Search

Background: Poor quality of life in adults with anorexia nervosa (AN) and persistent high rates of readmission highlight the necessity of developing interventions to optimize treatment outcomes. ECHOMANTRA is a novel online intervention based on interventions for carers (Experienced Carers Helping Others, ECHO) and patients (Maudsley Model of Anorexia Nervosa Treatment for Adults, MANTRA) with anorexia nervosa. The objective of this paper is to describe the study protocol of a randomized control trial (RCT) aimed at evaluating the efficacy of an adaptation of the ECHOMANTRA for adults AN inpatients and outpatients, and their carers, to be implemented as an add-on to treatment-as-usual (TAU). Methods: In a multi − center pilot randomized controlled trial (RCT), 148 adult AN patients, and their carers, will be randomized to receive treatment as usual (TAU) or TAU plus ECHOMANTRA. Assessments will take place at baseline (T0), post-intervention (2-month) (T1), 6-month follow-up (T2), and 12-month follow-up (T3). Primary outcomes will be eating disorder psychopathology and psychological well-being. For carers, outcome variables will include psychological well-being, accommodation and enabling behaviors, expressed emotion, illness burden, quality of life and care skills. Discussion: This study will provide evidence of the efficacy of this novel, online and protocolized intervention in facilitating the recovery of these patients. Trial registration: ISRCTN registry (Identifier: 80253157 https://doi.org/10.1186/ISRCTN80253157). [ABSTRACT FROM AUTHOR]

Background/Objectives: The aim of this paper was to compare voice and speech characteristics between post-COVID-19 and control subjects. The hypothesis was that acoustic parameters of voice and speech may differentiate subjects infected by COVID-19 from control subjects. Additionally, we expected to observe the persistence of symptoms in women. Methods: In total, 134 subjects participated in the study, were selected for convenience and divided into two groups: 70 control subjects and 64 post-COVID-19 subjects, with an average time of 8.7 months after infection. The recordings were made using the SPIRA software (v.1.0.) on cell phones, based on three verbal tasks: sustained production of the vowel/a/, reading a sentence, and producing a rhyme. Acoustic analyses of speech and voice were carried out with the PRAAT software (v.4.3.18), based on the following parameters: total sentence duration, number of pauses, pause duration, f0, f0SD, jitter, shimmer, and harmonics-to-noise ratio (HNR). Results: Regarding the acoustic characteristics of speech, there were no differences between the groups or between the sexes. Regarding the acoustic characteristics of voice, jitter, shimmer, and HNR, significant differences between the groups were found. Differences between sexes were observed in the following frequency-related parameters: f0, f0SD, and jitter. Conclusions: Some acoustic characteristics of the patients' voice may show a deteriorated condition even after exacerbation of the disease. These characteristics are compatible with some of the symptoms reported by post-COVID-19 subjects, such as the presence of tension and fatigue. These voice acoustic parameters could be used as biomarkers to screen voice disorders in long-COVID, using artificial intelligence (AI), accelerating the search for diagnosis by specialists. [ABSTRACT FROM AUTHOR]

Segmentation of brain tissue from MR images provides detailed quantitative brain analysis for accurate diagnosis, detection, and classification of brain diseases, and plays an important role in neuroimaging research and clinical environments. Recently, a plethora of deep learning-based approaches have been employed to achieve brain tissue segmentation in fetuses, infants, and adults with impressive outcomes. However, owing to the existence of noise, motion artifacts, and edge blurriness in MR images, automatically segmenting brain tissue accurately from MR images is still a very challenging task. This survey examines both deep learning and MRI, providing an overview of the latest advances in fetal, infant, and adult brain tissue segmentation techniques based on deep learning. It includes the performance and quantitative analysis of the state-of-the-art methods. Over 100 scientific papers covering various technical aspects, including network architecture, prior knowledge, and attention mechanisms, were reviewed and analyzed. This article also comprehensively discusses these technologies and their potential applications in the future. Brain tissue segmentation provides detailed quantitative brain analysis for accurate diagnosis, detection, and classification of brain diseases, and plays an important role in neuroimaging research and clinical environments. [ABSTRACT FROM AUTHOR]

Background: Internationally, COVID-19 restrictions impacted negatively on participation in sport and physical activity. Participation in community club sport was particularly disrupted with cancelled training and competitions, and this has been shown to impact the health of individuals. We now need to investigate the effects of the lifting of COVID-19 restrictions. Aim: The aim of this study was to longitudinally investigate the health of Australian adult sports club participants, during and post-COVID-19 restrictions. Methods: Two waves of an online survey were conducted in mid-2020 and mid-2021. The first wave also captured retrospective pre-COVID19 (2019) data. For each year 2019–2021 each survey respondent was categorized as participating (Yes/No) in club sport. Respondents also assessed their current health (overall, physical and mental) in both 2020 and 2021. The six health assessments were cross-tabulated against three patterns of participation (dropout, dropout and return, continuation), for the survey sample overall and for six demographic subsamples: 42 crosstabulations in all. Results: A total of 1,037 Australians aged 18 years and above completed both survey waves. Those who continued playing club sport throughout, and to a lesser degree those who returned to club sport in 2021, reported better physical and general health than those who dropped out. This pattern was consistent, for the overall survey sample and for the sub-samples based on gender, age and region of residence, with statistically significantly associations (p < 0.05) in 24 of 28 analyses. The pattern of club sport participation was only weakly associated with reported mental health, with only one of 14 associations being statistically significant. Conclusion: Changes in club sport participation impact general and physical health of adults; continuation or return were associated with better physical and general health than drop-out. There was little evidence of an association between participation in sport and mental health, which is inconsistent with previously reported cross-sectional results; this may be due to a combination of factors, including confounding with the broader effects of the pandemic. In conclusion, it is clear that retention in participation in sport is not just important for sports management policy and strategies; it is also important for the health of individuals. [ABSTRACT FROM AUTHOR]

Background: Multiple diseases, such as Adolescent Idiopathic Scoliosis (AIS), present at adolescent age and the impact on quality of life (QoL) prolongs into adulthood. For the EQ-5D, a commonly used instrument to measure QoL, the current guideline is ambiguous whether the youth or adult version is to be preferred at adolescent age. To assess which is most suitable, this study tested for equivalence along predefined criteria of the youth (EQ-5D-5L) and adult (EQ-5D-Y-5L) version in an adolescent population receiving bracing therapy for AIS. Methodology: 107 adolescents were recruited from 4 scoliosis centers in the Netherlands between March 2022 and January 2023; they completed both EQ-5D's and the SRS-22r (scoliosis-specific questionnaire). The following criteria were evaluated using the individual and sum of domains (level-sum-score (LSS)). Our primary criterion for non-equivalence of the EQ-5D's was less than excellent (≤ 0.9) intra-individual agreement using Intraclass Correlation Coefficient (ICC) analysis for LSS and weighted (quadratic) kappa for domains. Secondary criteria were differences in ceiling using McNemar test; a different number of quantified hypotheses for construct validity achieved using the SRS-22r as comparator; differences in test-retest reliability by comparing ICC/kappa values using a Z-test. Results: Adolescents had a mean age of 14 years (range 12–18), and 78% were female. Ceiling was mostly comparable between EQ-5D's, ranging from 78 to 81% for mobility and self-care, 52–54% for usual activities, and 31–36% for pain/discomfort. The EQ-5D-5L showed more ceiling (57%) compared to the EQ-5D-Y-5L (41%) on anxiety/depression (p = 0.006). Agreement between the EQ-5D's did not meet our criterion for the LSS (ICC 0.79 (95% confidence interval 0.70–0.85)), and decreased further at the domain-level. Both EQ-5D's achieved 5/7 validity hypotheses. Test-retest reliability was slightly better for EQ-5D-5L LSS (ICC 0.76 (0.64–0.84)) compared to EQ-5D-Y-5L LSS (ICC 0.69 (0.55–0.79)), although this was statistically insignificant (p = 0.284). This pattern was similar for most domains. Conclusions: The EQ-5D versions showed insufficient agreement, and cannot be considered fully equivalent. While they were similar in terms of validity and test-retest reliability, differences in score distribution were present. Taken together, we advise using the EQ-5D-5L to monitor the QoL in adolescent patients with AIS, as it avoids switching instruments and thus data discontinuities. Future studies should verify these findings in different patient groups and the general population. [ABSTRACT FROM AUTHOR]

Introduction: Anxiety and depression are significant mental health concerns for individuals with congenital heart disease (CHD). As group therapy has proven to be a valuable and effective treatment option for managing anxiety and depression, the aim of this study was to determine its effects on patients with CHD and anxious–depressive symptoms. Methods: We used non-pharmacological psychological group intervention, of six weekly sessions of 90 min each, administered by trained personnel, in adult patients with CHD. Measurement tools included quality of life (Euro quality of life-5D questionnaire), self-esteem (Rosenberg Self-Esteem Scale), anxiety (State–Trait Anxiety Inventory), depression (Beck Depression Inventory-II), and satisfaction surveys. Results: A total of 18 out of 21 CHD patients (mean age 35.8 ± 9.0 years old and 13 (72%) females) completed the program. According to CHD complexity, five (28%) patients had mild, six (33%) moderate, and seven (38%) great defects. Patients with CHD scored significantly higher in the Euro quality of life visual analogue scale (7.83 ± 1.4 vs. 7.14 ± 1.6, p = 0.012) and lower in the Beck Depression Inventory-II (12.3 ± 10.9 vs. 18.1 ± 12.1, p = 0.003) post-program than pre-intervention. Meanwhile, the Rosenberg Self-Esteem Scale score was close to reaching statistical significance (27.4 ± 6.0 vs. 25.1 ± 5.4, p = 0.051), while the State–Trait Anxiety Inventory did not. Finally, participants scored high in the satisfaction questionnaire at the end of the sessions, on a scale from 0 to 3, especially in the questions related to feeling comfortable with others (2.5 ± 0.6), recommending the program (2.3 ± 0.6), or being willing to attend future sessions (2.6 ± 0.8). Conclusions: Group psychological therapy proved to be a useful tool to reduce depressive symptomatology after a 6-week program, providing a comfortable environment to patients with CHD. [ABSTRACT FROM AUTHOR]

Objectives: Diagnosis of coeliac disease based on serology only has been allowed since 2018 in Finland for adults meeting specific criteria. We studied the patient experiences and perceptions of this novel diagnostic option. Methods: Altogether 194 adult patients were questioned on socio‐demographic and health-related characteristics, quality of life and various coeliac disease-related issues. The results were compared between patients diagnosed with intestinal biopsy or based on serology only. Results: Altogether 69 (36%) of the patients were diagnosed without duodenal biopsies. They were younger (median 43 vs. 51 years, p = 0.046), diagnosed more recently (2021 vs. 2020, p < 0.001) and more often in primary health care (78% vs. 43%, p = 0.001), had fewer esophageal symptoms at diagnosis (17% vs. 30%, p = 0.046) and considered the diagnostic process easier (49% vs. 30%, p = 0.032) than those diagnosed by duodenal biopsy (n = 125). The no-biopsy group received less often dietician follow-up (4% vs. 17%, p = 0.012), reported more persistent symptoms (36% vs. 21%, p = 0.026) and experienced more stress due to the diet (68% vs. 47%, p = 0.039). Symptom persistence or stress were not associated with year of diagnosis or dietician follow-up. The groups were comparable in socio-economic characteristics, general health, quality of life, diagnostic delay, dietician guidance at diagnosis, and dietary adherence. Conclusions: The non-invasive approach resulted in de-centralized diagnosis and easier patient-experienced diagnostic process of coeliac disease, but was associated with increased risk for persistent symptoms and stress due to gluten-free diet. These results highlight the significance of appropriate patient guidance and support regardless of the diagnostic strategy. KEY SUMMARY: Established knowledge on this subject Finland was the first country to allow the diagnosis of coeliac disease without duodenal biopsies and based on serology only to selected adult patients. Feasibility of no-biopsy diagnosis of coeliac disease for adults has been debated globally. Patient perceptions and acceptance of the diagnostic process are important as coeliac disease is treated with life-long, strict gluten-free diet. New findings of this study One-third of adult coeliac disease patients reported being diagnosed without duodenal biopsies, based on serology only in the period 2019–2022. No-biopsy diagnoses were made more often outside hospital settings and the patients found the diagnostic process less challenging than those diagnosed based on biopsy findings. No-biopsy diagnosis was associated with more common persistent symptoms and stress due to gluten-free diet, and less common dietician follow-up. The findings highlight the significance of adequate patient support and guidance regardless of diagnostic process. [ABSTRACT FROM AUTHOR]