Search

Fucoidan is a sulfated polysaccharide which is obtained from brown marine algae mainly. It is an important source of various sugar components. Among them, one of the crucial components is, L-fucose. L-fucose is rarely synthesized in nature but is essential for the metabolic activities of organisms. Fucoidan is attributed to its multifarious biological actions such as anticancer, anti-inflammatory, antioxidant activities, etc. and are rich in phytochemical constituents that are supposed to aid these responses. Fucoidan is widely available in marketed products in the form of dietary supplements. Its application has been extended to the cosmeceutical industry as a skin conditioning agent mainly. Recent fucoidan product that got Generally Recognized As Safe notification from The United States Food and Drug Administration is Maritech® in 2016 which is produced by Marinova and its intended usage is as a food ingredient in conventional foods. So many studies had been already conducted for several of its pharmacological activities except for its excipient nature. The researches proved that fucoidan has an ability to act as an excipient but sufficient studies have not been carried out to explore this potential to the fullest. The excipient nature of fucoidan that is proven is; emulsifying agent, antiaging, viscosity-enhancing agent, skin-protective agent, etc. Hence the main objective of this write-up is to point-out the excipient potential of fucoidan and help the researchers to develop a pocket and patient-friendly medicine. [ABSTRACT FROM AUTHOR]

Ileal Atresia is noted to be the commonest cause of intestinal obstruction in neonates worldwide but still under diagnosed in Sub-Saharan countries with scarce data reported on its occurrence. It is likely under diagnosed due to low index of suspicion. Advancement in foetal ultrasound during prenatal period will increase index of suspicion and hence early diagnosis and correction. This is the first case report in our setup highlighting this condition. We present a case of a 10-day-old male baby referred to us due to vomiting since birth. Clinically was in distress with a palpable supraumbilical mass that was firm and non-tender. Abdominal ultrasound scan showed poor peristalsis and minimal dilation of bowels suggestive of partial intestinal obstruction. Abdominal X-ray showed dilated bowels with multiple air-fluid levels, empty rectum with features suggestive of intestinal obstruction. Patient was successfully operated but unfortunately on day 3 post-surgery succumbed.

Summary:. The nipple-areola complex (NAC) must be considered as an integral part of the breast with regard to morale and self-assurance. Achieving good aesthetic outcome is a challenge after excision of the NAC in retroareolar tumors. This article looks into immediate reconstruction of the NAC using inferior pedicle skin in patients after central excision of retroareolar tumors. Sixteen patients had breast conservation surgery for retroareolar tumors by a single surgeon between September 2016 and November 2021, and six of them had nipple-areola reconstruction with inferior pedicle skin. None of the patients having NAC reconstruction had any recorded complications and none needed reexcision of the margins. Five out of six patients undergoing NAC reconstruction had good to excellent aesthetic outcome as recorded in the patient questionnaire. There was no locoregional recurrence or distant metastasis in the whole group after a median follow-up of 17 months (2–62).

Background:. Chest wall perforator flaps (CPF) and therapeutic mammoplasty (TM) are often done in patients with anticipated poor cosmetic outcome with level 1 breast conservation surgery. The aim of this study was to assess the complications and oncological outcomes between CPF and TM. Methods:. Prospectively collected data of breast conservation surgery between September 2016 and January 2021 by a single surgeon were reviewed. Specific outcomes included complications needing intervention, re-excision and mastectomy rate, locoregional recurrence, and distant metastasis. Patients were followed up at 3 months and then every 12 months. Statistical analysis included chi-squared test and independent t test, and a P value of less than 0.05 was considered significant. Results:. There was no statistically significant difference between CPF and TM with regard to patient characteristics except for BMI and bra cup size, which was significantly higher in the TM group. One patient who had TM returned to the operating room for a hematoma evacuation, and one patient who had CPF had fat grafting, for unsatisfactory cosmetic outcome. Five of the 30 patients having CPF had further re-excision surgery for inadequate margins, but none needed mastectomy, and four of the 43 patients having TM had further surgery (one had re-excision of margins and three had mastectomy) and this was not statistically significant (P = 0.346). There was no locoregional recurrence in CPF and TM groups after a median follow-up of 22 months and 25 months, respectively. Conclusion:. There is no significant difference in early complications and oncological outcomes between CPF and TM.

Background:. Subpectoral implant reconstruction (SIR) is associated with animation deformity and increased postoperative pain. The aim of our study was to compare the short- to medium-term outcome of prepectoral implant reconstruction (PIR) and SIR with acellular dermal matrix. Methods:. A review of prospectively collected data of patients who underwent PIR and SIR using biological mesh by a single surgeon between Nov 2016 and Nov 2020 was done. Presentation, smoking history, BMI, bra size, radiology size, pathology data, mastectomy weight, implant volume, radiation treatment, and outcomes were analyzed. For intergroup comparisons, the data were analyzed using Pearson chi-square test and the Student t-test. P values of less than 0.05 were considered statistically significant. Results:. Eighty-two patients had 109 implant reconstructions (85 PIR and 24 SIR). Median follow-up was 27 months (4–53). Twenty-five of PIR and six of SIR were risk reduction surgeries. Two groups were comparable except for significantly higher percentage of node positive (13/18, 72% versus 20/60, 33%; P = 0.003), Her 2-positive disease (7/18, 39% versus 9/60, 15%; P = 0.027), and radiotherapy (15/24, 63% versus 21/85, 25%; P = 0.001) in SIR. There was no statistically significant difference between the two groups with regard to hematoma, wound infection, red reaction, seroma needing aspiration, wound necrosis, and implant loss. Significantly more patients in the prepectoral group had rippling needing fat grafting (n = 13, 15% versus 0; P = 0.041) and significantly more patients in the subpectoral group had fat grafting for contour deformity (n = 6, 25% versus n = 6, 7%; P = 0.025). Conclusion:. PIR is comparable to conventional SIR with regard to most of the complications.

Introduction The transitional period of newly graduate nurses became more stressful, different coping mechanisms are essential. Therefore, effective coping with transition-related stress and anxiety is important for the life and professional of those nurses. Objectives To examine the transitional shock through assessing the occupational stress and coping mechanism of multi-nationality newly graduate nurses in Kuwait. Methods A descriptive correlational design was used to identify the occupational stress of the newly graduate nurses (NGNs) and their coping mechanisms during the transitional period to their professional life. All the NGNs were recruited. The total number of participants was 152 nurses. Results Highly significant correlations on almost all stress domains with p-values P

The negative impacts of perceived discrimination on health have been documented, but how perceptions of discrimination vary by sex among people with obesity (PWO) is not well understood. This study assessed sex differences in perceived discrimination among PWO. This cross-sectional study analysed self-reported data from racially/ethnically diverse PWO attending an academic obesity program. The primary outcome was perceived discrimination, assessed by the Major Experiences of Discrimination (MED) and Everyday Discrimination Scale (EDS). Sex differences were evaluated by univariate and multivariable regression analysis adjusted for key descriptive variables. The final analytical sample included 60 PWO (62% female, 61% non-Hispanic white (NHW), 12% Hispanic, 39% non-Hispanic black (NHB), mean age 53 years, mean BMI 34 kg/m 2 ). Women experienced everyday discrimination 59% less than men but this was not significant (OR 0.41; 95% CI 0.08-2.16; p = .29). Participant highest BMI was correlated with acute discrimination (total MED score) (r = 0.39; p = .0024) and chronic discrimination (total EDS score) (r = 0.28; p = .03). Most participants reported more chronic discrimination compared to acute discrimination (85% vs. 48%). Mean MED (β -0.18; 95% CI -0.93 to +0.56; p = .62) and EDS scores (β -0.25; 95% CI -3.37 to +2.87; p = .87) were not significantly different between women and men. Perceived discrimination was common and experienced equally between men and women with obesity. Incorporating discrimination experiences into obesity care models may be an important step to improving quality of care and outcomes., (© 2024 World Obesity Federation. Published by John Wiley & Sons Ltd.)

Objective: To study the clinical profile and management outcomes of non-tubal ectopic pregnancy at a tertiary care hospital in the United Arab Emirates (UAE)., Methods: Case files of non-tubal ectopic pregnancy (NTEP) patients from October 2017 to October 2020 presented to Alqasmi Women and Children's Hospital, Sharjah, were included in the study. The data was extracted from available medical records., Results: A total of 30 confirmed cases of NTEP were identified with the following break-up: caesarean scar ectopic pregnancy (n=14; 46.7%), cornual pregnancy (n=11; 36.7%), cervical pregnancy (n=3; 10%) and ovarian pregnancy n=2; 6.7%). Abdominal pain was the most common presenting symptom, present in 23 (76.7% patients) followed by vaginal bleeding in 17 (56.7%) patients. Ten women were managed medically, ten required surgical treatment, and eight were managed with combined medical and surgical treatments; Two patients were managed expectantly. Patients in each treatment strategy did well and there were no deaths. One patient in the medical treatment group developed complications after one month and underwent subtotal hysterectomy., Conclusion: Patients with NTEP were presented with varying symptoms and signs depending upon the location of NTEP. The different currently available management options for NTEP seem to be effective and safe when carefully selected based on the clinical merits of each case., (Copyright: © Pakistan Journal of Medical Sciences.)

Introduction: Metabolic and bariatric surgery (MBS) is safe and efficacious for adolescents with severe obesity. Pairing MBS with behavioral lifestyle interventions may be effective for optimizing treatment outcomes. However, no standardized program exists. Adolescent perspectives are critical to understanding how to design interventions to enhance engagement, sustain motivation, and meet informational needs for pre- and post-MBS self-management behaviors. The aim of this study was to develop an MBS lifestyle support intervention built on evidence-based content with input from adolescents and their families., Methods: A mixed-methods design identified adolescent preferences for MBS lifestyle support. Data were collected from a racially and ethnically diverse sample of adolescents ( N = 17, 76% females, 24% males 41.2% non-Hispanic Black, 41.2% Hispanic/Latino, 11.8% non-Hispanic White, 5.8% Other) and their mothers ( N = 13, 38.4% Hispanic) recruited from an MBS clinic. Quantitative surveys and qualitative interviews assessed preferred types of pre-post MBS content, modality, frequency, and delivery platforms to inform the design of the intervention. Mixed methods data were triangulated to provide a comprehensive understanding of adolescent/parent preferences., Results: Adolescents prioritized eating well, managing stress, and maintaining motivation as desired support strategies. Parents identified parental support groups and nutrition guidance as priorities. Peer support and social media platforms were identified as key approaches for boosting motivation and engagement., Conclusions: The patient voice is an important first step in understanding how, and whether behavioral lifestyle programs combined with MBS for weight management can be optimized. Adolescent preferences may enhance program fit and identify health behavior supports needed to sustain behavior change., Competing Interests: None., (© The Author(s) 2024.)

Purpose: Metabolic and bariatric surgery (MBS) is presently the most evidence-based, effective treatment of obesity. Nevertheless, only half of the eligible individuals who are referred for this procedure complete it. This study aims to investigate the association between social support and MBS completion, considering race and ethnicity., Methods: In this prospective cohort study, 413 participants were enrolled between 2019 and 2022. Using the 19-item Brief Family Relationship Scale, which comprises three subscales (eight-item Cohesion subscale, four-item Expressiveness subscale, and seven-item Conflict subscale), the quality of family relationship functioning was assessed. Multivariable logistic regression models were used to determine the association between MBS completion and social support status, adjusting for variables including race, ethnicity, age, gender, body mass index, and insurance., Results: The mean age of the sample was 47.55 years (SD 11.57), with 87% of the participants being female and 39% non-Hispanic White. Nearly 35% of participants (n = 145) completed MBS. Multivariable logistic regression analysis showed overall cohesion (adjusted odds ratio [aOR], 1.52 [95% CI, 1.15-2.00]; p = .003) and overall expressiveness (aOR, 1.58 [95% CI, 1.22-2.05]; p < .001) were associated with higher odds of pursuing MBS. There was no significant interaction between overall cohesion, expressiveness, conflict, and race/ethnicity (p = .61, p = .63, p = .25, respectively)., Conclusion: The findings indicated that there is a link between family-based social support and MBS completion, regardless of race and ethnicity. Future research should continue to explore the complex interplay between family dynamics and MBS outcomes, considering cultural variations to enhance the effectiveness of obesity interventions within diverse communities., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Objective: Early screening prevents chronic diseases by identifying at-risk adolescents through anthropometric measurements, but predictive value in diverse groups is uncertain., Methods: A cross-sectional analysis of 12- to 19-year-old individuals from the 2017-2018 National Health and Nutrition Examination Survey (NHANES) assessed the predictive ability of BMI percentile, total body fat percentage, waist circumference (WC), and waist-hip ratio (WHR) for four cardiometabolic risk factors across race and ethnicity groups using receiver operating characteristic curves., Results: The unweighted sample (N = 1194; 51.2% male individuals; 23.7% Hispanic, 13.2% non-Hispanic Black [NHB], 51.1% non-Hispanic White [NHW], 12.0% other/multirace) had a weighted prevalence of elevated blood pressure of 2.7%, hyperglycemia of 36.8%, hypertriglyceridemia of 4.8%, and low high-density lipoprotein (HDL) cholesterol of 15%. WHR (area under the curve [AUC] = 0.77), WC (AUC = 0.77), and BMI percentile (AUC = 0.73) outperformed total body fat percentage (AUC = 0.56) in predicting elevated blood pressure (p < 0.001 for all). BMI percentile was more accurate than total body fat percentage in predicting hypertriglyceridemia (AUC = 0.70 vs. 0.59; p = 0.02) and low HDL cholesterol (AUC = 0.69 vs. 0.59; p < 0.001). Race and ethnicity-based predictions varied: NHW adolescents had the highest AUC (0.89; p < 0.01) for elevated blood pressure prediction compared with Hispanic and NHB adolescents (AUC = 0.77 for both). Total body fat percentage was more accurate in predicting low HDL cholesterol among Hispanic versus NHW adolescents (AUC = 0.73 vs. 0.58; p = 0.04)., Conclusions: WHR, WC, and BMI percentile are better predictors of cardiometabolic risk factors in adolescents than total body fat percentage. Predictive abilities differed by race and ethnicity, highlighting the importance of tailored risk assessment strategies., (© 2024 The Obesity Society.)

Caregivers of children with attention deficit-hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) experience more stress than caregivers of typically developing children but there is limited research evaluating caregivers' quality of life (QoL). This study aimed to describe the association of caregiver QoL in children with ASD and/or ADHD. This study included patients with ADHD and/or ASD seen in one pediatric specialty clinic between September 2018-August 2020. Caregivers were classified as those caring for children with ASD-only, ADHD-only, or youth with both conditions (ADHD + ASD). An adapted version of the PedsQL Family Impact Module was used to measure caregiver QoL. The sample included caregivers of 931 children. The majority of these children were male (74.7%), non-Hispanic white (63.3%), and aged 6 to 12 years (57.8%). Across the groups, significant differences were observed in patient age (p < 0.0001), preferred language (p = 0.005), and insurance (p = 0.001). Caregivers of non-Hispanic Black children had 4-times the odds of reporting feeling isolated from others (OR 4.36, 95% CI 1.19-16.00 p = 0.03). Those caring for children with ADHD-only had significantly lower odds of reporting helplessness or hopelessness (OR 0.45, 95% CI 0.26-0.80, p = 0.004), and difficulty talking about their child's health with others (OR 0.30, 95% CI 0.17-0.54, p < 0.0001). Similarly, caregivers of children who had ADHD + ASD reported higher odds of difficulty making decisions together as a family (OR 14.18, 95% CI 1.15-17.91, p=0.04) and difficulty solving family problems together (OR 45.12, 95% CI 2.70-752.87), p = 0.008). Caring for children with ADHD and/or ASD may affect caregiver QoL., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: Less than 50% of eligible candidates who are referred complete Bariatric Metabolic Surgery (BMS). The factors influencing the decision to complete BMS, particularly how these factors vary across different racial and ethnic groups, remain largely unexplored., Methods: This prospective cohort study included adult patients referred to a bariatric surgeon or obesity medicine program between July 2019-September 2022. Sociodemographic characteristics, body mass index (BMI), anxiety, depression, body appreciation, and patient-physician relationship information were collected via survey and electronic health records. The association between BMS completion and potential decision-driving factors was examined using Classification and Regression Tree (CART) analysis., Results: A total of 406 BMS -eligible patients participated in the study (mean [SD] age: 47.5 [11.6] years; 87.2% women; 18.0% Hispanic, 39% non-Hispanic Black [NHB], and 39% non-Hispanic White [NHW]; mean [SD] BMI: 45.9 [10.1] kg/m 2 ). A total of 147 participants (36.2%) completed BMS. Overall, the most influential factor driving the decision to complete BMS was younger age (< 68.4 years), higher patient satisfaction, and BMI (≥ 38.0 kg/m 2 ). Hispanic participants prioritized age (< 55.4 years), female sex, and body appreciation. For NHB participants, the highest ranked factors were age < 56.3 years, BMI ≥ 35.8 kg/m 2 , and higher patient satisfaction. For NHW patients, the most influential factors were age (39.1 to 68.6 years) and higher body appreciation., Conclusion: These findings highlight racial and ethnic group differences in the factors motivating individuals to complete BMS. By acknowledging these differences, healthcare providers can support patients from different backgrounds more effectively in their decision-making process regarding BMS., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Introduction: This analysis sought to identify disparities in social determinants of health (SDOH) outcomes at a Texas pediatric hospital., Methods: This retrospective study used electronic health records of pediatric patients families surveyed August -December 2022. Outcomes for health literacy, social support, food, transportation, energy, digital, and housing insecurity, and tobacco exposure were analyzed across demographic categories., Results: Among 15,294 respondents to the survey (mean child age, 8.73 years; 43.68% Hispanic, 29.73% non-Hispanic White, 18.27% non-Hispanic Black, 6.79% other race/ethnicity; 53.95% male), 50.25% of respondents reported at least one SDOH, whereas 23.39% reported two or more SDOH. The most prevalent SDOH was lack of social support (3,456, 23.91%). Hispanic, non-Hispanic Black, and other race/ethnicity respondents, non-English speakers, and public insurance users had higher odds of reporting almost all SDOH in logistic regression models adjusted for age, race/ethnicity, language, gender, and insurance type., Discussion: Race/ethnicity, language, and insurance type disparities were identified for all SDOH., Competing Interests: CONFLICTS OF INTEREST None to report. The authors thank Elhaam Bandali for her assistance with the study documentation., (Copyright © 2023 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.)

Background: Metabolic and bariatric surgery (MBS) is safe and efficacious in treating adolescents with severe obesity. Behavioral/lifestyle programs can support successful preparation for surgery and post-MBS weight loss, but no standardized lifestyle intervention exists for adolescents. Here we describe the process of developing and adapting the Diabetes Prevention Program Group Lifestyle Balance (DPP/GLB) curriculum to support adolescents pre- and post-MBS., Methods: We collected both qualitative and quantitative data from a diverse group of adolescents (N = 19, mean age 15.2 years, range 13-17, 76% female, 42% non-Hispanic Black, 41% Hispanic, 17% other). Additionally, we included data from 13 parents, all of whom were mothers. These participants were recruited from an adolescent MBS program at Children's Health System of Texas. In an online survey, we asked participants to rank their preferences and interests in DPP/GLB content topics. We complemented these results with in-depth interviews from a subset of 10 participants. This qualitative data triangulation informed the development of the TeenLYFT lifestyle intervention program, designed to support adolescents who were completing MBS and described here. This program was adapted from adolescent and parent DPP/GLB content preferences, incorporating the social cognitive model (SCM) and the socioecological model (SEM) constructs to better cater to the needs of adolescent MBS patients., Results: Adolescents' top 3 ranked areas of content were: (1) steps to adopt better eating habits and healthier foods; (2) healthy ways to cope with stress; and (3) steps to stay motivated and manage self-defeating thoughts. Nearly all adolescent participants preferred online delivery of content (versus in-person). Mothers chose similar topics with the addition of information on eating healthy outside the home. Key themes from the adolescent qualitative interviews included familial support, body image and self-confidence, and comorbidities as key motivating factors in moving forward with MBS., Conclusions: The feedback provided by both adolescents and parents informed the development of TeenLYFT, an online support intervention for adolescent MBS candidates. The adapted program may reinforce healthy behaviors and by involving parents, help create a supportive environment, increasing the likelihood of sustained behavior change. Understanding adolescent/parent needs to support weight management may also help healthcare providers improve long-term health outcomes for this patient population., (© 2024. The Author(s).)

Background: Household food insecurity (FI) is a modifiable social determinant of health linked to chronic health outcomes. Little is known, however, about the prevalence of metabolic syndrome (MetS) in pediatric population-based studies by household FI status., Objectives: The objective of the study was to estimate the prevalence of the MetS by household FI status over the past 2 decades., Methods: This cross-sectional study used data from the 2001-2020 National Health and Nutrition Examination Survey (NHANES). Participants were nonpregnant adolescents ages 12- 18 y in United States. The prevalence of MetS [elevated waist circumference and >2 of the following risk factors: elevated blood pressure, and fasting glucose, triglyceride, and/or low high-density lipoprotein (HDL) cholesterol concentrations] by FI status was evaluated using chi-square and logistic regression analyses., Results: The estimated prevalence of MetS was 2.66% [95% confidence interval (CI): 2.28%, 3.09%] in the final analytical sample (unweighted N = 12,932). A total of 3.39% (95% CI: 2.53%, 4.53%) of adolescents from FI households had MetS compared to 2.48% (95% CI: 2.11%, 2.9%) among adolescents with no household FI. Hispanic adolescents had the highest prevalence of MetS (3.73%, 95% CI: 3.05, 4.56) compared with adolescents who identified as non-Hispanic White (2.78%, 95% CI: 2.25, 3.43), non-Hispanic Black (1.58%, 95% CI: 1.19, 2.10). Adolescents with household FI (23.20%) were more likely to have MetS [odds ratio (OR): 1.38; 95% CI: 1.02, 1.88; I=0.039) compared with adolescents with no household FI, but in fully adjusted models this was not significant (OR: 1.13; 95% CI: 0.75, 1.72)., Conclusions: Using the most current NHANES data, the estimated prevalence of MetS in adolescents in United States was slightly higher among those from FI households. However, after adjusting for potential confounders, the relationship between household FI and MetS was nonsignificant, highlighting the complexity of factors contributing to MetS in this population. Hispanic adolescents share a disproportionate burden of MetS compared with their non-Hispanic counterparts., (Copyright © 2023 The Author(s). Published by Elsevier Inc. All rights reserved.)

Background: The impact of employment and the work-from-home (WFH) setting on body weight among people with obesity is unknown., Objective: This study examined the relationship between employment status, WFH setting, and change in body weight among adults with obesity during the COVID-19 pandemic., Methods: Patients from an obesity medicine clinic completed an online survey in 2022 to assess health, work, and lifestyle behaviors. Multiple regression models examined the association between WFH status and change in body weight., Results: The analytical sample included 380 patients (81.9% female, mean age 52.5 years, mean body mass index 43.25, 50.0% non-Hispanic White, 25.7% non-Hispanic Black, 18.7% Hispanic, 5.7% other ethnicity). During the pandemic, 28.7% were employed in a WFH setting (73.4% of this subgroup were in a WFH setting only), 36.1% were employed but not in a WFH setting, 11.8% were unemployed, and 23.4% were retired. Mean body weight change for participants who partially WFH during the pandemic was +5.4 (±7.2) % compared to those completely WFH -0.3 (±9.8) % (P = 0.006). After adjusting for key demographics, participants who were partially WFH gained 7.8% more weight compared to those completely WFH (β= 7.28, SE = 1.91, p < 0.001). The most significant predictors for weight gain after adjusting for WFH frequency (partially vs. completely) included overeating (aOR 11.07, 95% CI 3.33-36.77), more consumption of fast food (aOR 7.59, 95% 2.41-23.91), and depression (aOR 6.07, 95% CI 1.97-18.68)., Conclusion: These results show that during the COVID-19 pandemic, the WFH hybrid (combination of office and WFH) setting is associated with greater weight gain compared to those who completely WFH in people with obesity. Risk factors include overeating, higher fast food consumption, and depression.

Objectives: There is limited in-depth research exploring persistent symptoms and conditions among children and adolescents who contracted COVID-19 illness that required hospitalisation. The main objective of this study was to conduct qualitative interviews among families who had a child hospitalised with COVID-19 illness to elucidate their child's physical, mental and social health outcomes months after initial acute infection., Design, Setting and Participants: A qualitative study that composed of in-depth interviews among families with a child hospitalised with COVID-19 illness in one large urban US paediatric healthcare system. Parents (N=25) were recruited from an ongoing quantitative study to estimate the prevalence of long COVID in children hospitalised with COVID-19 illness. During in-depth interviews, parents were invited to describe their child's post-COVID-19 symptoms and experiences. Interviews were audiotaped, transcribed and coded in NVivo., Results: Seven themes were identified concerning the child's prolonged COVID-19 experiences: (1) post-traumatic stress disorder, (2) social anxiety, (3) severe symptoms on reinfection, (4) worsened pre-existing conditions, (5) lack of insurance coverage for costly treatments, (6) access and utilisation of support systems and (7) overall resilience and recovery. Four parent-specific themes were identified: (1) fear of COVID-19 unknowns, (2) mixed messaging from health information sources, (3) schools being both a support system and a hindrance and (4) desire for and access to support systems., Conclusions: A subset of children who were hospitalised with COVID-19 illness are experiencing a range of serious mental health impacts related to persistent COVID-19 symptoms. Clinical and public health support strategies should be developed to support these children and their families as they reintegrate in school, social and community activities., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Introduction: The science of telemedicine has shown great advances over the past decade. However, the field needs to better understand if a change in care delivery from in-person to telehealth as a result of the COVID-19 pandemic will yield durable patient engagement and health outcomes for patients with obesity. The objective of this study was to examine the association of mode of healthcare utilization (telehealth versus in-person) and sociodemographic factors among patients with obesity during the COVID-19 pandemic., Methods: A retrospective medical chart review identified patients with obesity from a university outpatient obesity medicine clinic and a community bariatric surgery practice. Patients completed an online survey (1 June 2020-24 September 2020) to assess changes in healthcare utilization modality during subsequent changes in infection rates in the geographic area. Logistic regression analysis examined the association of mode of healthcare utilization and key sociodemographic characteristics., Results: A total of 583 patients (87% female, mean age 51.2 years (standard deviation 13.0), mean body mass index 40.2 (standard deviation 6.7), 49.2% non-Hispanic white, 28.7% non-Hispanic black, 16.4% Hispanic, 7% other ethnicity, 33.1% completed bariatric surgery) were included. Adjusted logistic regression models showed older age was inversely associated with telehealth use (adjusted odds ratio = 0.58, 95% confidence interval 0.34-0.98) and non-Hispanic black were more likely to use telehealth compared to non-Hispanic white (adjusted odds ratio = 1.72, 95% confidence interval 1.05-2.81)., Conclusions: The COVID-19 pandemic is impacting access to healthcare among patients with obesity. Telehealth is an emerging modality that can maintain healthcare access during the pandemic, but utilization varies by age and ethnicity in this high-risk population.

Purpose: Obesity is a complex, chronic disease that is strongly associated with complications which cost the US healthcare system billions of dollars per year. Endoscopic sleeve gastroplasty (ESG) has emerged as a safe and effective procedure for treatment of obesity, but without practice guidelines there are likely to be variations practice. We sought to describe current practice patterns amongst endoscopists who perform ESG to help define areas of focus for future research and guideline development., Methods: We conducted an anonymous cross-sectional survey to examine practice patterns related to ESG. The survey was organized in 5 sections: Endoscopic Practice, Training, and Resources; Pre-ESG Evaluation and Payment Model; Perioperative/Operative Period; Post-operative Period; and Endobariatric Practice Other Than ESG., Results: A variety of exclusion criteria were reported by physicians performing ESG. Most respondents (n = 21/32, 65.6%) would not perform ESG for BMI under 27, and 40.6% (n = 13/32) would not perform ESG on patients with BMI over 50. The majority of respondents (74.2%, n = 23/31) reported ESG was not covered in their region, and most reported patients covered residual costs (67.7%, n = 21/31)., Conclusions: We found significant variability with respect to practice setting, exclusion criteria, pre-procedural evaluation, and medication use. Without guidelines for the selection of patients or standards for pre- and post-ESG care, substantial barriers to coverage will remain, and ESG will remain limited to those who can meet out-of-pocket costs. Larger studies are needed to confirm our findings, and future research should be focused on establishing patient selection criteria and standards in practices to provide guidance for endobariatric programs., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: Mental health conditions including depression and anxiety are often prevalent among metabolic and bariatric surgery (MBS) patients, but it is not known if these conditions predict the decision to complete the procedure and if this varies by race and ethnicity. This study aimed to determine if depression and anxiety are associated with MBS completion among a race/ethnically diverse sample of patients., Methods: This prospective cohort study included participants who were referred to an obesity program or two MBS practices between August 2019 and October 2022. Participants completed the Mini International Neuropsychiatric Interview (MINI) instrument to determine history of anxiety and/or depression, as well as MBS completion status (Y/N). Multivariable logistic regression models determined the odds of MBS completion by depression and anxiety status adjusting for age, sex, body mass index, and race/ethnicity., Results: The sample consisted of 413 study participants (87 % women, 40% non-Hispanic White, 39% non-Hispanic Black, and 18% Hispanic). Participants with a history of anxiety were less likely to complete MBS (aOR = 0.52, 95% CI = 0.30-0.90, p = 0.020). Women had increased odds of a history of anxiety (aOR = 5.65, 95% CI = 1.64-19.49, p = 0.006) and of concurrent anxiety and depression (aOR = 3.07, 95% CI = 1.39-6.79, p = 0.005) compared to men., Conclusions: Results showed that participants with anxiety were 48% less likely to complete MBS compared to those without anxiety. Additionally, women were more likely to report a history of anxiety with and without depression versus men. These findings can inform pre-MBS programs about risk factors for non-completion., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

The reckless use of non-replenishable fuels by the growing population for energy and the resultant incessant emissions of hazardous gases and waste products into the atmosphere have insisted that scientists fabricate materials capable of managing these global threats at once. In recent studies, photocatalysis has been employed to focus on utilizing renewable solar energy to initiate chemical processes with the aid of semiconductors and highly selective catalysts. A wide range of nanoparticles has showcased promising photocatalytic properties. Metal nanoclusters (MNCs) with sizes below 2 nm, stabilized by ligands, show discrete energy levels and exhibit unique optoelectronic properties, which are vital to photocatalysis. In this review, we intend to compile information on the synthesis, true nature, and stability of the MNCs decorated with ligands and the varying photocatalytic efficiency of metal NCs concerning changes in the aforementioned domains. The review discusses the photocatalytic activity of atomically precise ligand-protected MNCs and their hybrids in the domain of energy conversion processes such as the photodegradation of dyes, the oxygen evolution reaction (ORR), the hydrogen evolution reaction (HER), and the CO 2 reduction reaction (CO 2 RR).

Background/aims: In pediatric populations, the epidemiology of facial trauma, their injury patterns, distribution, and outcomes are well known, However, little is known about the risk factors and impacts of minor and moderate facial injuries on in-hospital mortality among children in the United States of America (USA). The aim of this study was to determine the prevalence and risk factors for in-hospital mortality among pediatric patients following facial injuries in the USA., Material and Methods: A cross-sectional study was conducted with data from the National Trauma Data Bank's pediatric hospitalized patients (<18 years) with facial injuries (International Classification of Diseases, Ninth Revision codes 802.00 to 802.9 and Tenth Revision codes S02.2 to S02.92) between January 01, 2016-December 31, 2019. A multivariable logistic regression model was utilized to identify the risk factors for in-hospital mortality., Results: A total of 61,294 pediatric patients (mean age 11.9 years, 69.6% males) were included in the analysis. The estimated prevalence of in-hospital mortality following facial injuries was 2.4% (n = 1480). In terms of mortality, compared to those who sustained minor facial injuries, patients with (1) moderate injuries had 43% higher odds (OR = 1.43; 95% CI: 1.25-1.64, p < .0001), (2) serious injuries had seven times higher odds (OR = 7.81; 95% CI: 6.67-9.14, p < .0001), (3) severe injuries had 16 times higher odds (OR = 16.07; 95% CI: 12.62-20.46, p < .0001), and (4) critical/maximum injury virtually unsurvivable had 145 times higher odds (OR = 145.24; 95% CI: 113.82-185.33, p < .0001) of death after controlling for age, race, insurance status, comorbidities, and hospital complications., Conclusions: The severity of facial injury, age 5-17 years, uninsured status, and those with a mental/personality disorder were risk factors for in-hospital mortality among pediatric patients following facial injuries in this population-level analysis. A better understanding of these risk factors is needed for clinical management of pediatric patients to prevent in-hospital mortality following facial injuries., (© 2022 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: Little is known about how school breakfast programs are associated with school attendance and academic performance. This study evaluated Dallas Independent School District's (DISD) breakfast after the bell (BATB) program that provides breakfast for both habitually tardy and non-tardy students on (1) academic performance and (2) student attendance over 2 school years., Methods: A pre-post study design evaluated the impact of the BATB program in elementary/middle/high schools on student attendance and academic outcomes. Paired t-tests evaluated changes in outcomes between 2017 to 2018 and 2018 to 2019 school years., Results: The analytical sample consisted of 30,493 students (70.32% BATB participants, 50.47% male, 68.78% Hispanic). BATB participants were over 2.5 times more likely to attend school versus non-BATB participants (aOR = 2.55; 95% confidence interval [CI]: 2.23-2.92; p < .001). Compared to pre-participation (2017-2018), unadjusted models showed 2018 to 2019 BATB participants' mean reading scores increased from 1502.72 to 1545.76 during the 2018 to 2019 academic year (p < .001). There were no significant changes in reading and math scores over the 2-year implementation after adjustment., Conclusions: Results here showed that a school breakfast program that is housed in a large public school system that serves predominantly low resource, ethnically diverse students is associated with increased student attendance., (© 2023 American School Health Association.)