Weeks Of Follow-up Research Articles

Effects of online high-definition transcranial direct current stimulation over left dorsolateral prefrontal cortex on predominant negative symptoms and EEG functional connectivity in patients with schizophrenia: a randomized, double-blind, controlled trial.

Schizophrenia, a debilitating mental disorder, is characterized by persistent negative symptoms such as avolition and anhedonia. Currently, there are no effective treatments available for these symptoms. Thus, our study aims to assess the efficacy of online high-definition transcranial direct current stimulation (online HD-tDCS) in addressing the negative symptoms of schizophrenia, utilizing a double-blind, randomized, sham-controlled trial design. Fifty-nine patients with schizophrenia were randomized to receive either active HD-tDCS or sham stimulation, targeting the left dorsolateral prefrontal cortex. Outcomes were measured by changes in the Positive and Negative Syndrome Scale Factor Score for Negative Symptom (PANSS-FSNS). Exact low-resolution electromagnetic tomography was used to assess the functional connectivity. All 59 participants, including 50.84% females with an average age of 43.36 years, completed the trial. In the intention-to-treat analysis, patients receiving active HD-tDCS showed greater improvement in PANSS-FSNS scores compared to those receiving the sham procedure. The differences were 2.34 (95% confidence interval [CI], 1.28-3.40), 4.28 (95% CI, 2.93-5.62), and 4.91 (95% CI, 3.29-6.52) after the intervention, as well as at 1-week and 1-month follow-ups, respectively. A tingling sensation on the scalp was more common in the active group (63.3%) compared to the sham group (10.3%). Additionally, HD-tDCS was associated with a decrease in delta-band connectivity within the default mode network. High-definition transcranial direct current stimulation was effective and safe in ameliorating negative symptoms in patients with schizophrenia when combined with online functional targeting.

The effectiveness of aerobic exercise compared to other types of treatment on pain and disability in patients with orofacial pain: A systematic review.

To compile and synthesise the evidence regarding the effectiveness of aerobic exercise (AE) compared with other treatments to reduce pain and disability of individuals with orofacial pain (OFP). Electronic searches were conducted on five databases (MEDLINE, Embase, CINAHL, Cochrane Library, and Scopus). Randomised controlled trials (RCT) or controlled trials including adults of both sexes with painful OFP diagnoses were targeted. The intervention of interest was AE (e.g., walking, cycling, running, among others), compared to any other conservative and non-conservative therapy. The primary outcome was pain intensity. The risk of bias (RoB) was determined using a compiled set of items and the Cochrane RoB-2 tools. The overall certainty of the evidence was evaluated with the GRADE approach. Out of 4.669 records screened, four manuscripts were included. However, three of them used the same population but presented different outcomes. These studies included subjects with headache associated with temporomandibular disorders (TMD) and general TMD. Both studies used aerobic exercise (AE) as the intervention of interest. Manual therapy (MT) plus exercise (Ex) (strengthening exercise (Str ex) or general exercises) were used as a comparison group. The combined treatment, including a multimodal therapy (AE + MT + Str ex), was superior to MT + Ex (MD: -8.65 points [95% CI -13.73, -3.57]) on pain intensity (orofacial pain [OFP] and headache intensity) at the end of the treatment and also after 12-week follow-up (MD: -9.43 points [95% CI -14.97, -3.89]). Also, the combination of three treatment modalities (AE + MT + Ex) was better on quality of life than AE alone (MD: -14.60 points [95% CI -16.74, -12.46]) and MT + Ex (MD: -12.30 point [95% CI -14.50, -10.10]) at the end of the treatment. Aerobic exercise plus MT and general exercises achieved the greatest positive effects on pain and other outcomes in the short/medium term in patients with OFP. However, the scientific evidence supporting the isolated effects of AE for OFP is limited, indicating the need for more studies. Further studies are also needed to elaborate guidelines when using AE for individuals with OFP.

Individual, dyadic, collaborative planning, physical activity, and nutrition: A randomized controlled trial in parent-child dyads.

This study was designed to investigate the effects of individual, dyadic, and collaborative planning on moderate-to-vigorous physical activity (MVPA; primary outcome) and energy-dense food intake (secondary outcome) in dyads of parents and their 9-15-year-old children. Individual planning reflects an "I-for-me" planning of one person's behavior. Collaborative ("we-for-us") planning refers to joint planning of both dyad members' behavior, whereas dyadic ("we-for-me") planning involves joint planning of only the target person's behavior. N = 247 dyads participated in a randomized controlled trial with individual, dyadic, or collaborative physical activity (PA) planning and control conditions (education about PA, sedentary behavior, nutrition, energy intake-expenditure balance). MVPA was measured with ActiGraph wGT3X-BT accelerometers at baseline, 1-week, and 36-week follow-ups. Energy-dense food intake was self-reported at baseline, 9-week, and 36-week follow-ups. Linear mixed models were fit for parents and children separately. At the 36-week follow-up, children in the dyadic "we-for-me" planning condition decreased their MVPA compared to the control condition. At the same time, children in the dyadic planning condition also decreased energy-dense food intake at the 36-week follow-up. No effects were found among children in individual and collaborative PA planning conditions. Parents in any experimental conditions decreased energy-dense food intake. Children's decrease in MVPA in dyadic PA planning condition was offset by a reduction of energy intake, which may represent a compensatory mechanism. The limited effectiveness of the dyadic "we-for-me" interventions in parent-child dyads may result from young people's needs for individuation and their reactance to parental support. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Instrumental activities of daily living in neuro-oncology: International validation of the EORTC IADL-BN32 questionnaire

BackgroundNeurocognitive impairments are common in patients with a brain tumour, and may negatively impact on functioning in daily life, particularly on instrumental activities of daily living (IADL). The EORTC IADL-BN32 questionnaire was developed to measure IADL in this patient population. MethodsIn this international validation study, we evaluated the EORTC IADL-BN32 questionnaire on several psychometric properties in a large sample of patients with a primary or metastatic brain tumour. We administered the 32-item questionnaire three times: at ‘baseline’, after 2 weeks and after 3 months. Procedures were in accordance with EORTC Quality of Life Group module development guidelines. ResultsIn total, 326 patients participated in the study. A bifactor scale structure showed satisfactory model fit measures, with five multi-item scales and two single items, and an IADL sum score. The internal consistency of the multi-item scales ranged from good to excellent (range Cronbach’s α: 0.86–0.97). We found significant differences in scale scores between patients with and without neurocognitive impairments or complaints, supporting the construct validity. Initial cross-cultural validity analyses showed indications of item response biases for certain items. Analyses indicated moderate to good test-retest agreement (intraclass correlation coefficient > 0.70) between baseline and the 2-week follow-up assessment for all but one scale. Deterioration of EORTC IADL-BN32 scale scores were consistent with clinically relevant deterioration on other functional measures with small to large effect sizes, however, subgroup sample sizes were small. ConclusionOverall, the EORTC IADL-BN32 questionnaire exhibited adequate to excellent psychometric properties. Cross-cultural validity and responsiveness should be further explored.

Single-Level Unilateral Biportal Endoscopic versus Tubular Microdiscectomy: Comparing Surgical Outcomes and Opioid Consumption

Unilateral biportal endoscopic (UBE) microdiscectomy is an emerging minimally invasive surgery technique for treating symptomatic lumbar disc herniation. There is limited literature regarding outcomes. Here, we assess surgical outcomes and pain medication consumption for UBE vs. tubular lumbar microdiscectomy. This was a retrospective cohort study of adult patients undergoing primary, single-level UBE or tubular lumbar microdiscectomy surgery at a high-volume institution between 2018 and 2023. Variables of interest included operative time, complications and reoperations, as well as postoperative opioid and nonopioid pain medication consumption from discharge to 6 months. Opioid consumption was converted to morphine milligram equivalents. Standard statistical analyses were performed for comparative analyses. One hundred two patients-48 UBE and 54 tubular-were included. Average operative time (minutes) was higher for UBE patients (133.1 UBE vs. 86.6 tubular, P<0.001), which trended downward over time but did not reach statistical significance (P=0.07). There were no differences in complication or reoperation rates. Average daily MME was lower from discharge to 2-week follow-up in the UBE group (11.1 v. 14.1, P=0.02), but were comparative thereafter. Nonopioid medication prescription was lower in the UBE cohort from discharge to 2 weeks (70.8% vs. 92.6%, P=0.01) and 2 to 6 weeks (52.1% vs. 85.2%, P<0.001), with no significant differences thereafter. UBE microdiscectomy is associated with longer operating times. Both opioid and nonopioid pain medication consumption were lower for UBE patients during the initial postoperative period, perhaps owing to the less-invasive nature of the surgery.

Effectiveness of Trauma-Focused Art Therapy (TFAT) for psychological trauma: A mixed method single case study

Art therapy (AT) shows promise in treating clients with posttraumatic stress disorder (PTSD), especially those who don't respond well to traditional treatments (more than 30 %). This case study aimed to explore the effects of Trauma-Focused Art Therapy (TFAT) on PTSD symptoms and establish its viability as a non-verbal therapy for trauma-related issues. A 10-week intervention and a 3-week follow-up phase were explored using a mixed method single case experimental design (SCED) aimed at integrated results. Bringing the two types of data together adds value and enables to understand the findings better. Quantitative data was collected with weekly questionnaires focused on severity of depression, resilience, self-esteem, mental health and self-expression and emotion regulation in art therapy. The PTSD Checklist for DSM-5 (PCL-5) was completed in week 1 and 10. Qualitative data was collected through interviews, the patient dossier, and artwork. The combined findings indicate a decrease in PTSD symptoms, reduced depression symptoms, enhanced emotional articulation, increased mental resilience, self-esteem, and positive mental health. The qualitative data support these results, and also add improved emotional connection, increased emotional acknowledgment, and enhanced self-compassion. Based on the combined results of this mixed method design we understand that the TFAT protocol led to a clinically significant reduction in PTSD symptoms and improved mental health, demonstrating effectiveness of AT for trauma in this case. This is the first study that tested the TFAT protocol in posttraumatic distress.

Feasibility and acceptability of a parent-child intervention to improve step count in childhood cancer survivors exposed to cardiotoxic therapy: The STEP UP for FAMILIES Study.

Late morbidity after childhood cancer may be mitigated by healthy lifestyle behaviors. We piloted a game-based, parent-child digital intervention to increase activity in sedentary survivors. Survivors aged 10-16 treated with cardiotoxic therapy and not meeting US physical activity guidelines were enrolled in a single-arm study with a parent. Following a 14-day run-in, participants chose a prespecified step goal and wore an accelerometer daily for 24weeks (12-week game-based intervention; 12-week follow-up). Participants completed the Acceptability of Intervention Measure (AIM) at 24weeks; a subset of dyads completed qualitative interviews. Among 129 eligible survivors, 27 enrolled (20.9% participation rate) with a parent. Four dyads were removed during the 14-day run-in period due to noncompliance. Among the 23 dyads who continued to the study, the tracker was worn for 95% of days during the 12-week intervention (95% confidence interval [CI]: 94-96) and 81% during the 12-week follow-up (95% CI: 79-82). Overall, the prespecified step goal was met for 64% (95% CI: 63-66) of days during the intervention and 37% (95% CI: 35-38) during the follow-up. At the end of study, 17/23 dyads responded to AIM; 82% of survivors and 94% of parents reported the intervention as acceptable. During qualitative interviews (n=5), dyads noted that they liked the accountability of the "buddy system," but would have liked more personalized goal-setting. Despite high ratings of acceptability among participants, difficulties with sustained adherence and retention were encountered in this parent-child gamification intervention. Alternate, tailored designs should be considered in the future.

Frequency of weight and body composition increases in advanced non-small cell lung cancer patients during first line therapy.

The primary objective of this study was to assess the frequency of body composition increases and their relationships to changes in body weight in two cohorts of real world, treatment-naïve, advanced non-small cell lung cancer (NSCLC) patients. One cohort received the current standard of care (CSOC), which consisted of immunotherapy and newer chemotherapy regimens, and the other cohort was treated with the former standard of care (FSOC), consisting only of older platinum-containing regimens. CSOC (n=106) and FSOC (n=88) cohorts of advanced NSCLC patients were included in this study. Weights were collected at each clinical visit, and body composition analysis from routine chest computed tomography via automated segmentation software assessed at baseline and at 6 and 12weeks. Standard statistical methods were used to calculate relationships between changes in weight and in body composition. The CSOC cohort contained 106 stage IV NSCLC patients treated between 16/12/2014 and 22/10/2020 while the FSOC cohort contained 88 stage III/IV NSCLC patients treated between 16/6/2006 and 18/11/2014. While each cohort exhibited decreases in median weight, body mass index (BMI), mean skeletal muscle index (SMI) and subcutaneous adipose tissue index (SATI) at the 6 and 12week time points, a subset of patients experienced increases in these parameters. Using a threshold of ≥2.5% increase for weight, BMI, SMI, and SATI at the 12week time point, both cohorts showed similar (20.5% and 27.3%) increases in these parameters. With a cut point of ≥5% increase at 12weeks follow-up, 8.0% to 25.0% of the patients gained ≥5% in weight, BMI, SMI and SATI. Comparing these results in each cohort showed no significant differences. Pearson coefficients for weight change related to changes in SMI and SATI at 6 and 12weeks ranged from 0.31 to 0.58 with all P values <0.02. Pearson coefficients for weight change at 12weeks related to changes in VATI and IMATI ranged from 0.26 to 0.47 with all P values <0.05. Comparison of Pearson coefficients for each cohort showed no significant differences. Although decreases in median weight, BMI, SMI and SATI were observed in both cohorts, similar percentage of patients in each cohort experienced increases in these parameters. These findings, plus the positive correlations between longitudinal measurements of weight, muscle mass and adipose tissue, indicate that weight gain in these patients involves increases in both muscle mass and adipose tissue. Upon validation, these findings could have implications for clinical trial design and for translational research in cancer cachexia.

Meaningful engagement of people living with cancer: Leveraging breast cancer survivors in a stigma reduction intervention in Tanzania.

Cancer-related stigma is a key driver of advanced breast cancer stage in Sub-Saharan Africa (SSA). We developed and tested the impact of a breast cancer survivor-led Stigma reduction intervention (SRI) on stigma and treatment adherence of newly diagnosed patients with breast cancer in Tanzania. Breast cancer survivors were trained on breast cancer knowledge and motivational interviewing. A total of 4 trained survivors delivered a SRI (standardized flipchart breast education talk, personal testimony, and motivational interviewing) to 30 newly diagnosed patients with breast cancer before treatment. Pre- and post-intervention knowledge surveys and stigma scale surveys were analyzed via Fisher's exact test and Wilcoxon rank-sum tests. A discussion was held with a group of survivors after the intervention period to elicit feedback on their intervention experience. Among the 30 patients, breast cancer knowledge (median overall percent correct) increased from 28% (IQR: 18%-45%) to 85% (IQR: 79%-88%) (p<0.001) and stigma (median score) decreased from 75 (IQR: 57-81) to 53 (IQR: 44-66) (p<0.01) following the intervention. All participants were willing to pursue hospital-based treatment after undergoing the intervention. Eighty-seven percent (n=26) initiated treatment at 8-week follow-up after the intervention. All survivors endorsed feeling empowered and valued in their role in this intervention. Breast cancer survivors are a powerful group to combat the lack of knowledge and stigma in community and healthcare settings. Expanding the scope and scale of this intervention holds promise for improving treatment-seeking behavior and ultimately breast cancer outcomes in SSA.

Sensory Stimulation and Robot-Assisted Arm Training After Stroke: A Randomized Controlled Trial.

Functional recovery after stroke is often limited, despite various treatment methods such as robot-assisted therapy. Repetitive sensory stimulation (RSS) might be a promising add-on therapy that is thought to directly drive plasticity processes. First positive effects on sensorimotor function have been shown. However, clinical studies are scarce, and the effect of RSS combined with robot-assisted training has not been evaluated yet. Therefore, our objective was to investigate the feasibility and sensorimotor effects of RSS (compared to a control group receiving sham stimulation) followed by robot-assisted arm therapy. Forty participants in the subacute phase (4.4-23.9weeks) after stroke with a moderate to severe arm paresis were randomized to RSS or control group. Participants received 12 sessions of (sham-) stimulation within 3weeks. Stimulation of the fingertips and the robot-assisted therapy were each applied in 45-min sessions. Motor and sensory outcome assessments (e.g. Fugl-Meyer-Assessment, grip strength) were measured at baseline, post intervention and at a 3-week follow-up. Participants in both groups improved their sensorimotor function from baseline to post and follow-up measurements, as illustrated by most motor and sensory outcome assessments. However, no significant group effects were found for any measures at any time ( P >0.058). Stimulations were well accepted, no safety issues arose. Feasibility of robot-assisted therapy with preceding RSS in persons with moderate to severe paresis was demonstrated. However, RSS preceding robot-assisted training failed to show a preliminary effect compared to the control intervention. Participants might have been too severely affected to identify changes driven by the RSS, or these might have been diluted or more difficult to identify because of the additional robotic training and neurorehabilitation. for more insights from the authors (see the Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A478 ).

Scaling up! Staff e-learning for a national take-home naloxone program.

A staff e-learning course was developed to prepare for scaling up a national take-home naloxone (THN) program in Norway. The aims of the study were to (a) describe participant characteristics for those that completed a THN e-learning course, (b) compare opioid overdose knowledge scores before and after e-learning course completion, and (c) to explore subsequent THN distribution by those trained. This was a quasi-experimental pre-test, post-test longitudinal cohort study of individuals completing a THN e-learning course from April 2021 to May 2022. Frequency analyses were performed for participant characteristics and subsequent naloxone distributions at 1-week and 1-month follow-up. The opioid overdose knowledge scale (OOKS) was used to measure pre-test-post-test knowledge among participants. Wilcoxon signed-rank test was performed for comparison between pre-test and post-test. Effect size was calculated using Cohen criteria. In total, 371 individuals were included in this study. Most were either nurses or social workers (n = 277, 75%). Participant knowledge increased by medium or large effect for all items measured. At 1-month follow-up, 15% reported naloxone distribution. During the study period, 94 naloxone kits were distributed. Major reasons for not distributing were "clients not interested", "workplace not distributing" and "workplace in process of distributing". Our findings suggest that an e-learning course is equally effective in terms of knowledge transfer as an in-person classroom setting, and may provide engagement in terms of naloxone distribution. However, our findings also emphasize the importance of clear implementation routines, including support from central coordinators to optimize the implementation process.

Effect of knee strengthening exercises and lifestyle modifications through mobile phone support in people suffering from knee osteoarthritis.

The study aimed to evaluate the effectiveness of mobile phone-based support in improving exercise adherence and outcomes in knee OA. A prospective comparative cohort study was conducted with a follow-up at 3, 6, and 12 weeks, involving 210 participants allocated into intervention and control groups. The intervention group received knee exercise flyers and mobile phone-based adherence support, while the control group received only standard instructions after physiotherapy. Outcome measures included Western Ontario and McMaster Universities Arthritis Index (WOMAC) scores, numeric rating scale pain scores, and quality of life assessments at baseline and follow-ups at 3, 6 and 12 weeks. The intervention group exhibited significant reductions in WOMAC scores, pain scores and improvement in quality of life over the 12-week follow-up compared to baseline. The intervention group exhibited significantly greater improvements in the outcomes as compared to control group. A combined intervention of knee exercises leaflets and SMS/phone-call adherence support led to significant improvements in pain, functional outcomes and quality of life among individuals with knee OA. These findings underscore the potential of mobile phone-based interventions as effective adjuncts to traditional therapies for knee OA.

Managing Newborn Screening Repeat Collections for Sick and Preterm Neonates.

Some preterm and sick neonates have altered biochemical profiles and follow-up newborn screening (NBS) collections are recommended. The Victorian NBS program historically recommended repeat collections for babies with birth weight < 1500 g (managed by the maternity service provider) and 3 weeks post-transfusion (managed by the laboratory). We aimed to determine adherence to current guidelines and review the guidelines to improve NBS performance. To do this, we audited data from 348,584 babies between January 2018 and June 2022. Babies with a recorded birth weight of <1500 g were filtered for inclusion. For the overall review and visualization of the protocol, we sourced information from the literature, our professional society and tertiary hospital services. A total of 2647 babies had a birth weight recorded between 200 and 1499 g. Of these, 2036 (77%) had a second sample collected, indicating that >1 in 5 babies were not receiving a follow-up collection. Our timing of repeat collections for transfused babies, requiring a 3-week follow-up collection, was longer than in other Australasian jurisdictions. A new combined "sick-prem protocol" was launched to support repeat collections and after a 1-year review achieved 95% compliance. We recommend NBS laboratories audit preterm and sick neonate repeat collections to ensure appropriate follow-up. This should be supported with a visual process map to aid education and compliance.

Outcomes in peripheral right ventricular device support: Comparing the dual lumen, single canula and femoral vein cannulation strategies for right ventricular support.

The Protek Duo (PtD) dual lumen, single cannula was developed as a percutaneous system for temporary mechanical support, inserted through the internal jugular vein (IJ) for both atrial inflow and pulmonary artery outflow. Outcomes of PtD compared to alternative Peripheral Right Ventricular Assist Device (pRVAD) methods are limited. A retrospective analysis was conducted of pRVAD recipients from January 2017 - February 2022 (n = 111). These were classified into PtD (n = 52) patients and Non-Protek [(N-PtD) (n = 59)] recipients undergoing cannulation of the IJ and femoral vein. Results were further stratified by indication for pRVAD support: cardiogenic etiologies of heart failure and progressive ARDS. No survival benefit was detected between PtD and N-PtD groups at 1-week (OR: 1.32, 95% CI: 0.49-3.56, p = 0.58) or 6-month (OR: 9.83, 95% CI: 0.37-1.84, p = 0.64) follow-up. There were no statistically significant differences in whether patients' mobility progressed to out-of-bed activity (p = 0.26) or ambulation (p = 0.38). No differences were noted in time to out-of-bed (p = 0.26) or time to ambulation (p = 0.36). On subgroup analysis of patients by indication for pRVAD cannulation, these results persisted; no difference was noted in mid-term mortality (Cardiogenic: p = 0.39; ARDS: p = 0.91), progression to out-of-bed (p = 0.59; p = 1.00), or ambulation (p = 0.51; p-0.68). Among secondary outcomes, PtD patients had an increased dialysis requirement (p = 0.02). There were no differences in ability to wean from RVAD (p = 0.06), tracheostomy (p = 0.88), major bleeding events (p = 0.57), stroke (p = 0.58), or hospital length of stay (p = 0.39). Outcomes with PtD are comparable to those of traditional pRVAD cannulation strategies. Of note, no mobility benefit was observed to the use of PtD across several metrics.

Topical psoriasis therapy: An innovative classic

Introduction. Psoriasis affects various aspects of the quality of life of patients, causing psycho-emotional stress, anxiety and depression, therefore treatment of patients in terms of long-term control is the main goal of therapy.Aim. To study the effectiveness of drugs containing calcipotriol and betamethasone in the treatment of plaque psoriasis of smooth skin, scalp, palmoplantar mild to moderate severity.Material and methods. We observed 59 patients and 32 patients with moderate plaque psoriasis (PASI &gt; 10 and &lt; 20 points). In the groups, patients were randomized into subgroups with mild and moderate severity of psoriasis.Results. In patients with mild and moderate plaque psoriasis, after 4 weeks there was a decrease in the PASI index by 89.1% and 64.1%, respectively, the DLQI index decreased by 53.8% and 61.9%, the sPGA index by 71.8% and 64.9% for mild and moderate degrees, respectively. In patients with mild and moderate palmoplantar psoriasis, after 4 weeks there was a decrease in the PPASI index by 64.2% and 62.1%, respectively, the DLQI index decreased by 56.4% and 56.7%, and the sPGA index by 63.4 % and 66.7% for mild and moderate degrees, respectively. In patients with mild to moderate psoriasis of the scalp, after 4 weeks there was a decrease in the PSSI index by 75.1% and 72.6%, the DLQI index decreased by 64.6% and 69.6%, and the sPGA index by 62.3% and 67.6% for mild and moderate degrees, respectively.Conclusion. A 52-week follow-up demonstrated the effectiveness and safety of therapy with combination drugs (Daivobet® and Xamiol®) in patients with plaque psoriasis, including scalp psoriasis and palmoplantar psoriasis. It also showed a pronounced positive effect on the quality of life of patients, including in terms of long-term control of the disease.

Efficacy and safety of telitacicept, a BLyS/APRIL dual inhibitor, in the treatment of IgA nephropathy: a retrospective case-control study.

Telitacicept, a B lymphocyte stimulator/A proliferation-inducing ligand dual-target fusion protein, has recently been used in autoimmune diseases. We assessed the efficacy and safety of telitacicept in immunoglobulin A nephropathy (IgAN) patients. This study included 42 IgAN patients who received telitacicept treatment, forming the 'whole telitacicept group'. Among them, 20 patients who had not previously received corticosteroid (CS) therapy or immunosuppressive (IS) agents were categorized as the 'newly treated telitacicept subgroup'. Additionally, 28 patients who were selected to match historical controls received conventional IS therapy (CS therapy with/without IS agents) and were classified as the 'conventional IS group'. Telitacicept was partially used in combination with conventional IS therapy, including initial CS in different doses. Various indicators were compared at 4-week intervals up to 24weeks among the three groups. After 24weeks of treatment, the 24-hour proteinuria decreased from 1.70g [interquartile range (IQR) 1.05-2.58] to 0.21g (IQR 0.39-0.13) (P=.043) in the newly treated telitacicept subgroup, from 1.78g (IQR 0.97-2.82) to 0.44g (IQR 1.48-0.16) (P=.001) in the conventional IS group and from 1.07g (IQR 0.66-1.99) to 0.26g (IQR 0.59-0.17) (P=.028) in the whole telitacicept group. The estimated glomerular filtration rate (eGFR) increased from 76.58±30.26ml/min/1.73m2 to 80.30±26.76ml/min/1.73m2 (P=.016) in the newly treated telitacicept subgroup, from 72.73±33.41ml/min/1.73m2 to 84.08±26.81ml/min/1.73m2 (P=.011) in the conventional IS group and from 70.10±32.88ml/min/1.73m2 to 71.21±31.49ml/min/1.73m2 (P=.065) in the whole telitacicept group. During follow-up periods, the efficacy rates of the three groups did not show statistically significant differences and no serious adverse events were observed. Telitacicept may be a safe and effective treatment for IgAN, offering reductions in proteinuria and increases in eGFR similar to conventional IS therapy. After a 24-week follow-up, the incidence of adverse events was lower for telitacicept than for conventional IS therapy.

Impact of diet intervention on visceral adipose tissue and hepatic fat in patients with obesity or type 2 diabetes: a randomized trial

This study aimed to assess the effects of a diet intervention on visceral and hepatic fat in patients with obesity or type 2 diabetes (T2D). Participants with obesity or T2D were randomized to a diet intervention or their usual diet. The intervention comprised a “3G rice” regimen combined with a low-salt, high-fiber diet. The primary outcomes were changes in visceral adipose tissue (VAT) area and hepatic fat over 12 weeks assessed by magnetic resonance imaging. Eighty-six patients were randomized. Their mean age was 47.5 ± 11.0 years, and 82.3% were female. Eighty-one (94.2%) had obesity, and 16 (18.6%) had T2D. Baseline metrics were body weight 76.3 ± 16.1 kg, BMI 29.6 ± 4.6, VAT 12 629 ± 5819 mm2, and hepatic fat 7.9% ± 7.2%. At the 12-week follow-up, the diet group had greater VAT and hepatic fat reductions than controls (− 1468 ± 1468 vs. − 179 ± 1576 mm2, P = 0.001; and − 2.6% ± 3.4% vs. 0.4% ± 2.2%, P < 0.001). Adjusted differences remained significant for VAT (− 1093 mm2, P < 0.001) and hepatic fat (− 2.5%, P < 0.001). In conclusion, the 12-week diet intervention decreased VAT, hepatic fat, body weight, and BMI compared to a usual diet.

B - 44 Examining Test–Retest Reliability and Mean Score Differences in Self-Reported Neuropsychological Symptoms in Active-Duty and Veterans with Mild Traumatic Brain Injury (Mtbi)

Abstract Objective Test–retest reliability is a foundational psychometric property of tests, providing a means through which tests may be assessed for time invariant interpretation. This study evaluated the test–retest reliability of several self-report instruments commonly employed in a veteran/military neurocognitive rehabilitation setting. Method Repeat administration of the Neurobehavioral Symptom Inventory (NSI), Key Behaviors Change Inventory (KBCI), Veterans RAND 12 Item Health Survey (VR12), C4 Inventory, Center for Epidemiologic Studies-Depression, Post-traumatic Checklist-DSM-5 (PCL-5), and the Epworth Sleepiness Scale (ESS) was collected across baseline, one, four, and twelve week timepoints. Interclass correlation coefficients and a two-way mixed ANOVA was conducted on 31 Veteran and 22 Active-duty participants (71.5% male). Results Most measures demonstrated a significant mean difference during follow-up, with reductions across the 1- and 4-week follow-ups. ICC ranged from good to excellent (0.76–0.93) across the measures. Correlations between time points on measures were high (e.g., PCL-5 Baseline/4wk r = 0.93), suggesting high reliability for measures despite changing scores after treatment completion. Conclusions This study found good test–retest reliability across the three follow-up timelines, supporting the use of the included measures in neurocognitive rehabilitation settings. Reliability and post-treatment changes in symptoms observed across these measures will be further discussed.

Modified painless wheat-grain blistering moxibustion for allergic rhinitis of lung deficiency and cold attacking: a randomized controlled trial

To observe the clinical efficacy of modified painless wheat-grain blistering moxibustion for allergic rhinitis (AR) of lung deficiency and cold attacking, and to explore its effects on serum immunoglobulin E (IgE) and interleukin-10 (IL-10). Ninety-eight patients of perennial AR with lung deficiency and cold attacking were randomly divided into an observation group (49 cases, 2 dropped out) and a control group (49 cases, 2 dropped out). The control group received mometasone furoate nasal spray treatment. The observation group received modified painless wheat-grain blistering moxibustion at bilateral Feishu (BL 13), Gaohuang (BL 43), Zusanli (ST 36), and Shenzhu (GV 12) in addition to the control group's treatment. Moxibustion at Shenzhu (GV 12) was applied once every other day, 3 grains each time, forming moxibustion sores after about one week. After sores formed, moxibustion was applied once every other 2 days. For Feishu (BL 13), Gaohuang (BL 43), and Zusanli (ST 36), moxibustion was applied on one side first, every other day, 3 grains each time, until sores formed, then on the other side, alternating sides in a cycle. Both groups were treated for 4 weeks. The total nasal symptoms score (TNSS), nasal symptom visual analogue scale (VAS), and rhinoconjunctivitis quality of life questionnaire (RQLQ) scores were observed before and after treatment, and after 4 and 12 weeks of treatment completion (follow-ups). Serum IgE and IL-10 levels were measured before and after treatment, and treatment efficacy and recurrence rates at follow-ups were recorded. Compared before treatment, TNSS, VAS, and RQLQ scores in both groups were reduced after treatment and at follow-ups (P<0.05), and these scores in the observation group were lower than those in the control group (P<0.05). Except for TNSS scores in the control group at the follow-ups, and in the observation group at the 4-week follow-up, all scores at follow-ups in both groups were higher than those after treatment (P<0.05). Compared before treatment, serum IgE levels in both groups were decreased (P<0.05), and serum IL-10 levels were increased (P<0.05) after treatment. The observation group had lower serum IgE levels and higher IL-10 levels than the control group (P<0.05). The total effective rate in the observation group was 93.6% (44/47), higher than 74.5% (35/47) in the control group (P<0.05). The recurrence rates after 4 and 12 weeks of treatment completion in the observation group were lower than those in the control group (4.5% [2/44] vs 22.9% [8/35], 9.1% [4/44] vs 40.0% [14/35], P<0.05). On the basis of mometasone furoate nasal spray, modified painless wheat-grain blistering moxibustion could improve clinical symptoms in patients of AR with lung deficiency and cold attacking, and provide more sustained long-term efficacy, possibly through the regulation of serum IgE and IL-10 levels.

Effects of Antihypertensive Therapy During Pregnancy on Postpartum Blood Pressure Control.

To compare differences in postpartum blood pressure (BP) control (BP below 140/90 mm Hg) for participants with hypertension randomized to receive antihypertensive treatment compared with no treatment during pregnancy. This study was a planned secondary analysis of a multicenter, open-label, randomized controlled trial (The CHAP [Chronic Hypertension and Pregnancy] trial). Pregnant participants with mild chronic hypertension (BP below 160/105 mm Hg) were randomized into two groups: active (antihypertensive treatment) or control (no treatment unless severe hypertension, BP 160/105 mm Hg or higher). Study outcomes were BP control below 140/90 mm Hg (primary) and medication nonadherence based on a composite score threshold (secondary) at the 6-week postpartum follow-up visit. Participants without follow-up BP measurements were excluded from analysis of the BP control outcome. Participants without health care professional-prescribed antihypertensives at delivery were excluded from the analysis of the adherence outcome. Multivariable logistic regression was used to adjust for potential confounders. Of 2,408 participants, 1,684 (864 active, 820 control) were included in the analysis. A greater percentage of participants in the active group achieved BP control (56.7% vs 51.5%; adjusted odds ratio [aOR] 1.22, 95% CI, 1.00-1.48) than in the control group. Postpartum antihypertensive prescription was higher in the active group (81.7% vs 58.4%, P<.001), and nonadherence did not differ significantly between groups (aOR 0.81, 95% CI, 0.64-1.03). Antihypertensive treatment of mild chronic hypertension during pregnancy was associated with better BP control below 140/90 mm Hg in the immediate postpartum period.