Decline In Scores Research Articles

Impact of patient-centered communication on patient satisfaction scores in patients with chronic life-limiting illnesses: an experience from Kenya.

Patient satisfaction remains a key area of interest worldwide; utilizing a patient-centered communication approach, particularly with patients with chronic life-limiting illnesses may be one way to achieve this. However, there is a dearth of empirical information on the effect of patient-centered communication strategies in patients with chronic life-limiting illnesses in Kenya on patient satisfaction. The objective of this study was to assess the impact of patient-centered communication on patient satisfaction. We conducted our study at a tertiary teaching and referral hospital in Kenya. We utilized a quasi-experimental pre-test post-test study design and engaged 301 adult medical in-patients with chronic life limiting conditions. We randomized them to receive patient-centered communication, and evaluated the change in patient satisfaction scores using an adapted Medical Interview satisfaction Scale 21 (MISS 21). Two hundred and seventy-eight out of 301 recruited participants completed the study. The baseline characteristics of the participants randomized to the control and intervention arms were similar. Although both the control and intervention arms had a decline in the mean difference scores, the intervention arm recorded a larger decline, -15.04 (-20.6, -9.47) compared to -7.87 (-13.63, -2.12), with a statistically significant mean difference between the two groups at -7.16 (-9.67, -4.46). Participants in the intervention arm were less likely to: understand the cause of their illness (p < 0.001), understand aspects of their illness (p < 0.001), understand the management plan (p < 0.001), receive all the relevant information on their health (p < 0.001), and to receive adequate self-care information (p < 0.001). They were also less likely to acknowledge a good interpersonal relationship with the healthcare providers (p < 0.001), to feel comfortable discussing private issues (p < 0.004), and to feel that the consultation time was adequate (p < 0.001). Contrary to expectation, patient-centered communication did not result in improved patient satisfaction scores. Further studies can evaluate factors affecting and explaining this relationship and assess intermediate and long-term effects of provision of a patient-centered communication in diverse global contexts.

Pamphlet or a Lecture, which Method is more Effective in Educating Children about Proper Ways of Tooth Brushing? Quasi-Experimental Study

OBJECTIVE: To compare the effect of educating proper tooth brushing techniques via lecture or pamphlet on the reduction of dental plaque score among 12-year-old schoolchildren from subset Karachi. METHODOLOGY: A quasi-experimental study was performed from September to December 2021 in three underprivileged Karachi schools. After ethical approval schools were selected based on convenience sampling. Subjects were selected by random sampling and were divided into groups A, B, and C. The children of groups A&amp;B (lecture&amp; pamphlet) were taught tooth brushing as per American dental association criteria. The Plaque score at baseline was recorded. Group A was educated using a lecture with a live demonstration of brushing using models and charts. Group B was given Pamphlets, that had both text and illustrations, containing pictures of brushing techniques. Group C had no intervention i.e. a control group. The dental plaque score was calculated using the Loe and Silness scale. The Plaque score was measured at baseline (0), after one month, and after three months. RESULT: At baseline mean, the mean plaque score was 1.381±0.636, at 1-monthfollow-up 1.161±0.562, and at 3 months follow-up 1.065±0.658. There was a significant decline in mean plaque score in group A(lecture) followed by Group B(Pamphlet) after three months of intervention. No difference was seen in the control group. CONCLUSION: The study concluded that health education programs promote oral hygiene among school-going children as a significant improvement in mean plaque score reported from baselines to 3 months follow-up. KEYWORDS: Toothbrushing Technique, Dental Plaque, Lecture, intervention, Pamphlet.

To Evaluate Different Endodontic Instrumentation Systems Regarding Post-Operative Pain After Endodontic Therapy: A Clinical Study.

Despite substantial breakthroughs in instrumentation systems and pharmaceutical interventions, pain following endodontic therapy remains a serious concern. The effect of the type of endodontic instrumentation system in post-operative pain after endodontic therapy has been a matter of debate. To evaluate different endodontic instrumentation systems, namely Reciproc (GmbH, Munich), OneShape® (MicroMega, France), Protaper Gold (Dentsply Sirona, USA), and Hyflex® EDM (Coltène/Whaledent Inc., USA) file systems, regarding post-operative pain after endodontic therapy Methods and materials: The endodontic department treated healthy patients aged 20 to 50 years who were experiencing symptoms of irreparable pulpitis in one or more maxillary molars or mandibular molars. Five hundred was the determined size of the sample. The study participants were divided into five categories, each comprising 100 participants. These categories were: Category 1: Reciproc instrumentation system. Category 2: OneShape® instrumentation system. Category 3: ProtaperGold instrumentation system. Category 4: HyFlex® EDM instrumentation system. Category 5: Control (stainless steel K-files). Following endodontic therapy, these scores were recorded at 6 hours, 12 hours, 24 hours, 48 hours, and 72 hours using the VAS scale. The visual analog scale (VAS) score (mean±SD) in the control group was 0.73± 0.40 (<0.001). The VAS score in the Reciproc group was 0.43± 0.05 (<0.001). The VAS score in the OneShape® group was 0.36±0.09 (<0.001). The VAS score in the Protaper Gold group was 0.41 ±0.08 (<0.001). The VAS score in the HyFlex® EDM group was 0.55 ±0.02 (<0.001). The VAS score in all instrumentation techniques at 72 hours follow-up was lesser in comparison to a control group with meaningful statistical significance (<0.001). However, the post-operative pain among the Reciproc, OneShape®, Protaper Gold, and HyFlex® EDM instrumentation systems was not different clinically when compared among themselves. However, VAS values were greater in OneShape® and HyFlex® EDM compared to Reciproc and Protaper Gold, showing increased post-operative pain in OneShape and HyFlex® EDM compared to Reciproc and Protaper Gold. It was also observed that there was a decline in the VAS score in all instrumentation systems as the follow-up period increased from 6 hours to 72 hours, with maximum post-operative pain at 6 hours of follow-up and minimum post-operative pain at 72 hours of follow-up. However, the decline was lesser in OneShape® and HyFlex® EDM in comparison to Reciproc and Protaper Gold, with increased post-operative pain in OneShape® and HyFlex® EDM in comparison to Reciproc and Protaper Gold. Post-operative pain at all follow-ups of endodontic procedures was less in Reciproc, OneShape®, Protaper Gold, and HyFlex® EDM than in the control group. VAS scores were higher in the OneShape® and HyFlex® EDM groups compared to the Reciproc and Protaper Gold groups, indicating increased post-operative pain with OneShape® and HyFlex® EDM instruments in comparison to Reciproc and Protaper Gold.

The Memory Binding Test Detects Early Subtle Episodic Memory Decline in Preclinical Alzheimer's Disease: A Longitudinal Study.

The asymptomatic at-risk phase might be the optimal time-window to establish clinically meaningful endpoints in Alzheimer's disease (AD). We investigated whether, compared with the Free and Cued Selective Reminding Test (FCSRT), the Memory Binding Test (MBT) can anticipate the diagnosis of emergent subtle episodic memory (EM) deficits to an at-risk phase. Five-year longitudinal FCSRT and MBT scores from 45 individuals matched for age, education, and gender, were divided into 3 groups of 15 subjects: Aβ-/controls, Aβ+/stable, and Aβ+/progressors (preclinical-AD). The MBT adds an associative memory component (binding), particularly sensitive to subtle EM decline. In the MBT, EM decline started in the Aβ+/progressors (preclinical-AD) up to 4 years prior to diagnosis in delayed free recall (FR), followed by decline in binding-associated scores 1 year later. Conversely, in the FCSRT, EM-decline began later, up to 3 years prior to diagnosis, in the same group on both immediate and delayed versions of FR, while on total recall (TR) and intrusions decline started only 1 year prior to diagnosis. The MBT seems more sensitive than the FCSRT for early EM-decline detection, regarding the year of diagnosis and the number of scores showing AD-linked EM deficits (associated with the AD-characteristic amnesic hippocampal syndrome). Considering the MBT as a detection tool of early subtle EM-decline in an asymptomatic at-risk phase, and the FCSRT as a classification tool of stages of EM-decline from a preclinical phase, these tests ought to potentially become complementary diagnostic tools that can foster therapies to delay cognitive decline. Clinical trial registration title: Electrophysiological markers of the progression to clinical Alzheimer disease in asymptomatic at-risk individuals: a longitudinal event-related potential study of episodic memory in the INSIGHT pre-AD cohort (acronym: ePARAD).

Abstract 69: Trajectory of Cardiovascular Health Across Childhood and Adolescence in Project Viva

Introduction: The American Heart Association recently put forth the Life’s Essential 8 (LE8) algorithm to assess cardiovascular health (CVH) status based on 8 health and behavioral factors. Few studies, however, have characterized the natural history of CVH status across development or identified sociodemographic determinants of CVH trajectories in children. We sought to address this research gap using data from Project Viva, a pre-birth cohort in eastern Massachusetts. Methods: We applied the LE8 algorithm to derive CVH score (range 0-100 points) in early childhood (median age 3.2y), mid-childhood (7.7y), early adolescence (13y), and late adolescence (17.5y). We used segmented mixed-effect models to characterize sex-specific CVH trajectories across these life stages and estimate three subject-specific trajectory parameters: timing of inflection point when CVH score declines; slope before and after the inflection point. We used linear regression models to assess the association of child race and ethnicity, mother’s education level, and annual household income with each trajectory parameter. Results: Among 1,523 children included, 48.7% were female, 3.5% Asian, 15.2% Black, 4.8% Hispanic, 11.5% Other, and 65.0% White. The mean (SD) CVH score was 82.6 (8.6) points in early childhood, 84.1 (8.3) points in mid-childhood, 82.0 (9.8) points in early adolescence, and 73.8 (11.5) points in late adolescence. Females (vs. males) exhibited slower rate of CVH score gain before the inflection point (0.3 vs. 1.0 points/y), later timing of inflection point when CVH score started declining (10.1 vs. 9.6y), and slower rate of CVH score decline after the inflection point (-1.3 vs. -1.5 points/y). Children of Black (β 0.48y; 95% CI 0.28, 0.68) or Other (β 0.28y; 95% CI 0.08, 0.49) race had a later timing of inflection point compared with White children. Children whose mothers were college-educated (vs. non-college educated) had higher CVH score throughout childhood, and exhibited faster rate of CVH score gain before the inflection point (β 0.19 points/y; 95% CI 0.03, 0.34), earlier timing of inflection point (β -0.37y; 95% CI -0.53, -0.22), and faster rate of CVH score decline after the inflection point (β -0.24 points/y; 95% CI -0.38, -0.10). No associations were observed for household income. Conclusions: This cohort study identified a key timepoint between mid-childhood and early adolescence where CVH trajectory declines over time, as well as sociodemographic differences in CVH trajectory parameters. Future studies are warranted to assess other determinants and consequences of these trajectory parameters.

Corporate culture, staggered boards, and managerial entrenchment: Evidence from textual analysis

Capitalizing on an innovative measure of corporate culture derived from sophisticated machine learning algorithms and textual analysis, we explore how corporate culture is influenced by one of the most controversial corporate governance mechanisms, i.e., staggered boards. Our findings demonstrate that corporate culture is considerably weakened in the presence of a staggered board, consistent with the notion that staggered boards exacerbate managerial entrenchment and lead to more adverse corporate policies and outcomes. Specifically, corporate culture is approximately 7% weaker, as indicated by a decline in the text-based corporate culture score, in firms with a staggered board than those with a unitary board. Furthermore, we show that the negative effect of staggered boards on corporate culture is significantly more pronounced during more uncertain times. Additional analysis validates the results, i.e., propensity score matching, entropy balancing, and instrumental-variable analysis.

Takaful and Insurance Efficiency Determinants: Pre and Post Covid-19 Pandemic

This study aims to compare the efficiency of the performance of sharia insurance companies (full fledge) and conventional insurance operating in Indonesia using two stages of data envelopment analysis (DEA) for the period before and during Covid-19 (2018 - 2021). The first stage is to measure efficiency using the non-parametric DEA approach and the second stage uses the Tobit Regression model to see the factors that affect the efficiency level of insurance companies during the period of Covid-19. This result indicates the average efficiency score of Sharia and conventional insurance fluctuated, especially in 2020 there was a decline in efficiency scores, and it is evidence that Covid-19 has had little effect on the insurance business, both conventional and sharia insurance. However, this study reveals that the average conventional insurance can adjust to these conditions faster than the average sharia insurance. The effect on the efficiency level of the insurance companies can be seen from internal and external factors. The findings in this study indicate that insurance efficiency is more influenced by internal variables such as SIZE, ROA and NPM than external variables. There was no significant change in insurance efficiency during the Covid-19 pandemic.

Reserve drug as first-line management: Topical interferon α-2b for vernal keratoconjunctivitis.

To elucidate the efficacy and safety profile of interferon α-2b in vernal keratoconjunctivitis (VKC). In this prospective interventional study, VKC patients fulfilling the inclusion and exclusion criteria were included and their signs and symptoms were scored based on the Clinical Scoring System. Patients were treated with topical interferon α-2b eye drop (1 MIU/ml) QID dosing for 6 weeks. Changes in symptoms and signs were evaluated at 2, 4, 8 weeks and 6 months after initiating treatment. A higher score meant severe disease, and a decline in score meant improvement in clinical signs and symptoms. Categorical variables were presented in number and percentage (%) and continuous variables as mean ± standard deviation (SD). Post-medication total subjective symptom score (TSSS) and total objective sign score (TOSS) were compared with baseline, and a P- value of <0.05 was considered significant. Possible ocular and systemic complications were evaluated. The study included 40 patients (32 male and eight female) with a mean age of 8.05 ± 2.33 years. Mean baseline TSSS and TOSS were 6.71 ± 0.564 and 6.59 ± 0.262, respectively, which reduced to 2.71 ± 0.011 ( P = 0.040) and 2.96 ± 0.210 ( P = 0.032), respectively, at 4 weeks and further reduced to 0.42 ± 0.552 and 0.47 ± 0.434, respectively, at 8 weeks. After 6 months of stopping the drug, mean TSSS and TOSS did increase to 2.80 ± 0.820 ( P = 0.044) and 2.50 ± 0.520 ( P = 0.030), respectively, but was still statistically significant improvement compared to the baseline. Also, no ocular or systemic side effects were observed anytime during the study period. Eye drop interferon α-2b (1 million IU/ml) is a safe and effective option as first-line monotherapy for VKC. No side effects and recurrence were observed for 6 months.

Association of intrinsic capacity with functional ability, sarcopenia and systemic inflammation in pre-frail older adults.

Decline in intrinsic capacity (IC) has been shown to accelerate progression to disability. The study aims to explore association of IC composite score with functional ability, sarcopenia and systemic inflammation in pre-frail older adults. Cross-sectional study of pre-frail older adults ≥60 years old recruited from the community and primary care centers. Composite scores of four domains of IC were measured: locomotion, vitality, cognition and psychological. FRAIL scale was used to define pre-frailty. Muscle mass was measured using the bioelectrical impedance analysis. Systemic inflammation biomarkers [Interleukin-6 (IL-6), Interleukin-10 (IL-10), Tumor Necrosis Factor Alpha (TNF-α), and Growth differentiated factor 15 (GDF-15)] were measured. Participants in the lowest tertile (T1) exhibited greater decline in IC. A total of 398 pre-frail older adults were recruited, mean age was 72.7 ± 5.8 years, 60.1% female, education level 7.8 years, and 85.2% were of Chinese ethnicity. A total of 75.1% had decline in locomotion, 40.5% in vitality, 53.2% in cognition and 41.7% in psychological domain. A total of 95% had decline in at least one domain. T1 was significantly associated with ADL impairment (aOR 3.36, 95% CI 1.78-6.32), IADL impairment (aOR 2.37, 95% CI 1.36-4.13), poor perceived health (aOR 0.96, 95% CI 0.95-0.98), fall (aOR 1.63, 95% CI 1.05-2.84), cognitive impairment (aOR 8.21, 95% CI 4.69-14.39), depression (aOR 101.82, 95% CI 33.62-308.37), and sarcopenia (aOR 2.40, 95% CI 1.60-5.45). T1 had significant associations with GDF-15, IL-10, and IL-10 to TNF-α ratio. Decline in IC composite score among pre-frail older adults was associated with functional limitation, sarcopenia, and systemic inflammation.

Exploring The Efficacy Of Self-Concept And Psychosocial Skill Enhancement Interventions In Hearing-Impaired Children: A Comparative Analysis

This comparative study aimed to measure the impact of social skills training on the self-perception and psychosocial challenges experienced by school children with hearing impairment. The participants were divided into two groups: one received social skills training, and other was a control group, and self-report measures were used to evaluate their self-concept and psychosocial problems before and after the training. The outcomes displayed a significant upgrading in self-concep[1]t scores and a decline in psychosocial problem scores following the training. Gender differences were observed, with girls go through greater self-concept improvement, while boys displayed higher psychosocial problem scores post-training. In addition, a multivariate analysis proved a significant relation between gender and treatment group, suggesting potential gender-specific effects of social skills training. Conversely, the study was subject to certain limitations, including a small sample size and reliance on self-report measures. Future research should address these limitations and investigate the mechanisms and long-term effects of social skills training in hearing-impaired children, while considering gender-specific factors. Overall, this study contributes valuable insights to the existing literature on the effectiveness of social skills training in enhancing the well-being of hearing-impaired school children.

Changes in the Physicochemical Properties and Microbial Communities of Air-Fried Hairtail Fillets during Storage.

This study assessed the physicochemical properties of air-fried hairtail fillets (190 °C, 24 min) under different storage temperatures (4, 25, and 35 °C). The findings revealed a gradual decline in sensory scores across all samples during storage, accompanied by a corresponding decrease in thiobarbituric acid reactive substances (TBARS) and total viable count over time. Lower storage temperatures exhibited an effective capacity to delay lipid oxidation and microbiological growth in air-fried hairtail fillets. Subsequently, alterations in the microbiota composition of air-fried hairtail fillets during cold storage were examined. Throughout the storage duration, Achromobacter, Escherichia-Shigella, and Pseudomonas emerged as the three dominant genera in the air-fried hairtail samples. Additionally, Pearson correlation analysis demonstrated that among the most prevalent microbial genera in air-fried hairtail samples, Achromobacter and Psychrobacter exhibited positive correlations with the L* value, a* value, and sensory scores. Conversely, they displayed negative correlations with pH, b* value, and TBARS. Notably, air-fried samples stored at 4 °C exhibited prolonged freshness compared with those stored at 25 °C and 35 °C, suggesting that 4 °C is an optimal storage temperature. This study offers valuable insights into alterations in the physicochemical properties and microbial distribution in air-fried hairtail fillets during storage, facilitating the improvement of meat quality by adjusting microbial communities in air-fried hairtail fillets.

Patient-reported outcomes following total shoulder arthroplasty and hemiarthroplasty: an analysis of data from the National Joint Registry

IntroductionTotal shoulder arthroplasty (TSA) and hemiarthroplasty (HA) are used in the management of end stage glenohumeral arthritis. Improvement in shoulder function and resolution of symptoms are high priorities for patients. The aim of this study was to compare patient-reported outcome measures (PROMs) following TSA and HA. MethodRecords from the National Joint Registry of England, Wales, Northern Ireland and the Isle of Man were linked to the PROMs dataset. The study included anatomical shoulder arthroplasties performed for osteoarthritis in patients with an intact rotator cuff. Patients with preoperative and postoperative Oxford Shoulder Scores (OSSs) were included. The improvement in OSS at 6 months and 5 years, and the trend in scores over time were analyzed for each prosthesis. A cohort of 2,002 patients were matched on 10 variables using propensity scores. OSSs at 6 months following TSA versus HA were compared in the matched sample. ResultsThere was a significant improvement in the OSS in both groups (p<0.001). At 6 months the OSSs were superior following TSA compared to HA (median 42 vs 36, p<0.001). The median score at 5 years was 44 following TSA and 35 following HA. Score distributions were skewed towards the maximum score. The highest possible score (48) was achieved in 28% (134/478) of TSAs and 9% (20/235) of HAs at 5 years. The improvement in the preoperative to 6-month OSS reached the minimal clinically important difference of 5.5 in 92% (1653/1792) of TSAs and 80% (416/523) of HAs. At 5 years this improvement was maintained in 91% (339/374) of TSAs and 78% (136/174) of HAs. ConclusionTSA resulted in superior OSSs at 6 months in patients with osteoarthritis. The median OSS improved from 6 months to 5 years following TSA, however there was a small decline in scores following HA. A ceiling effect was shown in the OSS following TSA at 5 years.

COVID-19 Impact on Family Medicine Residents Exam Performance.

The COVID-19 pandemic began interrupting family medicine residency training in spring 2020. While a decline in scores on the American Board of Family Medicine In-Training Examination (ITE) has been observed, whether this decline has translated into the high-stakes Family Medicine Certification Examination (FMCE) is unclear. The goal of this study was to systematically assess the magnitude of COVID-19 impact on medical knowledge acquisition during residency, as measured by the ITE and FMCE. A total of 19,101 initial certification candidates from 2017 to 2022 were included in this study. Annual ITE scores and FMCE scores were reported on the same scale (200-800) and served as the outcome measure. We conducted multilevel regression analysis to determine ITE score growth and FMCE scores compared to cohorts prior to COVID-19. During COVID-19, the increase in ITE scores from postgraduate year 2 (PGY-2) to PGY-3 was 25.5 points less, representing a 57.6% relative decrease; and from PGY-3 ITE to FMCE, it was 8.6 points less, a 12.7% relative decrease, compared with cohorts prior to COVID-19. FMCE scores were 6.6 points less during COVID-19, representing a 1.2% relative decline from the average FMCE score prior to COVID-19. This study found nonsubstantive COVID-19 impact on FMCE scores, but a considerable knowledge acquisition decline during residency, especially during the PGY-2 to PGY-3 period. While COVID-19 impacted learning, our findings indicated that residencies were largely able to remediate knowledge deficits before residents took the FMCE.

The impact of motivation on mathematics achievement of Saudi students using structure equation method and mediation analysis

This study focuses on the decline in math scores among fourth-grade students in Saudi Arabia, which is a significant concern. The Saudi Arabian Ministry of Education is taking steps to improve education and provide students with the necessary skills for their future careers. Understanding what affects student achievement is key to solving this problem. Motivation in education is a critical factor that influences students' attitudes and their success in school. This research looks at how academic motivation affects educational success through a process called mediation analysis. It considers how self-concept and values, which come from motivation, play a role. The study uses the expectancy-value theory of achievement motivation to create a model that explores how motivation and other factors like school bullying, feeling connected to school, and perceptions of teachers interact and affect each other. Mediation analysis helps examine the direct and indirect effects these factors have on student achievement. Data from the trends in international mathematics and science study (TIMSS) for fourth graders in Saudi Arabia is used to see if the theory fits with the experiences of Saudi students. The findings show that self-confidence is crucial for academic performance, affecting students' motivation, readiness to face challenges, and overall learning attitude. However, math attitude does not directly influence self-concept. School bullying is identified as a significant negative factor in math achievement. These outcomes stress the need to address school bullying to improve math scores and highlight the importance of self-concept and motivation in boosting academic success.

Longitudinal study of cognitive decline among women with and without urinary incontinence

BACKGROUNDCross-sectional and short-term cohort studies have demonstrated an association between urinary incontinence and dementia as well as lower performance on cognitive testing. The Health and Retirement Study, a longitudinal study of community-dwelling older adults, offers an opportunity to assess the temporal association between these conditions, as this study included an assessment of incontinence symptoms as well as biennial assessments of cognitive function. OBJECTIVESThis study aimed to evaluate if urinary incontinence before age 70 had an effect on changes in cognitive function among women participating in the Health and Retirement Study. STUDY DESIGNThis secondary analysis included data from female respondents in the Health and Retirement Study ages 58 to 67 years with ≥2 cognitive assessments. Urinary incontinence was defined as any involuntary loss of any urine in the preceding 12 months. A control group without incontinence was reweighted for better comparability using coarsened exact matching for age and comorbidities. Validated methods, including neuropsychological test data, estimated a Memory score and DP for each participant biennially. Coprimary outcomes were the changes in Memory score and dementia probability.Linear regression models were used to estimate the association of urinary incontinence with change in Memory score and dementia probability, adjusting for baseline demographics and comorbidities. A subgroup analysis was performed to assess the effects of urinary incontinence frequency on these outcomes. The infrequent subgroup reported less than fifteen days of leakage per month and the frequent subgroup reported fifteen or more days of leakage per month. RESULTSAmong eligible female respondents, 40.6% reported urinary incontinence between ages 58 to 69 years. Baseline Memory scores and dementia probability were similar between those with urinary incontinence (n=1706) and controls (n=2507). Memory score declined significantly in both cohorts, indicating poorer memory over time -0.222 among those with incontinence (95% confidence interval (CI) -0.245, -0.199) versus -0.207 in controls (95% CI: -0.227, -0.188). The decline of Memory score was not statistically different between cases and controls (mean difference -0.015, 95% CI: -0.045, 0.015). Dementia probability increased significantly in both groups, indicating a greater probability of dementia: 0.018 among those with incontinence (95% CI: 0.015, 0.020) and by 0.020 among controls (95% CI: 0.017, 0.022). The change in DEMENTIA PROBABILITY was not significantly different between groups (mean difference -0.002, 95% CI: -0.006, 0.002).Frequent urinary incontinence was reported in 105/1706 (6%) with urinary incontinence. Memory score declined and dementia probability increased with time (p<0.001) in frequent and infrequent UI subgroups. There was no dose-response relationship. CONCLUSIONSMeasures of cognitive performance declined with approximately 10 years of observation; the changes in performance were not associated with the presence of urinary incontinence in their younger years.

Neurocognitive Changes in Patients with Post-COVID Depression.

Background: Depression and cognitive impairment are recognized complications of COVID-19. This study aimed to assess cognitive performance in clinically diagnosed post-COVID depression (PCD, n = 25) patients using neuropsychological testing. Methods: The study involved 71 post-COVID patients with matched control groups: recovered COVID-19 individuals without complications (n = 18) and individuals without prior COVID-19 history (n = 19). A post-COVID depression group (PCD, n = 25) was identified based on psychiatric diagnosis, and a comparison group (noPCD, n = 46) included participants with neurological COVID-19 complications, excluding clinical depression. Results: The PCD patients showed gender-dependent significant cognitive impairment in the MoCA, Word Memory Test (WMT), Stroop task (SCWT), and Trail Making Test (TMT) compared to the controls and noPCD patients. Men with PCD showed worse performances on the SCWT, in MoCA attention score, and on the WMT (immediate and delayed word recall), while women with PCD showed a decline in MoCA total score, an increased processing time with less errors on the TMT, and worse immediate recall. No differences between groups in Sniffin's stick test were found. Conclusions: COVID-related direct (post-COVID symptoms) and depression-mediated (depression itself, male sex, and severity of COVID-19) predictors of decline in memory and information processing speed were identified. Our findings may help to personalize the treatment of depression, taking a patient's gender and severity of previous COVID-19 disease into account.

Efficacy and safety of pinaverium bromide as an add-on therapy in refractory dyspepsia: A randomized controlled trial.

Functional dyspepsia (FD) remains a therapeutic challenge, and the efficacy of antispasmodic agents as adjunctive therapy is not well established. This study aimed to evaluate the efficacy and safety of pinaverium bromide added to omeprazole in treating refractory FD. We conducted a randomized, placebo-controlled trial in patients with refractory dyspepsia. Participants were randomly assigned to receive pinaverium (50 mg, 3 times/day, n = 36) or placebo (n = 36) in addition to omeprazole for 8 weeks. The primary endpoint was the responder rate for adequate relief. Secondary outcomes included the Global Overall Symptom Scale (GOSS), quality of life, and safety profile. No statistically significant differences were observed in the adequate relief response rate between the pinaverium bromide and control group at week 2 (58.3% vs. 62.9%, P = 0.697), week 4 (62.9% vs. 78.1%, P = 0.173), week 6 (64.7% vs. 75.0%, P = 0.363), and week 8 (64.7% vs. 75.0%, P = 0.363). Additionally, there were no significant differences observed in the decline of symptom score between the two groups at week 4 (8.4 ± 7.6 vs. 7.7 ± 7.1, P = 0.702) and week 8 (10.9 ± 8.2 vs. 8.4 ± 7.2, P = 0.196). Similarly, there were no significant differences in terms of quality of life between the two groups. Adverse event rates were also comparable between the two groups. Pinaverium bromide was found to be safe in the treatment of refractory dyspepsia, but it did not demonstrate a significant benefit in improving symptoms.

Neuropsychiatric Symptoms Predict Faster Cognitive Decline in Dementia Collaborative Care Than Antipsychotic Use.

To compare short-term cognitive outcomes among groups with and without neuropsychiatric symptoms (NPSs) or antipsychotic prescription and to determine which disease status or treatment modality is associated with relatively faster cognitive decline. We retrospectively analyzed a prospective cohort of patients diagnosed with dementia and mild cognitive impairment. All participants were evaluated using the Cognitive Abilities Screening Instrument (CASI) during their initial clinical assessments and at the annual follow-up. The dependent variable was annual delta CASI. Multivariate linear regression analysis was used to assess the degree of association between NPS, antipsychotic use, and cognitive decline after adjusting for confounding factors. Neuropsychiatric symptoms were examined individually to determine their predictive value for cognitive decline. A total of 407 (N = 407) patients were included in the study. NPSs, rather than antipsychotic use, led to faster cognitive decline. A higher baseline NPI total score predicted a significantly faster decline in CASI scores (1-year delta CASI = -0.22, 95% CI = -0.38~ -0.05, p = 0.010). Specific items (delusions, agitation, depression, anxiety, euphoria, and apathy) in the NPS significantly increased cognitive decline. Certain neuropsychiatric symptoms, rather than antipsychotic use, lead to faster cognitive decline in a dementia collaborative care model. Checking for and providing appropriate interventions for NPS in people with dementia and their caregivers are highlighted.

Efficacy of leuprorelin in spinal and bulbar muscular atrophy: a 3-year observational study.

This study aimed to investigate the long-term effects and functional outcomes of androgen suppression therapy using leuprorelin among Korean patients with spinal and bulbar muscular atrophy (SBMA). This observational study enrolled patients with genetically confirmed SBMA who provided informed consent. Leuprorelin was administered via subcutaneous injection every 12weeks. The primary outcome measure was the change in total Spinal and Bulbar Muscular Atrophy Functional Rating Scale (SBMAFRS) scores. A total of 48 SBMA patients were evaluated in this study. Among them, 39 patients underwent androgen suppression therapy over a 3-year period. The total SBMAFRS score decreased from 41.72 ± 5.55 to 36.74 ± 7.74 (p < 0.001) in patients who completed their treatment. The subgroup with a baseline SBMAFRS score of ≥ 42 had a significantly lower decline in SBMAFRS score than did those with a baseline SBMAFRS score of ≤ 41. We determined that at a baseline, SBMAFRS cutoff value of 41.5 could predict good prognosis, with a corresponding area under the curve of 0.689. Despite androgen suppression therapy, all enrolled participants exhibited a decrease in the overall SBMAFRS score. However, those with a baseline SBMAFRS of ≥ 42 showed a mild decrease in scores, indicating a more favorable prognosis. These findings suggest that a higher baseline motor function was a key prognostic indicator in SBMA treatment and that initiating early leuprorelin treatment in patients with high baseline function may lead to good clinical outcomes.

Sense of Belonging Pre/Post Transition to Secondary School: Privileging Student Voice

In Queensland, Australia, there has been a major reform shifting Year 7 from Primary to Secondary Schools and implementing the Junior Secondary initiative for Years 7-9 in government schools. Six Guiding Principles, including establishing a Distinct Identity, provide the framework. This study examined 317 students transitioning from Year 6 to 7, with a focus on how, and to what extent, they established a Distinct Identity, evident in their sense of belonging and connectedness, and of feeling safe and confident in their school. This longitudinal study was conducted in two Phases with data collected over a year. Phase 1, pre-transition, involved 471 Year 6 students in 18 primary schools. Phase 2, post-transition, involved 317 matched respondents now in Year 7 in 11 secondary schools. Student voice is featured in this study as a key point of difference to previous studies about young people’s transitions. The findings reveal that students’ sense of belonging at school remained mostly stable and positive across the Year 6 to 7 transition, with a small decline in mean scores. This finding is a positive reflection on the effectiveness of the Junior Secondary initiative, which set out to address declines previously reported in the literature.