depth documentation). Prevalence of IPV ranged from 34 to 46% (full and reduced sample respectively) with violent death more common for this group. CFs with noted IPV histories were more likely to involve school-aged children from larger families. Such cases were more likely to include primary caregivers with noted mental health and substance abuse concerns, and/or prior criminal justice system contact and secondary caregivers with criminal justice histories. IPV was common among preventable CFs with prior CPS histories. Caregivers in these families had substantial prior contact with both CPS and other adult service and criminal justice systems. Implications for risk screening and preventive services within adult-serving systems and schools are discussed. [ABSTRACT FROM AUTHOR]

Racial/ethnic minorities have demonstrated lower rates of physical activity (PA) than non-Hispanic Whites. This study examined outcomes in PA measures after participation in a community health worker (CHW) intervention. We performed a secondary data analysis from four randomized controlled trials utilizing CHWs (n = 842) in New York City (Bangladeshi—diabetes management, Filipino—hypertension management, and Korean and Asian Indian—diabetes prevention). Outcomes included total weekly PA, PA self-efficacy, PA barriers, and PA social interaction. Each measure was examined at baseline and study endpoint. Generalized estimating equation models were fitted to assess the repeated measures over time, while accounting for study group and socio-demographic factors. Moderate PA, recommended PA, and self-efficacy increased significantly among treatment group participants. PA social interaction increased significantly among Filipinos and Asian Indians. In adjusted regression analysis, time x group interaction was significant for all PA outcomes except for PA barriers. Culturally-adapted lifestyle interventions may potentially improve PA-related outcomes in Asian immigrant communities. Trial registration at ClinicalTrials.gov includes: NCT03530579 (RICE Project), NCT02041598 (DREAM Project), and NCT03100812 (AsPIRE). [ABSTRACT FROM AUTHOR]

Refugees are a vulnerable, growing population who confront a myriad of traumas leading to their forced migration. Although psychiatric illnesses of resettled refugees are well-documented, there is a paucity of studies characterizing their neurological disease profiles. This study aimed to characterize the frequency and range of neurological disorders in a sample of resettled refugees receiving care at a community health center in Massachusetts, U.S.A. We performed a retrospective medical record review of adult (≥ 18 years) resettled refugees between May 2001 and December 2012 at a community health center in Northeast Massachusetts. Sociodemographic and clinical characteristics pertaining to neuropsychiatric health were collected from medical records using a standardized data extraction tool. Group comparisons between those with and without neurological illness and associated sociodemographic and psychiatric characteristics were evaluated using χ2 and independent samples two-tailed t-tests. In our sample (n = 779), 53.3% (n = 415) were male and 48.8% (n = 380) were from the African continent. The mean age was 33.2 ± 12.4 years (range 18–85). 36.8% were diagnosed with at least one neurological disorder and 18.1% with more than one neurological illness. The most common diagnoses were headaches (28.3%), sleep disorders (11.2%), cognitive impairment/ dementia (5.5%), and head trauma (5.5%). Exploratory analyses revealed that participants with neurological illness were more likely to be older (p <.001), female (p =.002), and diagnosed with co-morbid psychiatric diagnoses (p <.001) than those without neurological illness. Neurological disorders frequently co-occur with psychiatric comorbidities among U.S. resettled adult refugees. Standard refugee health assessments should incorporate screening and treatment for neurological illnesses. [ABSTRACT FROM AUTHOR]

Hardships in early childhood impact health. Few longitudinal studies have examined pandemic-related hardships among families with young children by race/ethnicity or nativity. We used prospective longitudinal data from 1,165 caregivers of children < 4 years surveyed in English and Spanish face-to-face in 5 urban hospitals 1/2018 to 3/2020 (pre-pandemic) and again by telephone 9/2020 to 3/2021 (during pandemic). Caregivers reported hardships (household food insecurity [HFI], child food insecurity [CFI]), behind on rent [BOR]) and maternal race/ethnicity and nativity. During the pandemic vs pre-pandemic, families with immigrant mothers had greater increases in HFI [aOR = 2.15 (CI 1.49–3.09)] than families with US-born mothers [aOR = 1.44 (CI 1.09–1.90)] and greater increases in BOR [families with immigrant mothers aOR = 4.09 (CI 2.78–6.01) vs. families with US-born mothers aOR = 2.19 (CI 1.68–2.85)]. CFI increases for all groups did not vary by nativity nor race/ethnicity. HFI and BOR increases during COVID were significantly greater in families with Latina mothers and those with immigrant mothers than other groups. [ABSTRACT FROM AUTHOR]

Objectives: To describe the presence of anti-SARS-CoV-2 IgA and IgG in the blood and colostrum of women with COVID-19 infection during pregnancy and associate the presence of anti-SARS-CoV-2 IgA in colostrum with clinical symptoms of their newborns. Methods: A cross-sectional study was developed with 165 participants with COVID-19 infection during pregnancy and their newborns. Data collected: characteristics COVID-19 infection in pregnant women, gestational age, and clinical symptoms in their newborns (fever, hypothermia, respiratory distress, hypotonia, hypoactivity, hypoglycemia, cyanosis, vomiting/regurgitation, abdominal distention, and jaundice). Maternal blood and colostrum samples were collected postpartum to to detect the presence of IgA and IgG anti-SARS-CoV-2. Results: The median interval between COVID-19 diagnosis and delivery was 37.5 days (IQ = 12.0, 73.0 days). Clinical symptoms during hospitalization were observed in 55 newborns (33.3%), and two (1.6%) tested RT-PCR positive for COVID-19. Positive colostrum for anti-SARS-CoV-2 IgA was found in 117 (70.9%) women. The presence of anti-SARS-CoV-2 IgA in colostrum was associated independently with lower clinical symptoms in their newborns (OR = 0.42; 95% CI 0.202 to 0.84; p = 0.015). Conclusions for Practice: The presence of anti-SARS-CoV-2 IgA in colostrum was detected in more than two-thirds of the women evaluated and was associated with a lower frequency of clinical symptoms in their newborns. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to evaluate the effects of histogram equalization (HE) and contrast limited adaptive histogram equalization (CLAHE) on periapical images and fractal dimensions in the periapical region. Methods: In this cross-sectional study, digital periapical images were selected from the archive of Dentistry School of Isfahan University of Medical Sciences. The radiographs were taken from mandibular and maxillary anterior single root teeth with healthy root and periodontium. After applying HE and CLAHE algorithms to images, two radiologists evaluated the quality of apex detection from using a 5-point Likert scale (from 5 for very good image quality to 1 for very bad image quality). Afterward, all the images were imported to the ImageJ application, and the region of interest (ROI) was specified as the region between the two central incisors. The fractal box-counting method was used to determine fractal dimensions (FD) values. Nonparametric Wilcoxon–Friedman test, Intraclass Correlation Coefficient test, T-test, and Pair T-test were performed as statistical analysis (α = 0.05). Results: Fifty-three radiographs were analyzed and the image quality assessments were significantly different between raw images and images after performing HE, CLAHE (p value < 0.001), and using CLAHE algorithm significantly increases image quality assessments more than HE (p value = 0.009). There was a significant difference in FD values for images after applying CLAHE and HE compared to raw images (p value < 0.001), and HE decreased the FD value significantly more than CLAHE (p value = 0.019). Conclusions: Employing CLAHE and HE algorithm via OpenCV python library improves the periapical image quality, which is more significant using the CLAHE algorithm. Moreover, applying CLAHE and HE reduces trabecular bone structure detection and FD values in periapical images, especially in HE. [ABSTRACT FROM AUTHOR]