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Copyright of Science & Technology of Food Industry is the property of Science & Technology of Food Industry Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The current study relied on community‐based participatory action research and qualitative methodology to explore the necessary skills and knowledge psychotherapists need to work effectively with foster youth and their families. In this study, the research team conducted interviews and focus groups with stakeholders (n = 48) in child welfare to learn how to support therapeutic relationships with foster youth clients. Using qualitative content analysis, the research team identified eight categories for needed knowledge and/or skills, such as collaboration with and inclusion of others in a client's system; flexibility and open‐mindedness to individualize care follow the client's lead; and a solid understanding of trauma and attachment supported by therapist training and regular consultation specifically around foster care. These findings offer tangible suggestions for skills that psychotherapists can learn and practice in order to support beneficial mental health services for foster youth. [ABSTRACT FROM AUTHOR]

Objective: Children and pregnant and lactating women, as two special groups, could face certain risks from blindly consuming various foods. To explore the proportion of suitability labeling for these two groups in health food products, analyze the reasons, and propose suggestions from multiple perspectives to improve the safety of health food consumption for these special groups. Methods: The data on health food products with top 10 function claim registrations were retrieved from the Special Food Information Query Platform of the State Administration for Market Regulation and Administration spanning from June 1996 to December 2022. The study was conducted from functional claims, approval timelines, and ingredient compositions. Chi-square tests and regression analyses were performed using SPSS Statistics 26 software to scrutinize the composition of special populations in relation to inappropriate labeling. Results: Special populations accounted for over 30% of inappropriate labeling in the ten product categories. There was a significant disparity in the composition ratio of special populations in similar products with inappropriate labeling (P

Several factors need to be considered for special populations with chronic hepatitis B (CHB), such as the family history of liver cirrhosis and liver cancer, age, disease stage, and antiviral response. It is necessary to select the appropriate timing of antiviral therapy and timely adjust antiviral strategies for CHB populations, which plays an important role in delaying disease progression and reducing the development of liver cirrhosis and hepatocellular carcinoma. This article elaborates on the timing and strategies for antiviral therapy in the special populations such as patients with chronic HBV infection who have an age of ≤30 years and a normal alanine aminotransferase (ALT) level, pregnant women with chronic HBV infection who have an age of >30 years and a normal ALT level, children with chronic HBV infection, and treatment-experienced HBeAg-positive CHB patients with low-level viremia, so as to help clinicians choose a better timing of antiviral therapy and optimize the strategies of antiviral therapy for special CHB populations. [ABSTRACT FROM AUTHOR]

Background: Little evidence has been provided regarding the effects of carrying standardized load equipment and foot parameters during quiet standing. Therefore, the main purpose of the study was to examine whether a load carriage might impact static foot parameters in police recruits. Methods: Eight hundred and forty-five police recruits (27.9% women) were tested in 'no load' vs. standardized '3.5 kg load' conditions. Foot characteristics during standing were assessed with the Zebris FDM pedobarographic pressure platform. Results: Carrying a 3.5 kg load significantly increased the 95% confidence ellipse area (∆ = 15.0%, p = 0.009), the center of pressure path length (∆ = 3.3%, p = 0.023) and average velocity (∆ = 11.1%, p = 0.014), the length of the minor axis (∆ = 8.2%, p < 0.009) and the deviation in the X (∆ = 12.4%, p = 0.005) and Y (∆ = 50.0%, p < 0.001) axes. For relative ground reaction forces, a significant increase in the left forefoot (∆ = 2.0%, p = 0.002) and a decrease in the left hindfoot (∆ = −2.0%, p = 0.002) were shown. No significant changes in relative ground reaction forces beneath the forefoot and hindfoot regions for the right foot were observed (p > 0.05). Conclusions: The findings suggest that spatial and temporal foot parameters may be more prone to change while carrying heavy loads, especially the center of pressure characteristics. [ABSTRACT FROM AUTHOR]

Cannabinoid use has surged in the past decade, with a growing interest in expanding cannabidiol (CBD) and delta-9-tetrahydrocannabinol (THC) applications into special populations. Consequently, the increased use of CBD and THC raises the risk of drug–drug interactions (DDIs). Nevertheless, DDIs for cannabinoids, especially in special populations, remain inadequately investigated. While some clinical trials have explored DDIs between therapeutic drugs like antiepileptic drugs and CBD/THC, more potential interactions remain to be examined. This review summarizes the published studies on CBD and THC–drug interactions, outlines the mechanisms involved, discusses the physiological considerations in pharmacokinetics (PK) and DDI studies in special populations (including pregnant and lactating women, pediatrics, older adults, patients with hepatic or renal impairments, and others), and presents modeling approaches that can describe the DDIs associated with CBD and THC in special populations. The PK of CBD and THC in special populations remain poorly characterized, with limited studies investigating DDIs involving CBD/THC in these populations. Therefore, it is critical to evaluate potential DDIs between CBD/THC and medications that are commonly used in special populations. Modeling approaches can aid in understanding these interactions. [ABSTRACT FROM AUTHOR]

Although carrying heavy loads impacts gait characteristics in military personnel, less studies have examined whether a gradually load increase affects foot parameters during quiet standing in the different population of intervention police officers. Therefore, the main purpose of the study was to examine differences in postural sway and ground reaction force characteristics during a quiet stance while carrying progressively heavier equipment. Ninety-six elite intervention male police officers were assessed under four conditions: (i) 'no load', (ii) 'a 5 kg load', (iii) 'a 25 kg load', and (iv) 'a 45 kg load'. Foot characteristics during standing were assessed with the Zebris pedobarographic pressure platform. Heavier loads increased 95% confidence ellipse area (p=.012, η2=0.028), the center of pressure path length (p=.010, η2=0.029) and average velocity (p=.011, η2=0.029), and length of the minor (p<.001, η2=0.040) and major axis (p=.004, η2=0.035). No significant changes in relative ground reaction forces beneath the forefoot and hindfoot regions of both feet were observed (p>.05). The findings suggest that spatial and temporal foot parameters may be more prone to change while carrying heavy loads, especially the center of pressure characteristics. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Hospital Pharmacy / Journal Canadien de la Pharmacie Hospitalière is the property of Canadian Society of Hospital Pharmacists and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Little evidence has been provided regarding the effects of carrying standardized load equipment and foot parameters during quiet standing. Therefore, the main purpose of the study was to examine whether a load carriage might impact static foot parameters in police recruits. Methods: Eight hundred and forty-five police recruits (27.9% women) were tested in ‘no load’ vs. standardized ‘3.5 kg load’ conditions. Foot characteristics during standing were assessed with the Zebris FDM pedobarographic pressure platform. Results: Carrying a 3.5 kg load significantly increased the 95% confidence ellipse area (∆ = 15.0%, p = 0.009), the center of pressure path length (∆ = 3.3%, p = 0.023) and average velocity (∆ = 11.1%, p = 0.014), the length of the minor axis (∆ = 8.2%, p < 0.009) and the deviation in the X (∆ = 12.4%, p = 0.005) and Y (∆ = 50.0%, p < 0.001) axes. For relative ground reaction forces, a significant increase in the left forefoot (∆ = 2.0%, p = 0.002) and a decrease in the left hindfoot (∆ = −2.0%, p = 0.002) were shown. No significant changes in relative ground reaction forces beneath the forefoot and hindfoot regions for the right foot were observed (p > 0.05). Conclusions: The findings suggest that spatial and temporal foot parameters may be more prone to change while carrying heavy loads, especially the center of pressure characteristics.

Cannabinoid use has surged in the past decade, with a growing interest in expanding cannabidiol (CBD) and delta-9-tetrahydrocannabinol (THC) applications into special populations. Consequently, the increased use of CBD and THC raises the risk of drug–drug interactions (DDIs). Nevertheless, DDIs for cannabinoids, especially in special populations, remain inadequately investigated. While some clinical trials have explored DDIs between therapeutic drugs like antiepileptic drugs and CBD/THC, more potential interactions remain to be examined. This review summarizes the published studies on CBD and THC–drug interactions, outlines the mechanisms involved, discusses the physiological considerations in pharmacokinetics (PK) and DDI studies in special populations (including pregnant and lactating women, pediatrics, older adults, patients with hepatic or renal impairments, and others), and presents modeling approaches that can describe the DDIs associated with CBD and THC in special populations. The PK of CBD and THC in special populations remain poorly characterized, with limited studies investigating DDIs involving CBD/THC in these populations. Therefore, it is critical to evaluate potential DDIs between CBD/THC and medications that are commonly used in special populations. Modeling approaches can aid in understanding these interactions.

Immune checkpoint inhibitors (ICIs) targeting programmed cell death 1, programmed cell death ligand 1, and cytotoxic T lymphocyte-associated antigen-4 have shown significantly durable clinical benefits and tolerable toxicities and have improved the survival of patients with various types of cancer. Since 2018, the National Medical Products Administration of China has approved 17 ICIs as the standard treatment for certain advanced or metastatic solid tumors. As ICIs represent a broad-spectrum antitumor strategy, the populations eligible for cancer immunotherapy are rapidly expanding. However, the clinical applications of ICIs in cancer patient populations with special issues, a term that refers to complex subgroups of patients with comorbidities, special clinical conditions, or concomitant medications who are routinely excluded from prospective clinical trials of ICIs or are underrepresented in these trials, represent a great real-world challenge. Although the Chinese Society of Clinical Oncology (CSCO) has provided recommendations for screening before the use of ICIs in special populations, the recommendations for full-course management remain insufficient. The CSCO Expert Committee on Immunotherapy organized leading medical oncology and multidisciplinary experts to develop a consensus that will serve as an important reference for clinicians to guide the proper application of ICIs in special patient populations. This article is a translation of a study first published in Chinese in The Chinese Clinical Oncology (ISSN 1009-0460, CN 32-1577/R) in May 2022 (27(5):442–454). The publisher of the original paper has provided written confirmation of permission to publish this translation in Therapeutic Advances in Medical Oncology. [ABSTRACT FROM AUTHOR]

Drug development for idiopathic pulmonary fibrosis (IPF) has been challenging due to poorly understood disease etiology, unpredictable disease progression, highly heterogeneous patient populations, and a lack of robust pharmacodynamic biomarkers. Moreover, because lung biopsy is invasive and dangerous, making the extent of fibrosis as a direct longitudinal measurement of IPF disease progression unfeasible, most clinical trials studying IPF can only assess progression of fibrosis indirectly through surrogate measures. This review discusses current state-of-art practices, identifies knowledge gaps, and brainstorms development opportunities for preclinical to clinical translation, clinical populations, pharmacodynamic endpoints, and dose optimization strategies. This article highlights clinical pharmacology perspectives in leveraging real-world data as well as modeling and simulation, special population considerations, and patient-centric approaches for designing future studies. [ABSTRACT FROM AUTHOR]

The greater utilization and acceptance of physiologically‐based pharmacokinetic (PBPK) modeling to evaluate the potential metabolic drug–drug interactions is evident by the plethora of literature, guidance's, and regulatory dossiers available in the literature. In contrast, it is not widely used to predict transporter‐mediated DDI (tDDI). This is attributed to the unavailability of accurate transporter tissue expression levels, the absence of accurate in vitro to in vivo extrapolations (IVIVE), enzyme‐transporter interplay, and a lack of specific probe substrates. Additionally, poor understanding of the inhibition/induction mechanisms coupled with the inability to determine unbound concentrations at the interaction site made tDDI assessment challenging. Despite these challenges, continuous improvements in IVIVE approaches enabled accurate tDDI predictions. Furthermore, the necessity of extrapolating tDDI's to special (pediatrics, pregnant, geriatrics) and diseased (renal, hepatic impaired) populations is gaining impetus and is encouraged by regulatory authorities. This review aims to visit the current state‐of‐the‐art and summarizes contemporary knowledge on tDDI predictions. The current understanding and ability of static and dynamic PBPK models to predict tDDI are portrayed in detail. Peer‐reviewed transporter abundance data in special and diseased populations from recent publications were compiled, enabling direct input into modeling tools for accurate tDDI predictions. A compilation of regulatory guidance's for tDDI's assessment and success stories from regulatory submissions are presented. Future perspectives and challenges of predicting tDDI in terms of in vitro system considerations, endogenous biomarkers, the use of empirical scaling factors, enzyme‐transporter interplay, and acceptance criteria for model validation to meet the regulatory expectations were discussed. [ABSTRACT FROM AUTHOR]

Diabetic ketoacidosis (DKA) is the most common hyperglycemic emergency and causes the greatest risk for death that could be prevented in patients with diabetes mellitus. DKA occurs more commonly among patients with type-1 diabetes with a thirty percent of the cases take place in patients with type 2 diabetes. DKA is characterized by sever hyperglycemia, metabolic acidosis and ketosis. Proper management of DKA requires hospitalization for aggressive replacement and monitoring of fluids, electrolytes and insulin therapy. Management of DKA has been updated with guidelines, to help standardize care, and reduce mortality and morbidity. The major precipitating factors for DKA include new diagnosis of diabetes, non-adherence to insulin therapy as well as infection in patients with diabetes. Discharge plans should include appropriate selection of insulin dosing and regimens as well as patient education to prevent recurrence of DKA. Further, definition and management of euglycemic DKA in patients prescribed sodium-glucose co-transporter 2 inhibitors are discussed. Special consideration is reviewed for specific patient population including pregnancy, renal replacement, acute pancreatitis, and insulin pump users as well as patients with COVID-19.

Abstract The first direct-acting antiviral (DAA) medications were approved for the treatment of chronic hepatitis C virus (HCV) in 2011. Later, the appearance of novel DAAs had revolutionized the landscape of HCV treatment whose early treatment options were limited to interferon (IFN) either alone or in combinations. This review discusses the paradigm shift in legibility for treating different groups of patients with HCV after the introduction of DAAs, along with the consequent changes in treatment guidelines. IFN-based therapy was the firstly used for treating chronic HCV. Unfortunately, it exhibited many pitfalls, such as low efficacy in some patients and unsuitability for usage in lots of patients with some specific conditions, which could be comorbidities such as autoimmune thyroiditis, or liver related as in decompensated cirrhosis. Furthermore, IFN failed to treat all the extrahepatic manifestations of HCV. Nowadays, the breakthroughs brought by DAAs have benefited the patients and enabled the treatment of those who could not be treated or did not usually respond well to IFN. DAAs achieve a high success rate of HCV eradication in addition to avoiding unfavorable harms and, sometimes, adverse effects related to the previously used PEGylated IFN regimens.

Iodine is a crucial trace element for the human body and the basic raw material for the synthesis of thyroid hormones. Oral inorganic iodine includes dietary iodine and therapeutic iodine, both of which are closely associated with thyroid immunity and metabolism. Graves' disease (GD), also known as diffuse toxic goiter, is characterized by hyperthyroidism and high iodine metabolism. Clinically, patients diagnosed with GD are often asked to limit iodine intake or even avoid iodine in their diet. The latest research has demonstrated that the interference of dietary iodine with antithyroid drugs (ATDs) treatment may be overestimated. In addition, as a medication for GD treatment, the administration of inorganic iodine has shown positive results in patients with mild hyperthyroidism, a low thyroid autoantibody concentration, a small thyroid volume, a high iodine diet and so on. Inorganic iodine may also be used as an alternative when patients experience side effects with traditional ATDs and for those who still prefer conservative treatment. Due to its low teratogenicity, blood toxicity and bone marrow toxicity, inorganic iodine plays a unique role in special populations, such as pregnant or lactating patients and patients receiving tumor radiotherapy or chemotherapy. In this review, the research progress, biological function, doses and effects, applicable populations and specific applications of dietary iodine and therapeutic iodine are summarized to provide references for the diagnosis and treatment of GD, thus improving the quality of life of GD patients. [ABSTRACT FROM AUTHOR]

Since its food and drug administration (FDA) approval in 2011, transcatheter aortic valve replacement (TAVR) has revolutionized the highly prevalent disease of aortic stenosis. In this review, we present a comprehensive overview of the data and considerations for utilization of TAVR in special populations who were either excluded from or not adequately represented in the seminal TAVR trials, due to high-risk valvular and/or systemic factors. These include nonagenarians, patients with renal dysfunction, chronic thrombocytopenia, bicuspid aortic valve, rheumatic valve disease, patients with failed aortic valve bioprosthesis requiring valve-in-valve intervention and patients with mixed aortic valve disease. In short, TAVR is a feasible therapeutic strategy in high-risk and special populations with mortality benefit and improvement in quality of life. Randomized controlled trials in high-risk populations are recommended to confirm results from observational studies. [ABSTRACT FROM AUTHOR]

There are more than 7000 rare diseases affecting approximately 30 million people in the United States. More than 90% of these diseases lack approved therapies. Several challenges face the development of "orphan drugs", such as the small populations of patients, high development costs, and long development timelines. This study evaluates clinical pharmacology assessments conducted during the development of drugs to treat rare diseases approved by the United States Food and Drug Administration in 2020 and 2021. Thirty‐nine new drug applications (NDAs) have been identified and the associated regulatory reviews, approved labels, and approval letters were reviewed. Approximately, 95%, 74%, and 77% of these submissions contained at least one type of drug–drug interaction, the effect of organ impairment (hepatic and renal) on drug exposure, and QT liability assessment, respectively. Modeling and simulation approaches were utilized to address many clinical pharmacology questions, with population pharmacokinetic analyses used extensively in the evaluation of the effect of organ impairment on drug exposure and with physiologically based pharmacokinetic analyses used mainly in assessing drug interaction risks. In general, the clinical pharmacology packages in the NDAs of orphan drugs are not optimal and more work is needed to obtain a complete clinical pharmacology package at the time of initial approval to ensure the safe and effective use of these drugs across the spectrum of the target patient population. This study provides insights into the clinical pharmacology studies needed for drugs to treat rare diseases and would help both the regulators and drug developers to identify challenges and opportunities in conducting clinical pharmacology assessments for drugs developed to treat rare diseases. [ABSTRACT FROM AUTHOR]

Diabetic ketoacidosis (DKA) is the most common hyperglycemic emergency and causes the greatest risk for death that could be prevented in patients with diabetes mellitus. DKA occurs more commonly among patients with type-1 diabetes with a thirty percent of the cases take place in patients with type 2 diabetes. DKA is characterized by sever hyperglycemia, metabolic acidosis and ketosis. Proper management of DKA requires hospitalization for aggressive replacement and monitoring of fluids, electrolytes and insulin therapy. Management of DKA has been updated with guidelines, to help standardize care, and reduce mortality and morbidity. The major precipitating factors for DKA include new diagnosis of diabetes, non-adherence to insulin therapy as well as infection in patients with diabetes. Discharge plans should include appropriate selection of insulin dosing and regimens as well as patient education to prevent recurrence of DKA. Further, definition and management of euglycemic DKA in patients prescribed sodium-glucose co-transporter 2 inhibitors are discussed. Special consideration is reviewed for specific patient population including pregnancy, renal replacement, acute pancreatitis, and insulin pump users as well as patients with COVID-19. [ABSTRACT FROM AUTHOR]

Research suggests that healthy eating and exercise decrease the likelihood of developing osteoarthritis (OA) with age. Despite this, OA is a prevalent chronic condition that typically causes joint pain at rest and during exercise, making it difficult to develop effective training programs. Recently, blood flow restriction (BFR) training has shown to be a beneficial alternative to traditional resistance training to improve muscle function. In this article, we provide a rationale as to how BFR may be a beneficial resistance training alternative that would allow individuals with osteoarthritis to experience similar improvements in muscle function compared with traditional resistance training using lower relative intensities. [ABSTRACT FROM AUTHOR]

Introduction: Down syndrome (DS) is one of the most common genetic abnormalities, with highly variable prognosis. Oral diseases such as periodontal disease, malocclusion, mouth breathing, macroglossia, delayed teeth eruption, missing and malformed teeth, microdontia, diastema, and bruxism are common among individuals with DS. Hence, a study was planned to assess the caries experience and periodontal status of subjects with DS. Materials and Methods: A cross-sectional study was conducted among 92 DS patients in two different centers in Chennai and Pondicherry to assess the prevalence of dental caries and gingivitis, using dft/DMFT and Modified Loe and Silness Gingival Index, respectively. The subjects were examined by three trained and calibrated examiners using a pre-tested and pre-validated proforma. Data were entered in a Microsoft Excel spreadsheet and analyzed using SPSS software (version 20). Descriptive statistics were used. A value of P < 0.05 was considered significant. Results: The mean DMFT was low among male (1.47 ± 2.31) when compared to female (2.57 ± 4.57) which was found to be significant statistically. The gingival score was low among male (.85 ± 0.36) when compared to female (1 ± 1.00) which was found to be significant statistically. The mean dft among male and female were (.49 ± 1.37;.43 ± 1.09), respectively, which was found to be not significant statistically. Conclusion: Dental caries and gingival diseases are higher among children with DS. Dental caries was found both in primary dentition and permanent dentition.

This in-depth analysis illuminates a translational journey of a community-university research collaboration that examined health disparities among incarcerated pregnant women and spanned the translational spectrum, with the initial collaboration in 2011 paving the way for consequent research grants, publications, practices, programs, and legislation passed years later. The case study utilized data from interviews with research stakeholders, institutional and governmental sources, peer-reviewed publications, and news stories. Identified research and translational challenges included cultural differences between research and prison system; the prison system’s lack of transparency; politics of using and translating research to policy change; and issues of capacity, power, privilege, and opportunity when doing community-engaged research/science. Among the facilitators of translation were the Clinical and Translational Science Award and institutional support; engagement of key stakeholders and influencers; authentic collaboration and team science; researchers as translation catalysts; pragmatic scientific approach; and policies and legislative activities. The research contributed to a variety of community and public health, policy/legislative, clinical/medical, and economic benefits. The case study findings enhance our understanding of translational science principles and processes leading to improved wellbeing and serve as a call for advancing the research agenda addressing health disparities related to criminal and social justice issues.

Vaccination of children with special health status has become one of the most urgent issues in China. We aim to evaluate vaccination coverage and safety as well as its associated factors among children with special health status in China during 2016‒2020. We conducted a retrospective cohort review of all children with special health status recorded in the Electronic Immunization Registries System in Chongqing, China, between 2016 and 2020. Univariate and multivariate logistic regression analyses were used to analyze the influence factors. Among the 2,175 children with special health status enrolled in the study, the overall vaccination coverage rate was lower than that among the general population, and the incidence of adverse event in them following immunization was very rare. Children with congenital heart disease were better vaccinated (aOR = 1.508–6.331), while most of the jaundice children had missed vaccination (aOR = 0.441‒0.556). The purchase of vaccine compensation insurance was associated with higher completion rate of basic immunization for Bacillus Calmette-G vaccine (aOR = 1.706, 95% CI: 1.249‒2.329) and rotavirus vaccine (aOR = 1.346, 95% CI: 1.061‒1.708). Children with special health status can be safely vaccinated. However, the vaccination coverage in these huge and vulnerable group is too low to protect them from vaccine-preventable diseases through immunization. More researches and interventions should be conducted to ensure a higher vaccination rate among the children with special health status.

The first direct-acting antiviral (DAA) medications were approved for the treatment of chronic hepatitis C virus (HCV) in 2011. Later, the appearance of novel DAAs had revolutionized the landscape of HCV treatment whose early treatment options were limited to interferon (IFN) either alone or in combinations. This review discusses the paradigm shift in legibility for treating different groups of patients with HCV after the introduction of DAAs, along with the consequent changes in treatment guidelines. IFN-based therapy was the firstly used for treating chronic HCV. Unfortunately, it exhibited many pitfalls, such as low efficacy in some patients and unsuitability for usage in lots of patients with some specific conditions, which could be comorbidities such as autoimmune thyroiditis, or liver related as in decompensated cirrhosis. Furthermore, IFN failed to treat all the extrahepatic manifestations of HCV. Nowadays, the breakthroughs brought by DAAs have benefited the patients and enabled the treatment of those who could not be treated or did not usually respond well to IFN. DAAs achieve a high success rate of HCV eradication in addition to avoiding unfavorable harms and, sometimes, adverse effects related to the previously used PEGylated IFN regimens. [ABSTRACT FROM AUTHOR]

Introduction: Down syndrome (DS) is one of the most common genetic abnormalities, with highly variable prognosis. Oral diseases such as periodontal disease, malocclusion, mouth breathing, macroglossia, delayed teeth eruption, missing and malformed teeth, microdontia, diastema, and bruxism are common among individuals with DS. Hence, a study was planned to assess the caries experience and periodontal status of subjects with DS. Materials and Methods: A cross-sectional study was conducted among 92 DS patients in two different centers in Chennai and Pondicherry to assess the prevalence of dental caries and gingivitis, using dft/DMFT and Modified Loe and Silness Gingival Index, respectively. The subjects were examined by three trained and calibrated examiners using a pre-tested and pre-validated proforma. Data were entered in a Microsoft Excel spreadsheet and analyzed using SPSS software (version 20). Descriptive statistics were used. A value of P < 0.05 was considered significant. Results: The mean DMFT was low among male (1.47 ± 2.31) when compared to female (2.57 ± 4.57) which was found to be significant statistically. The gingival score was low among male (.85 ± 0.36) when compared to female (1 ± 1.00) which was found to be significant statistically. The mean dft among male and female were (.49 ± 1.37;.43 ± 1.09), respectively, which was found to be not significant statistically. Conclusion: Dental caries and gingival diseases are higher among children with DS. Dental caries was found both in primary dentition and permanent dentition. [ABSTRACT FROM AUTHOR]

Abstract Background People with physical disabilities (PWPD) have limited opportunities to participate in sport activities. Sitting light volleyball (SLVB) is an adapted sport that combines light volleyball and paralympic sitting volleyball. This study examined the effectiveness of an SLVB intervention program to improve the physical and psychological health outcomes of PWPD in Hong Kong, China. Methods Thirty-two PWPD [13 women; SLVB group, n = 18; control group (CG), n = 14] with an average age of 48.89 years (SD = 14.42 years) participated in a 16-week intervention consisting of basic SLVB skills, and they also received instructions on the required posture, team tactics, and SLVB rules. Physical (i.e., muscular strength, muscular endurance, body composition, flexibility, and aerobic endurance) and psychological (i.e., physical activity enjoyment and quality of life) health outcomes were measured before and after the intervention. Results Individuals in the SLVB group exhibited statistically significant improvements in cardiovascular endurance [F(1,29) = 4.23, p = .049], body composition [F(1,23) = 6.67, p = .017], and physical activity enjoyment [F(1,29) = 16.94, p = .001] compared with adults in the CG. Conclusions Participating in SLVB has physical and psychological benefits for adults with physical disabilities in this study. Registration number of trial registry: The trial is registered at chictr.org.cn, number ChiCTR2000032971 on 17/05/2020.

Three Japanese adolescents with chronic hepatitis C were treated by direct‐acting antivirals (DAAs). No adverse events or laboratory abnormalities were observed during and after DAA therapy, and a sustained virological response was achieved in all cases. The emotional functioning of the patients and their mothers were improved after DAA therapy. Key Clinical Message: The efficacy/safety of therapy with direct‐acting antivirals for chronic hepatitis C in Japanese adolescents were favorable and the improvement of emotional functioning of them and their mothers by viral eradication was observed in all cases. [ABSTRACT FROM AUTHOR]

Abstract Three Japanese adolescents with chronic hepatitis C were treated by direct‐acting antivirals (DAAs). No adverse events or laboratory abnormalities were observed during and after DAA therapy, and a sustained virological response was achieved in all cases. The emotional functioning of the patients and their mothers were improved after DAA therapy.

PURPOSE: Health coaching is effective for chronic disease self-management in the primary care safety-net setting, but little is known about the persistence of its benefits. We conducted an observational study evaluating the maintenance of improved cardiovascular risk factors following a health coaching intervention. METHODS: We performed a naturalistic follow-up to the Health Coaching in Primary Care Study, a 12-month randomized controlled trial (RCT) comparing health coaching to usual care for patients with uncontrolled diabetes, hypertension, or hyperlipidemia. Participants were followed up 24 months from RCT baseline. The primary outcome was the proportion at goal for at least 1 measure (hemoglobin A1c, systolic blood pressure, or LDL cholesterol) that had been above goal at enrollment; secondary outcomes included each individual clinical goal. Chi-square tests and paired t-tests compared dichotomous and continuous measures. RESULTS: 290 of 441 participants (65.8%) participated at both 12 and 24 months. The proportion of patients in the coaching arm of the RCT who achieved the primary outcome dropped only slightly from 47.1% at 12 to 45.9% at 24 months (P = .80). The proportion at goal for hemoglobin A1c dropped from 53.4% to 36.2% (P = .03). All other clinical metrics had small, nonsignificant changes between 12 and 24 months. CONCLUSIONS: Results support the conclusion that most improved clinical outcomes persisted 1 year after the completion of the health coaching intervention.

PurposeHealth coaching is effective for chronic disease self-management in the primary care safety-net setting, but little is known about the persistence of its benefits. We conducted an observational study evaluating the maintenance of improved cardiovascular risk factors following a health coaching intervention.MethodsWe performed a naturalistic follow-up to the Health Coaching in Primary Care Study, a 12-month randomized controlled trial (RCT) comparing health coaching to usual care for patients with uncontrolled diabetes, hypertension, or hyperlipidemia. Participants were followed up 24 months from RCT baseline. The primary outcome was the proportion at goal for at least 1 measure (hemoglobin A1c, systolic blood pressure, or LDL cholesterol) that had been above goal at enrollment; secondary outcomes included each individual clinical goal. Chi-square tests and paired t-tests compared dichotomous and continuous measures.Results290 of 441 participants (65.8%) participated at both 12 and 24 months. The proportion of patients in the coaching arm of the RCT who achieved the primary outcome dropped only slightly from 47.1% at 12 to 45.9% at 24 months (P = .80). The proportion at goal for hemoglobin A1c dropped from 53.4% to 36.2% (P = .03). All other clinical metrics had small, nonsignificant changes between 12 and 24 months.ConclusionsResults support the conclusion that most improved clinical outcomes persisted 1 year after the completion of the health coaching intervention.

Lu Li, Xiaojuan Wang, Rongrong Wang, Yunzhen Hu, Saiping Jiang, Xiaoyang Lu Department of Pharmacy, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, People’s Republic of ChinaCorrespondence: Xiaoyang Lu; Saiping Jiang Email luxiaoyang@zju.edu.cn; j5145@zju.edu.cnAbstract: Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is now a global outbreak of disease. The antiviral treatment acts as one of the most important means of SARS-CoV-2 infection. Alteration of physiological characteristics in special populations may lead to the change in drug pharmacokinetics, which may result in treatment failure or increased adverse drug reactions. Some potential drugs have shown antiviral effects on SARS-CoV-2 infections, such as chloroquine, hydroxychloroquine, favipiravir, lopinavir/ritonavir, arbidol, interferon alpha, and remedsivir. Here, we reviewed the literature on clinical effects in COVID-19 patients of these antiviral agents and provided the potential antiviral agent options for pregnant women, elderly patients, liver or renal dysfunction patients, and severe or critically ill patients receiving renal replacement therapy or ECMO after SARS-CoV-2 infection.Keywords: coronavirus disease 2019, severe acute respiratory syndrome coronavirus 2, antiviral therapy, special population

Since its food and drug administration (FDA) approval in 2011, transcatheter aortic valve replacement (TAVR) has revolutionized the highly prevalent disease of aortic stenosis. In this review, we present a comprehensive overview of the data and considerations for utilization of TAVR in special populations who were either excluded from or not adequately represented in the seminal TAVR trials, due to high-risk valvular and/or systemic factors. These include nonagenarians, patients with renal dysfunction, chronic thrombocytopenia, bicuspid aortic valve, rheumatic valve disease, patients with failed aortic valve bioprosthesis requiring valve-in-valve intervention and patients with mixed aortic valve disease. In short, TAVR is a feasible therapeutic strategy in high-risk and special populations with mortality benefit and improvement in quality of life. Randomized controlled trials in high-risk populations are recommended to confirm results from observational studies.

Hepatitis B virus(HBV) infection is a major public health problem worldwide. With the extensive prophylactic vaccination with hepatitis B vaccine for neonates and an increasing number of patients receiving antiviral treatment, remarkable achievements have been made in HBV infection among Chinese children. However at present, there is still a high HBsAg-positive rate among the adults in China, and with more and more special populations, it is necessary to perform timely screening and diagnosis and give antiviral therapy as early as possible, so as to prevent or delay the progression to liver cirrhosis, liver failure, and hepatocellular carcinoma after HBV infection. The selection of treatment timing and drugs should not only focus on HBV virology and liver function, but also consider chronic underlying diseases, mother-to-child transmission, and reactivation of HBV in patients receiving chemotherapy and immunosuppressants, thereby realizing the timely screening, diagnosis, and treatment of the population at a high risk of HBV and special populations and bringing more benefits to patients. [ABSTRACT FROM AUTHOR]

Cutaneous squamous cell carcinoma (cSCC) may develop in patients with dysregulated immune activation (pre-existing autoimmune diseases or immunosuppression due to hematopoietic/solid organ transplant recipients), patients with a compromised immune function (long-term immunosuppression), and patients carrying chronic viral infections, or those affected by lymphoproliferative diseases. It should be also considered that patients presenting with immunosuppression have a high incidence of cSCC (65–250-times higher than general population), highlighting the central role played by the immune system in the development of cSCC. All these cases must be considered as “special populations” for treatment with immune checkpoint inhibitors (ICIs), as the safety and activity of these drugs have not been studied on these specific cases, since these patients were excluded from clinical trials leading to approval of ICIs. It is therefore important to gain as much information as possible from the analysis of real-life data, to derive an indication to be adopted in everyday clinical setting. Moreover, therapeutic alternatives other than ICIs are scarce, mainly consisting in chemotherapy and anti-EGFR agents, whose activity is lower than immunotherapy and whose toxicity (particularly with chemotherapy) are not sustainable by this frail population. Here, we describe the current evidence of treatment with ICIs in special populations and conclude that it is necessary to find a balance between treatment risks (toxicities) and benefits (efficacy), as well as engaging a multidisciplinary team of experts to thoroughly manage and treat these patients.

Background: People with physical disabilities (PWPD) have limited opportunities to participate in sport activities. Sitting light volleyball (SLVB) is an adapted sport that combines light volleyball and paralympic sitting volleyball. This study examined the effectiveness of an SLVB intervention program to improve the physical and psychological health outcomes of PWPD in Hong Kong, China. Methods: Thirty-two PWPD [13 women; SLVB group, n = 18; control group (CG), n = 14] with an average age of 48.89 years (SD = 14.42 years) participated in a 16-week intervention consisting of basic SLVB skills, and they also received instructions on the required posture, team tactics, and SLVB rules. Physical (i.e., muscular strength, muscular endurance, body composition, flexibility, and aerobic endurance) and psychological (i.e., physical activity enjoyment and quality of life) health outcomes were measured before and after the intervention. Results: Individuals in the SLVB group exhibited statistically significant improvements in cardiovascular endurance [F(1,29) = 4.23, p =.049], body composition [F(1,23) = 6.67, p =.017], and physical activity enjoyment [F(1,29) = 16.94, p =.001] compared with adults in the CG. Conclusions: Participating in SLVB has physical and psychological benefits for adults with physical disabilities in this study. Registration number of trial registry: The trial is registered at chictr.org.cn, number ChiCTR2000032971 on 17/05/2020. [ABSTRACT FROM AUTHOR]

Objective  New treatments are needed for multidrug-resistant (MDR) gram-negative infections in neonates. Ceftolozane/tazobactam is a β-lactam/β-lactamase inhibitor combination that has broad-spectrum activity against most common gram-negative bacteria, including MDR strains. We evaluated pharmacokinetics (PK) and safety of ceftolozane/tazobactam in term and premature neonates and young infants. Study Design  This is a subgroup analysis of a phase 1, noncomparative, open-label, multicenter study that characterized the PK, safety, and tolerability of a single intravenous (IV) dose of ceftolozane/tazobactam in pediatric patients with proven/suspected gram-negative infection or receiving perioperative prophylaxis. Results  Seven patients were enrolled in Group A (birth [7 days postnatal] to < 3 months, > 32 weeks gestation) and six patients were enrolled in Group B (birth [7 days postnatal] to < 3 months, ≤ 32 weeks gestation). PK profiles in neonates and young infants were generally comparable to those of older children receiving a single IV dose of ceftolozane/tazobactam. No serious adverse events (AEs), treatment-related AEs, severe AEs, or clinically significant laboratory abnormalities were reported. Conclusion  Among term and premature neonates and young infants, PK was comparable to older children and ceftolozane/tazobactam was generally well tolerated. An adaptable and flexible study design is necessary for enrollment in neonatal PK trials. [ABSTRACT FROM AUTHOR]

Introduction: Blood speckle imaging (BSI) is a new speckle-tracking-based technique for blood flow study. Flows assessment is particularly challenging in Congenital heart diseases (CHDs), where a profound distortion in cardiac anatomy gives reason of alteration in fluid mechanics. Up until now doppler methods were the only ones used for the analysis of fluid. Overcoming standard Doppler limits, BSI is becoming a promising new approach for the study of fluid dynamics.The aim of the study was to assess fluid-dynamics of different CHDs by using BSI. Methods and results: Ten children (7 with suspected CHDs and 3 controls) were enrolled for the purpose between January and June 2019. All of them underwent a complete 2D and Doppler echocardiographic assessment plus a further BSI study. We studied: one complex transposition of great arteries, one coarctation of aorta, one tetralogy of Fallot, one complete atrio-ventricular septal defect, one suspicious flow in pulmonary artery, one aortic stenosis, one hypertrophic cardiomyopathy and three normal controls. Conclusion: Compared to conventional Doppler methods, BSI was able to better describe fluid dynamics and hemodynamics of these CHDs by showing laminar and turbulent flows and vortices. In our experience, it helped to define the diagnosis and, in some cases, drove the management.

Background:Mycobacteriumtuberculosis [Mtb] could be present in different metabolic population in the lung lesions, and nonreplicating persisters [NRP], associated with latent tuberculosis [TB], are the most difficult to kill.Objective: Test the combination of tedizolid, moxifloxacin, and faropenem for activity against NRP using Mtb SS18b in the hollow fiber model [HFS-TB].Methods: Tedizolid and moxifloxacin were tested as, first, two-drug combination against log-phase growth [LPG] and, second, slowly replicating bacilli [SRB] under acidic condition and with faropenem to create a three-drug combination regimen. Finally, standard regimen [isoniazid-rifampin-pyrazinamide] was used as comparator in the HFS-TB experiment with NRP Mtb. HFS-TB units were sampled for drug-concentration measurement as well as for estimation of bacterial burden using solid agar and mycobacterial growth indicator tube [MGIT] method. Linear regression was used to calculate the kill slopes with each treatment regimen and analysis of variance (ANOVA) to compare the regimen.Results: Tedizolid at standard dose in combination with high-dose moxifloxacin killed 3.05 log10 CFU/ml LPG Mtb and 7.37 log10 CFU/ml SRB in the bactericidal and sterilizing activity HFS-TB experiments, respectively. There was no statistical difference between tedizolid-moxifloxacin-faropenem combination and the standard regimen as both killed 7.35 log10 CFU/ml NRP Mtb in 21 days. There was no emergence of resistance to any of the drugs studied in the three HFS-TB experiments.Conclusion: The experimental regimen of tedizolid, moxifloxacin, and faropenem could effectively kill NRP population of Mtb, and given the efficacy against different metabolic population of Mtb could serve as a pan-TB regimen. Clinical studies are warranted to validate the in vitro findings.

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Adolescence is an important ontogenetic period that is characterized by behaviors such as enhanced novelty-seeking, impulsivity, and reward preference, which can give rise to an increased risk for substance use. While substance use rates in adolescence are generally on a decline, the current rates combined with emerging trends, such as increases in e-cigarette use, remain a significant public health concern. In this review, we focus on the neurobiological divergences associated with adolescent substance use, derived from a cross-sectional, retrospective, and longitudinal studies, and highlight how the use of these substances during adolescence may relate to behavioral and neuroimaging-based outcomes. Identifying and understanding the associations between adolescent substance use and changes in cognition, mental health, and future substance use risk may assist our understanding of the consequences of drug exposure during this critical window.

As a first step toward the development of adapted physical activity (PA) programs for adults with visual impairment (VI), the purpose of this study was to determine the time frame needed to reliably estimate weekly PA in adults with VI. Thirty-three adults with VI completed 7 days of pedometer-based PA assessment. Generalizability theory analyses were conducted to quantify sources of variance within the PA estimate and determine the appropriate number of days of PA monitoring needed for the total sample and for participants with mild-to-moderate and severe VI. A single-facet, crossed design was employed including participants and days. Participants and days correspondingly accounted for 33-55% and 0-3% of the total variance in PA. While a reliable account of PA was obtained for the total sample over a 6-day period, shorter (4-day) and longer (9-day) periods were required for persons with mild-to-moderate and severe VI, respectively. [ABSTRACT FROM AUTHOR]