Chronic Illness Research Articles

Cross-cultural adaptation and primary approbation of the Russian version of Posttraumatic Growth and Depreciation Inventory — Expanded version

Numerous studies suggest that caring for someone with a chronic disease is often associated with the various negative consequences for the patient’s informal caregivers. At the same time, positive changes caused by the stress influence of patient’s disease can be also noted. For example, the so-called posttraumatic growth. Currently, there is a lack of assessment tools in domestic psychology, that allow to investigate the relation between constructive (developmental) and destructive aspects of the relative’s mental response in a situation of chronic illness of a loved one.The aim of this work was to carry out cross-cultural adaptation and primary approbation of the Posttraumatic Growth and Depreciation Inventory — Expanded version (PTGDI-X). Primary approbation was performed on a focus group of relatives of patients with cerebral pathology (n = 61, mean age 51,2 [SD = 15,3] years). Convergent and discriminant validity of the PTGDI-X assessed using World Assumption Scale (WAS), Symptom Checklist-90-Revised (SCL-90-R), Level of Relatives’ Emotional Burnout Questionnaire (LREB). In addition, a specially adapted for the research Burden questionnaire was used.The analysis revealed good psychometric characteristics of the PTGDI-X Russian version in terms of: internal subscales consistency (Cronbach’s α coefficients varied from 0,73 to 0,86), internal and external construct validity

Screening for Pulmonary Hypertension in Pregnant Women with Sickle Cell Disease in Sub-Saharan Africa

BackgroundSickle cell disease (SCD) has evolved from a condition predominantly fatal in childhood to a chronic illness impacting many adults, including women of reproductive age. For females with SCD, pregnancy represents one of the greatest health threats, exacerbating existing health challenges and introducing new risks. Despite advancements in healthcare, routine screening for existing complications like pulmonary hypertension (PH) remains inconsistent, particularly in low- and middle-income countries (LMICs), where the prevalence of SCD is highest. Objective(s)This study aimed to assess the feasibility of screening for pulmonary hypertension (PH) in pregnant women with sickle cell disease (SCD) in LMICs, with the goal of enhancing maternal health outcomes in this vulnerable population. Study DesignA prospective multi-centre feasibility study was conducted from September 2022 to February 2023 at teaching hospitals in Ghana and Nigeria. The study included pregnant women with SCD between 28 and 34 weeks of gestation. Screening for PH utilized a tricuspid regurgitation velocity (TRV) criterion (>2.5 m/s), with adherence to American Society of Echocardiography guidelines. Statistical analysis included descriptive statistics and proportions. ResultsAmong 3091 pregnant women attending antenatal care, 88 had SCD (2.8%), and 55 were eligible for the study. We recruited 44 participants (mean age 28.9 years, SD 4.8), with 48% (21/44) SS genotype and 52% (23/44) SC genotype. Most participants (95.3%) had normal TRV (<2.5 m/s), with only one showing elevated TRV, successfully referred. Protocol adherence was 100%. Antenatal outcomes showed 95% echo uptake and 95.7% retention to term whilst postnatal echo follow-up was 43.5%. Notably, 27.1% (10/37) of deliveries required NICU admission, and 18.2% were preterm. The sole participant with PH required ICU care and experienced a preterm delivery with neonatal death on day five. Conclusion(s)Screening and referral for PH in pregnant women with SCD in LMICs are feasible but face challenges in early diagnosis, healthcare personnel availability, and postnatal follow-up. Strategic planning is crucial to address these challenges and improve outcomes in this high-risk population

Sleep, Sleep Apnea, and Fatigue in People Living With HIV

Background: People living with HIV (PLWH) often report fatigue even when viral load is suppressed. Obstructive sleep apnea (OSA), which is often associated with fatigue, is common in PLWH, but whether OSA explains fatigue in this population is unknown. Setting: Academic university-affiliated HIV and Sleep Medicine Clinics. Methods: PLWH, aged 18–65 years, with a body mass index of 20–35 kg/m2 and viral suppression (RNA &lt;200 copies per mL), were recruited to undergo daytime questionnaires, including the Functional Assessment of Chronic Illness Therapy Fatigue Scale and Epworth Sleepiness Scale, 7 days of actigraphy (to determine daily sleep duration and activity amplitude and rhythms), and an in-laboratory polysomnography to assess for the presence and severity of OSA. Results: Of 120 subjects with evaluable data, 90 (75%) had OSA using the American Academy of Sleep Medicine 3% desaturation or arousal criteria, with an apnea–hypopnea index &gt;5/h. There was no difference in Functional Assessment of Chronic Illness Therapy scores between those with and without OSA, although those with OSA did report more daytime sleepiness as measured using the Epworth Sleepiness Scale. In a multivariable model, predictors of fatigue included more variable daily sleep durations and decreased mean activity counts. Sleepiness was predicted by the presence of OSA. Conclusion: OSA was very common in our cohort of PLWH, with those with OSA reporting more sleepiness but not more fatigue. Variability in sleep duration was associated with increased fatigue. Further study is needed to determine if treatment of OSA, or an emphasis on sleep consistency and timing, improves symptoms of fatigue in PLWH.

Change starts with the body: Interoceptive appreciation mediates the effect of mindfulness training on behavior change – an effect moderated by depression severity

Mindfulness catalyzes health behavior change. Yet, interoception is dysregulated in depression, potentially impairing behavioral activation. We examined the mediating role of interoceptive appreciation, as measured by how much one trusts and listens to internal bodily signals, on behavior change. Primary care patients with depression, anxiety, or stress disorders related to chronic illness were randomized to Mindfulness Training for Primary Care (MTPC) using the Mindful Behavior Change curriculum or a low-dose mindfulness comparator. Participants (N = 274) completed the Multidimensional Assessment of Interoceptive Awareness (MAIA) at 0 and 8 weeks. At week 7, participants chose a health behavior action plan. During weeks 8–10, participants reported their action plan initiation (API) level. We investigated the effect of MTPC on API level (MTPC-API), the mediating role of interoceptive appreciation (Body Listening [MAIA-BL] + Trusting [MAIA-T]), and baseline depression severity as a moderator. MTPC had a significant direct effect on API. Interoceptive appreciation (MAIA-BL + MAIA-T) had a significant indirect effect on API (CI=0.15–0.56). Without depression (n = 76), MAIA-BL partially mediated MTPC-API (CI=0.02–0.87). With moderate-to-severe depression (n = 132), MAIA-T partially mediated MTPC-API (CI=0.01–0.85). Interoceptive appreciation helps people listen to motivating bodily signals. In depression, regaining body trust may be an important step on a mindful path towards change.

An Insight into the Promising Therapeutic Potential of Chicoric Acid.

The pharmacological treatments that are now recommended for the therapy of chronic illnesses are examined in a great number of studies to determine whether or not they are both safe and effective. Therefore, it is important to investigate various alternative therapeutic assistance, such as natural remedies derived from medicinal plants. In this context, chicoric acid, classified as a hydroxycinnamic acid, has been documented to exhibit a range of health advantages. These include antiviral, antioxidant, anti-inflammatory, obesity-preventing, and neuroprotective effects. Due to its considerable pharmacological properties, chicoric acid has found extensive applications in food, pharmaceuticals, animal husbandry, and various other commercial sectors. This article provides a comprehensive overview of in vitro and in vivo investigations on chicoric acid, highlighting its beneficial effects and therapeutic activity when used as a preventative and management aid for public health conditions, including diabetes, cardiovascular disease, and hepatic illnesses like non-alcoholic steatohepatitis. Moreover, further investigation of this compound can lead to its development as a potential phytopharmaceutical candidate.

Welcome To #Spoonietok: Understanding and Supporting Disability Expertise, Storytelling Abilities, and Collective Information Practices on Tiktok and Beyond

ABSTRACTThis poster reports developing dissertation research, exploring the individual and collective storytelling practices of people experiencing difficult to diagnose chronic pain and fatigue (CSSs) on TikTok to understand and ultimately support these embodied, creative, and collective storytelling abilities on and off‐app. Ongoing data collection and analysis using constant comparison, guided by critical disability studies sensitizing concepts, of 150 videos and their top‐20 comments, and interviews with 6 community members indicate that people with CSSs are using TikTok affordances to tell and scaffold complex micro‐stories sharing disabled expertise; creatively visualize invisible illness; use intimate, documentary cinematography; tell composite stories using skits and collapsed time; and make audio, visual, and community/collective mimetic alterations. This poster shares a pragmatic sampling approach using algorithm training, and results from visualization activities during interviews which indicate a messy overlapping landscape of what I call algorithmically mediated online health communit(ies) (AMOHCs), which have slippery boundaries, where health information is found serendipitously, and people connect across specific chronic illness categories. This dissertation‐in‐progress is developing a set of disability‐specific storytelling abilities, which interview participants indicate are transferable to off‐app settings; and upcoming codesign workshops creating storytelling support materials with community members will further distill disability storytelling support needs.

Multi-dimensional patient-reported outcomes and quality of life at diagnosis of IBD: A population-based inception cohort study

Background and aimsPatient-reported outcomes (PROs) are pivotal in assessing treatment efficacy and estimating the burden of inflammatory bowel diseases (IBD). We investigated PROs at the time of IBD diagnosis. MethodsThe Short Inflammatory Bowel Disease Questionnaire (SIBDQ), IBD-Disability Index (IBD-DI), Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F), and disease activity-related PROs were assessed in the Copenhagen IBD Inception Cohort, a prospective, population-based cohort of patients newly diagnosed with IBD between May 2021 and May 2023. ResultsA total of 203 UC and 116 CD patients were recruited. At diagnosis, 160 (78.8%) and 99 (85.3%) patients with UC and CD, respectively, reported moderate-to-severe impairment in at least one PRO (p=0.18), with 89 (43.8%) and 74 (63.8%), respectively, reporting moderate-to-severe impairment in at least two PROs (p<0.01). Being female, the disease extent of UC, and extraintestinal manifestations were associated with impaired PROs. There were no differences found according to CD phenotype. FACIT-F, IBD-DI, and SIBDQ scores showed weak, but significant, correlations with the Mayo Endoscopic Score in UC, and the FACIT-F score with C-reactive protein (CRP). In CD, SIBDQ, IBD-DI, and FACIT-F correlated moderately with CRP and fecal calprotectin, but not with the endoscopic severity of CD. None of the PROs correlated with iron, ferritin, or vitamin D levels. Among the most prevalent symptoms reported were fatigue, abdominal pain, urgency, and passing of blood in both CD and UC. ConclusionWe found a substantial patient-reported disease burden in newly diagnosed IBD, underscoring the importance of vigilant PRO monitoring in clinical practice. FundingThis study was funded by an unrestricted grant from the Novo Nordisk Fonden.

Improved Fatigue Management in Primary Sjögren's Syndrome: A Retrospective Analysis of the Efficacy of Methotrexate in Chinese Patients.

To assess the efficacy of methotrexate (MTX) and hydroxychloroquine (HCQ) in improving fatigue symptoms in patients with primary Sjögren's syndrome (pSS). A single-center retrospective study was conducted on pSS patients experiencing fatigue symptoms. All patients received either MTX, HCQ, or a combination of MTX + HCQ for a period of six months. Clinical efficacy was measured using the European League Against Rheumatism (EULAR) Sjögren's Syndrome Disease Activity Index (ESSDAI), EULAR Sjögren's Syndrome Patient Reported Index (ESSPRI), Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F), fatigue severity scale (FSS), and visual analog scale (VAS) score. These measures were assessed at baseline and at 1, 2, 3, and 6 months. A total of 86 pSS patients with fatigue symptoms were enrolled (27 received MTX, 29 received HCQ, and 30 received MTX + HCQ). Patients receiving MTX and MTX + HCQ showed significant improvements at 6th month in ESSDAI, ESSPRI, FSS, FACIT-F, and VAS scores (all P < 0.01) compared with baseline. Repeated-measures analysis of variance revealed that patients treated with MTX and MTX + HCQ experienced significant improvements in ESSDAI, FSS, FACIT-F, and VAS scores (all P < 0.01) from baseline to the 6th month. The HCQ group did not show significant improvement in FSS, FACIT-F, and VAS scores (all P > 0.05), although their ESSDAI and ESSPRI scores did improve significantly (all P < 0.01). Patients in the MTX group showed the most improvement in mean changes of ESSDAI score, FSS score, FACIT-F score, and VAS score from baseline to the 6th month. And patients received MTX treatment significantly had more fatigue remission numbers (all P < 0.05). In clinical practice, methotrexate is more effective than hydroxychloroquine in improving fatigue symptoms, as measured by patient-reported fatigue scales (FSS, FACIT-F, and VAS scores) in patients with pSS.

EPIDEMIOLOGICAL AND CLINICAL PROFILE OF HOSPITALIZATIONS IN THE MEDICAL CLINIC WARD OF THE CEILÂNDIA REGIONAL HOSPITAL

The objective of this work is to describe the quantitative and descriptive form of the profile of patients who were admitted to the Internal Medicine Infirmary unit of the Regional Hospital of Ceilândia in the Federal District between 01/07/2021 e 31/12/2021. The retrospective study will be carried out from the analysis of records. For a statistical analysis, the Excel® 2019 program will be used. Patients will export epidemiological data on sex, age, marital status, hometown, city of domicile, previous chronic illness, cause, and duration of immediate outcomes. It should be noted that the financial information acquired in the study can contribute to assistance and permanent education in the planning of the service.

Barriers Towards Healthcare Access and Services among People with Disabilities: A Scoping Review of Qualitative Studies

Healthcare access and services is one of the challenges faced by people with physical disability (PWPD). PWPD also has at risk of early death and preventable chronic illness. Lack of access to healthcare services includes delay or failure to receive needed care, lack of continuity of care and financial burden will result in deterioration of health, wellbeing and functional status. The aim of this paper was to review barriers towards healthcare access and services among PWPD based on the existing qualitative studies. We conducted a scoping review of relevant qualitative articles from PubMed, Scopus and ProQuest. The article search was based on the available keyword in the title with the publication restricted within 10 years (between 2012 to 2021). The search strategy was conducted using MeSH terms of ‘barriers, healthcare access, healthcare services and physical disability’. In this review, people with different kinds of physical disabilities were included. There were 2004 articles obtained from the initial search. 27 articles met the inclusion criteria for the final review. In each study, PWPD noted various barriers to access healthcare services. Findings from this review revealed five themes: personal; financial; attitudinal and communication; health system; structural and physical barriers. The findings showed that PWPD faces various barriers when accessing healthcare services. Addressing these barriers could help create a healthcare system that is inclusive and accessible for all.

Impact of a Nutrition and Diabetes Continuing Education Program on Primary Care Provider's Knowledge, Attitude, and Clinical Practice.

Diet/nutrition is the first-line non-pharmacological therapy in the treatment of diabetes. Diet/nutrition counseling is infrequently provided by primary care providers (PCPs), who have limited nutrition education in both medical and advanced practice provider curricula. This quality improvement project aimed to improve knowledge and attitude, and frequency of diet/nutrition counseling by PCPs among patients with uncontrolled diabetes (glycosylated hemoglobin A1c ≥8%), by providing an online continuing medical education (CME) program on diabetes diet/nutrition. At a community health center in New England, PCPs attended a live 50-minute online CME program that was developed internally, which taught PCPs current diet/nutrition guidelines and recommendations related to diabetes. Knowledge was assessed prior to and two weeks following the program, utilizing a 10-question tool, the Nutrition Management of Diabetes Assessment (NMDA). Similarly, attitude was evaluated using two subscales of the Nutrition in Patient Care Survey (NIPS): Nutrition in routine care and Physician efficacy. Chart audits of patients with uncontrolled diabetes were evaluated to assess PCPs documentation of diet/nutrition counseling four weeks prior to and six weeks following the CME program. In September 2023, PCPs (n = 29) completed the CME program. There was an improvement in knowledge in the NMDA amongst PCPs (36% difference, p < 0.001). Attitude scores from two subscales of the NIPS were evaluated and both showed improvement, however only physician efficacy was significant (15% difference, p < 0.01). There was a positive difference in the trend of diet/nutrition counseling after the education program (p < 0.05). An online CME program improved diabetes diet/nutrition knowledge and attitude of PCPs and improved counseling practices for patients living with uncontrolled diabetes. The education program provided PCPs current standards of care guidelines/recommendations, which they can utilize when counseling patients with diabetes. PCPs would benefit from dedicated continuing education programs regarding diet/nutrition therapy for chronic illnesses.

Implementing Mental Health Screening for Adolescent Hematology and Oncology Patients: A Quality Improvement Initiative.

Purpose: Adolescents and young adults (AYA) with chronic illnesses experience an increase in mental health concerns. A mental health screening (MHS) process for hematology and oncology patients was implemented in a single institution. The quality improvement project was conducted to integrate a MHS process, educate providers about the importance of mental health in this patient population, and evaluate the process. Methods: The COM-B (capability, opportunity, motivation-behavior) model for behavior change was used to inform strategic planning and Plan-Do-Study-Act (PDSA) methodologies for process improvement. Retrospective chart reviews and surveys were conducted to determine missed screening rates and providers' perceptions, knowledge, attitudes, and skills of the MHS process. Results: Of 334 eligible patient encounters, the missed screening rate was 15.0%, the overall error rate of completing the screening was 3.8%, the error rate of completing the suicide or self-harm indicator was 2.6%, and the missed medical social worker touch point was 4.8%. Conclusion: The rising rates of mental health concerns in AYA hematology and oncology patients call for streamlined MHS processes to improve the identification of patients who may need intervention and services. Processes should be tailored to workflows and available resources. Future PDSA cycles will include providing dedicated nursing education and determining the cost needed to meet the rising mental health needs of the AYA hematology and oncology population.

Influence of Depression and Subjective Health Status on COVID-19 Vaccine Acceptance: Based on the 2021 Community Health Survey

Background: Coronavirus Disease 2019 (COVID-19) is a novel coronavirus identified in 2019 that exhibited an exceptionally rapid spread. Although the development and administration of COVID-19 vaccines progressed quickly, concerns about side effects and safety persisted. This study utilized data from the 2021 Community Health Survey to analyze the relationship between COVID-19 vaccination and psychosocial factors, including depression and subjective health status.Methods: Analysis included 203,449 individuals, excluding those who had not received or were ineligible for the COVID-19 vaccine, based on the 2021 Community Health Survey. The chi-square tests assessed sociodemographic and health status differences related to vaccination status. Subjective health status was categorized based on survey responses as ‘good’ or ‘poor,’ and depression was assessed using the self-reported Patient Health Questionnaire-9. The association between depression, subjective health status, and vaccination status was examined using chi-square tests, followed by multiple logistic regression to determine independent effects.Results: Vaccination rates were higher among the elderly, those with lower education, higher income, healthcare workers, and individuals with lower depression, higher subjective health, and chronic conditions like hypertension or diabetes. Significantly lower vaccination rates were observed in those with lower subjective health and Patient Health Questionnaire-9 scores ≥5 or ≥10. Among individuals with chronic illnesses, those with good subjective health had the lowest odds for non-vaccination (odds ratio=0.42; 95% confidence interval, 0.39-0.45), while those without chronic illnesses and poor subjective health had the highest odds (odds ratio=1.89; 95% confidence interval, 1.76-2.02).Conclusions: This study found significantly higher odds ratios for vaccine non-receipt among individuals with lower levels of depression and subjective health status. Incorporating psychosocial factors such as depression and subjective health status may be crucial in developing strategies to enhance vaccination rates during future outbreaks of novel infectious diseases.

Prevalence and factors associated with suicidal behaviors among domestic workers

BackgroundDue to urbanization and changes in family structure, the need for domestic workers has surged in many developing countries, including Rwanda. While being employed as a domestic worker presents financial benefits to many of them and their dependents, it also comes with risks and difficulties that might harm the domestic worker's mental health.AimThis study aimed to determine the prevalence and factors associated with suicidal behaviors (i.e., suicidal ideations, plans, and attempt(s)) among domestic workers in Rwanda.MethodIn this cross-sectional study, data was captured from 884 domestic workers in Kigali, Rwanda. Suicidal ideation was measured using questions from the General Health Questionnaire (GHQ-28), while suicide attempts and plans were measured using questions adopted from previous studies in the region. The methods used/plan to attempt suicide were also captured from individuals with a recent history of suicide plan/attempt(s). Three separate regression models were employed to ascertain the factors associated with suicidal behaviors.ResultsThe prevalence of past-year suicidal behaviors was 32.5% for suicidal ideations, 9.5% for suicide plans, and 7.8% for suicidal attempts. Being female and having a chronic medical illness were linked to a higher risk of participating in any form of suicidal behavior. Suicidal ideations were less likely to occur among those who attained secondary education. However, more years of working as a domestic worker were associated with an increased likelihood of suicidal ideations. Having more than five dependents at work increased the likelihood of experiencing suicidal plans or attempts among domestic workers. For those who attempted suicide, overdosing with medications/drugs was the most common method of attempting.ConclusionDomestic workers have prevalent suicide behaviors, especially among females and those with a chronic medical illness, more years of work experience, and those with many household members at work. Based on the present study, for domestic workers at risk, there is a critical need for focused mental health interventions and support networks in various sectors of the domestic labor force.

Nursing care aspects and indicators impacted by information and communication technology: Systematic review

Background: Information technology is used in healthcare to solve the problems of an aging population, an increase in chronic illnesses, and the growing need for autonomy, independence, and quality of life. The adoption rate of IT applications among professionals such as nurses is relatively low, and it appears that not using them is the norm. Finding nursing care aspects and indications that have been altered by IT was our goal in doing this research. Method: The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement (9) was adhered to in this systematic review. Our search objective was to locate papers that addressed nursing care aspects and indicators that were changed by IT. The search method was used in the Google Scholar, CINAHL, and PubMed databases between 2015 and 2023. Result: Five publications were included in this systematic review. Four studies found elements related to teams that affect the adoption of telemedicine. The organizational and team culture is one of the main determinants of technology adoption. One study found that creative companies support employees in adjusting to new circumstances and that telemedicine implementation requires cultural transformation in enterprises. Implementing telemedicine in a company can be hindered by working in a changing environment and resisting change. Employees felt overwhelmed by all of the changes they experienced at work. Workloads increased as other advances were sometimes considered more significant than the use of telemedicine. Conclusion: When technology is used improperly, nurses can get disillusioned with its use for tasks that are traditionally completed by humans. Therefore, if healthcare professionals want to include telemedicine into their regular workflow, they must remove hurdles.

Exploring perceptions and attitudes towards pregnancy danger signs among childbearing age women in the Al-Baha Region, Saudi Arabia.

The World Health Organization (WHO) estimates that complications related to pregnancy and childbirth affect approximately 300 million women in developing countries, causing both acute and chronic illnesses. Direct obstetric complications such as hemorrhage, sepsis, hypertensive disorders during pregnancy, obstructed and prolonged labor, and unsafe abortion account for approximately 75% of maternal deaths. This study aimed to assess the perceptions and attitudes towards pregnancy danger signs among women of childbearing age in the Al-Baha Region, Saudi Arabia. A descriptive cross-sectional hospital-based study was conducted using simple random sampling to select 446 pregnant women. After outlining the study's goal and ensuring confidentiality, data were gathered through a pre-tested, well-designed questionnaire. Data were analyzed using Excel and SPSS version 28. The assessment of the study participants about perceptions of pregnancy danger signs revealed that many were aware of signs such as bleeding, abdominal pain, and lack of fetal movement, indicating a comprehensive understanding of potential pregnancy complications. The study participants exhibited good knowledge and relatively positive attitudes towards pregnancy danger signs. However, a significant fraction showed negative attitudes and insufficient knowledge, suggesting room for improvement in maternal health literacy. The study also found a significant relationship between sociodemographic characteristics and knowledge.Most participants had good knowledge and perceptions about pregnancy danger signs, and their attitudes were relatively positive. However, there is a need to increase awareness and improve attitudes towards pregnancy danger signs among women in the Al-Baha Region.

Faith-Healing and Chronic Illness: Cardiovascular Patient Experiences in Kashmir, India

Faith-Healing and Chronic Illness: Cardiovascular Patient Experiences in Kashmir, India

The Rule of CTLA-4 +49 G/A Gene Polymorphism Association With T2DM

The existing study has been designed to consider relationship among polymorphism of CTLA-4 +49 A/G (rs231775) in patients through diabetes mellitus type 2 (T2D). The training has stayed directed on adult at the subdivision of College of Medicine, AlQadisiya University throughout the period prolonged as of October, 2023 to April, 2024. Fifty patients with 50 control healthy assigned to 2 equal groups, collection blood samples with EDTA tubes. The study enrolled 50 Type 2 Diabetes patients and 50 healthy subjects, with no important variances in age, gender, or residency. Demographic appearances displayed no important alteration among the two groups. Chronic illnesses, such as diabetes mellitus and systemic hypertension, were found to be highly significant between patients and control subjects. Hypertension rates were higher in patients than in control subjects, while liver disease rates were higher in patients. Heart attacks were upper in sick than in controlling issues, and hyperlipidemia rates were higher in patients. Drug types and treatment periods were not statistically significant among T2D patients and healthy control. Genomic DNA stayed removed from blood testers by means of a gSYAN DNA kit withdrawal kit and checked using a Nano drop spectrophotometer. The polymorphism of CTLA-4 +49 A/G (rs231775) displayed that the AG genotype and the A allele were more frequent in the type 2 diabetes patients compared to controls, indicating they may be risk factors for developing T2D.

Predicting Parental Post-Traumatic Stress Symptoms Following their Child's Stay in a Pediatric Intensive Care Unit, Prior to Discharge.

Objective: Develop an inpatient predictive model of parental post-traumatic stress (PTS) following their child's care in the Pediatric Intensive Care Unit (PICU). Design: Prospective observational cohort. Setting: Two tertiary care children's hospitals with mixed medical/surgical/cardiac PICUs. Subjects: Parents of patients admitted to the PICU. Interventions: None. Measurements and Main Results: Preadmission and admission data from 169 parents of 129 children who completed follow up screening for parental post-traumatic stress symptoms at 3-9 months post PICU discharge were utilized to develop a predictive model estimating the risk of parental PTS 3-9 months after hospital discharge. The parent cohort was predominantly female (63%), partnered (75%), and working (70%). Child median age was 3 years (IQR 0.36-9.04), and more than half had chronic illnesses (56%) or previous ICU admissions (64%). Thirty-five percent (60/169) of parents met criteria for PTS (>9 on the Post-traumatic Stress Disorder Symptom Scale-Interview). The machine learning model (XGBoost) predicted subjects with parental PTS with 76.7% accuracy, had a sensitivity of 0.83 (95% CI 0.586, 0.964), a specificity of 0.72 (95% CI 0.506, 0.879), a precision of 0.682 (95% CI 0.451, 0.861) and number needed to evaluate of 1.47 (95% CI 1.16, 1.98). The area under the receiver operating curve was 0.78 (95% CI 0.64, 0.92). The most important predictive pre-admission and admission variables were determined using the Local Interpretable Model-Agnostic Explanation, which identified seven variables used 100% of the time. Composite variables of parental history of mental illness and traumatic experiences were most important. Conclusion: A machine learning model using parent risk factors predicted subsequent PTS at 3-9 months following their child's PICU discharge with an accuracy of 76.7% and number needed to evaluate of 1.47. This performance is sufficient to identify parents who are at risk during hospitalization, making inpatient and acute post admission mitigation initiatives possible.

In Vitro Inhibition of Enzymes and Antioxidant and Chemical Fingerprinting Characteristics of Azara serrata Ruiz &amp; Pav. Fruits, an Endemic Plant of the Valdivian Forest of Chile

The World Health Organization has emphasized the importance of consuming small fruits for the prevention of chronic health problems, including diabetes, cardiovascular diseases, cancer, and obesity, which are named chronic non-communicable diseases (NCDs). Azara serrata Ruiz &amp; Pav., commonly called “aroma de Castilla”, is a shrub endemic to Chile from the Salicaceae family that produces an underutilized blue-grey berry that grows wild in southern Chile. The species is widely used as a medicinal plant by the Andean communities of southern Chile. In this work, a high-resolution mass spectrometric analysis of the methanolic extract revealed several phenolic compounds for the first time in the edible berry of this endemic species. Furthermore, several glycosylated anthocyanins were detected and quantified using UHPLC coupled with UV/Vis detection and trapped ion mobility mass spectrometry (UHPLC-DAD-TIMS-TOF) for the anthocyanin-rich extract, which was prepared using an optimized anthocyanin extraction protocol. The extract proved to be active in the inhibition of several enzymes linked to NCDs, such as acetylcholinesterase, tyrosinase, amylase, lipase, and glucosidase (IC50 = 3.92 ± 0.23, 12.24 ± 0.03, 11.12 ± 0.10, 32.43 ± 0.0, and 371.6 ± 0.0 μg/mL, respectively). Furthermore, the extract concentrated in anthocyanins showed good antioxidant activity evidenced by the bleaching of the radicals DPPH and ABTS, ferric-reducing antioxidant power (FRAP), and oxygen radical absorbance capacity (ORAC). The results show that these neglected endemic small berries can be a source of healthy phytochemicals. These Chilean berries can be used as functional food and their extracts are candidates for use as functional ingredients in naturally healthy products.