Interventions For Individuals Research Articles

Unraveling the Link between Obesity and Tuberculosis: A Systematic Review of the Underlying Mechanisms

Background: Tuberculosis (TB) and obesity are significant global health concerns with potentially complex interactions. Obesity, through its effects on metabolism, inflammation, and the immune system, may influence TB susceptibility, progression, and treatment outcomes. This systematic review aims to analyze the published literature on the relationship between obesity and TB, focusing on the underlying mechanisms. Methods: A systematic search of PubMed, Science Direct, and Google Scholar was conducted for articles published in the last 10 years. The search strategy included keywords such as "tuberculosis," "TB," "obesity," and "BMI." Articles were selected using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) method. Results: The review identified 11 studies that met the inclusion criteria. The studies revealed a complex relationship between obesity and TB, with nutritional status, immunity, and diabetes mellitus (DM) playing key roles. Obesity can alter the immune response to TB, potentially increasing the risk of disease and affecting treatment efficacy. Conclusion: The relationship between obesity and TB is multifaceted, with obesity potentially influencing both disease susceptibility and outcomes. Further research is needed to fully elucidate the underlying mechanisms and to develop targeted interventions for individuals with both obesity and TB.

Systematic Integrative Review: Sex Education for People with Autism Spectrum Disorder

PurposePeople with autism spectrum disorder (ASD) require comprehensive sexuality and relationship education (SRE) for healthy sexual development, which refers to the lifelong process of acquiring knowledge, attitudes, and behaviors around sexual health that foster well-being and personal fulfillment. In this emerging research field, our aim is to consolidate scientific literature findings and gain a clear understanding of existing gaps. We plan to achieve this by conducting a systematic integrative review, analyzing the development and design process of interventions for individuals with ASD or Developmental Disorder up to February 2023. Furthermore, we place significant emphasis on evaluating the effectiveness of programs for both participants and their families. This comprehensive approach allows us to analyze the overall impact of interventions and provide a more complete understanding of their effectiveness in practical contexts. Methods: A systematic search was conducted on seven databases: ProQuest Dissertation, Scopus, Web of Science, Dialnet, ERIC, PsycInfo, and Pubmed. 20 articles met the inclusion criteria (1 randomized controlled trial, 7 mixed methods, and 12 non-randomized). The methodological quality of the studies was assessed with Mixed Methods Appraisal Tool (MMAT), version 2018. Results: The low quality of the studies does not allow us to confirm that the programs are effective in increasing the level of knowledge, although most of the studies reflect positive results that suggest that the participants have benefited from the training received. Conclusions: This review has allowed us to discover the existing deficiencies in this field, as well as to detect how they could be improved.

Revealing the Mechanism of Hemerocallis citrina Baroni in Depression Treatment Through Integrated Network Pharmacology and Transcriptomic Analysis

Background/Objectives: Hemerocallis citrina Baroni (HCB) is a traditional herb for the treatment of depression in China. However, the active constituents and the underlying mechanisms of its antidepressant effects remain unclear. The aim of this study was to identify the bioactive constituents of HCB and elucidate its underlying mechanism for the treatment of depression. Methods: The constituents of HCB were systematically analyzed using UHPLC-Q-Orbitrap HRMS. Its antidepressant effect was evaluated by chronic unpredictable mild stress (CUMS)-induced depression. The mechanism of HCB in treating depression was investigated through network pharmacology and molecular docking. Subsequently, its potential mechanism for the treatment of depression was carried out by RNA sequencing. Finally, the mechanism was further verified by Western blot. Results: A total of 62 chemical constituents were identified from HCB using UHPLC-Q-Orbitrap HRMS, including 17 flavonoids, 11 anthraquinones, 11 alkaloids, 10 caffeoylquinic acid derivatives, five phenolic acids, five triterpenoids, and three phenylethanosides, 13 of which were identified as potential active constituents targeting 49 depression-associated proteins. Furthermore, HCB was found to significantly reduce cognitive impairment, anxiety-like behavior, and anhedonia-like behavior. The expression levels of 5-hydroxytryptamine (5-HT), dopamine (DA), and brain-derived neurotrophic factor (BDNF) were elevated in the hippocampal CA3 region. Results from network pharmacology and transcriptomics indicated that the PI3K/Akt/CREB signaling pathway is essential for the therapeutic effects of HCB on depression. Research in the field of molecular biology has conclusively demonstrated that HCB is associated with an increase in the expression levels of several important proteins. Specifically, there was a notable upregulation of phosphorylated PI3K (p-PI3K) relative to its unphosphorylated form PI3K, as well as an elevation in the ratio of phosphorylated Akt (p-Akt) to total Akt. Additionally, the study observed increased levels of phosphorylated CREB (p-CREB) compared to its unphosphorylated CREB. Conclusions: This study provides compelling evidence that HCB possesses the ability to mitigate the symptoms of depression through its influence on the PI3K/Akt/CREB signaling pathway. HCB could be developed as a promising therapeutic intervention for individuals struggling with depression, offering new avenues for treatment strategies that target this particular signaling mechanism.

Influence of The Anabolic Steroid Usage on The Physical Health: A Review

Introduction: Anabolic steroids are synthetic derivatives of testosterone commonly used to enhance athletic performance and physical appearance. Despite their popularity, their non-medical use is associated with significant health risks. This review aims to synthesize current knowledge on the impact of anabolic steroid use on physical health, emphasizing cardiovascular, hepatic, endocrine, and musculoskeletal systems, as well as broader systemic effects. Materials and Methods: A systematic literature review was conducted using peer-reviewed articles from databases such as PubMed, Scopus, and Google Scholar published between 2000 and 2023. Studies were selected based on relevance, with particular focus on human clinical trials, observational studies, and meta-analyses. Keywords included "anabolic steroids," "health effects," "cardiovascular risk," and "endocrine disruption." Results: Anabolic steroid use is linked to increased cardiovascular risks, liver dysfunction, endocrine disturbances, and musculoskeletal injuries. Key effects include hypertension, hepatotoxicity, testosterone suppression, infertility, and tendon injuries. Psychological impacts such as aggression and mood changes were also observed. Conclusions: Anabolic steroid use poses significant risks to multiple organ systems and overall health. Despite widespread awareness of these dangers, misuse persists, often driven by societal pressures and misinformation. Healthcare providers should prioritize prevention through education, early intervention, and support for individuals at risk. Future research should focus on long-term effects and effective strategies for harm reduction.

Randomized controlled trial of a pilot PrEP linkage intervention for individuals leaving incarceration in a southern state: Design and baseline characteristics.

We report baseline characteristics of a pilot intervention, PrEP-Link, which uses a community health worker (CHW) model to provide navigation to PrEP, the daily HIV preventative medication, and other medical and social services upon release from incarceration. This pilot study uses a randomized controlled trial design. The control group receives enhanced standard of care, and the intervention receives enhanced standard of care plus personalized navigation services from the CHW for up to one year. PrEP-Link is modeled after the Transitions Clinic Program, where a CHW who has lived experience of incarceration builds close relationships with individuals and community partners. After COVID-19 restrictions prevented recruitment within local jails, recruitment for this study took place in local reentry centers which house individuals as they near completion of their jail or prison sentence. Data are collected at baseline, 6 months, and 12 months. Planning and reporting was guided by the CONSORT 2010 checklist. We enrolled 80 participants between September 2021 and April 2023. Thirty-nine participants were assigned to the control group and forty-one to the intervention group. Data collected at baseline included measures of PrEP usage, HIV risk, drug and alcohol use, healthcare usage, and history of incarceration. Analysis of baseline characteristics show comparability of both demographic and HIV-related risk factors between the two arms. At baseline, participants had high clinical indication for potential PrEP benefit, particularly with respect to self-reported intravenous drug use and condomless sex. Participants responded with high PrEP acceptability within both study arms. Participants reported low preventative healthcare utilization at baseline. Barriers to accessing PrEP among the study population are significant. Results of this pilot RTC will help inform CHW lead PrEP-linkage interventions for people leaving incarceration.

Predicting vulnerable coronary arteries: a combined radiomics-biomechanics approach

Background and ObjectiveNowadays, vulnerable coronary plaque detection from coronary computed tomography angiography (CCTA) is suboptimal, although being crucial for preventing major adverse cardiac events. Moreover, despite the suggestion of various vulnerability biomarkers, encompassing image and biomechanical factors, accurate patient stratification remains elusive, and a comprehensive approach integrating multiple markers is lacking. To this aim, this study introduces an innovative approach for assessing vulnerable coronary arteries and patients by integrating radiomics and biomechanical markers through machine learning methods. MethodsThe study included 40 patients (7 high-risk and 33 low-risk) who underwent both CCTA and coronary optical coherence tomography (OCT). The dataset comprised 49 arteries (with 167 plaques), 7 of which (with 28 plaques) identified as vulnerable by OCT. Following image preprocessing and segmentation, CCTA-based radiomic features were extracted and a finite element analysis was performed to compute the biomechanical features. A novel machine learning pipeline was implemented to stratify coronary arteries and patients. For each stratification task, three independent predictive models were developed: a radiomic, a biomechanical and a combined radiomic-biomechanical model. Both k-nearest neighbors (KNN) and decision tree (DT) classifiers were considered. ResultsThe best radiomic model (KNN) detected all 7 vulnerable arteries and patients and was associated with a balanced accuracy of 0.86 (sensitivity=1, specificity=0.71) for the artery model and of 0.83 (sensitivity=1, specificity=0.67) for the patient model. The best biomechanical model (DT) detected 6 over 7 vulnerable arteries and patients and remarkably increased the specificity, resulting in a balanced accuracy of 0.89 (sensitivity=0.86, specificity=0.93) for the artery model and of 0.88 (sensitivity=0.86, specificity=0.91) for the patient model. Notably, the combined approach optimized the performance, with an increase in the balance accuracy up to 0.94 for the artery model and up to 0.92 for the patient model, being associated with sensitivity=1 and high specificity (0.88 and 0.85 for artery and patient models, respectively). ConclusionThis investigation highlights the promise of radio-mechanical coronary artery phenotyping for patient stratification. If confirmed from larger studies, our approach enables a more personalized management of the disease, with the early identification of high-risk individuals and the reduction of unnecessary interventions for low-risk individuals.

Interventions for comorbid learning disabilities

AbstractComorbidity, the simultaneous or successive co‐occurrence of two or more disorders in one individual, is common among individuals with learning disabilities (LDs). The topic has garnered much attention in the field of LD, with advances over the past three decades in describing, predicting, and explaining comorbid LDs. However, efforts to design, evaluate, and implement interventions for individuals with comorbid LDs have received far less attention. In this article, we focus on these critical matters. After discussing how comorbidity and LDs have been conceptualized, defined, and explained, we consider what the field has learned about how individuals with comorbid LDs respond to academic interventions and what approaches may be effective for supporting their educational development.

Brain activation patterns in normal hearing adults: An fNIRS Study using an adapted clinical speech comprehension task

ObjectivesUnderstanding brain processing of auditory and visual speech is essential for advancing speech perception research and improving clinical interventions for individuals with hearing impairment. Functional near-infrared spectroscopy (fNIRS) is deemed to be highly suitable for measuring brain activity during language tasks. However, accurate data interpretation also requires validated stimuli and behavioral measures. DesignTwenty-six adults with normal hearing listened to sentences from the Oldenburg Sentence Test (OLSA), and brain activation in the temporal, occipital, and prefrontal areas was measured by fNIRS. The sentences were presented in one of the four different modalities: speech-in-quiet, speech-in-noise, audiovisual speech or visual speech (i.e., lipreading). To support the interpretation of our fNIRS data, and to obtain a more comprehensive understanding of the study population, we performed hearing tests (pure tone and speech audiometry) and collected behavioral data using validated questionnaires, in-task comprehension questions, and listening effort ratings. ResultsIn the auditory conditions (i.e., speech-in-quiet and speech-in-noise), we observed cortical activity in the temporal regions bilaterally. During the visual speech condition, we measured significant activation in the occipital area. Following the audiovisual condition, cortical activation was observed in both regions. Furthermore, we established a baseline for how individuals with normal hearing process visual cues during lipreading, and we found higher activity in the prefrontal cortex in noise conditions compared to quiet conditions, linked to higher listening effort. ConclusionsWe demonstrated the applicability of a clinically inspired audiovisual speech-comprehension task in participants with normal hearing. The measured brain activation patterns were supported and complemented by objective and behavioral parameters.

The SMHP™ position statement on therapeutic carbohydrate reduction for type 1 diabetes

This article presents the position of the Society of Metabolic Health Practitioners (SMHP) regarding therapeutic carbohydrate reduction (TCR) nutrition interventions for type 1 diabetes mellitus (T1DM). A modified Delphi methodology was used to arrive at a consensus consisting of several focus groups, multiple rounds, and an anonymous survey. The field of endocrinology has seen many new advances for the treatment of T1DM including hybrid closed-loop insulin delivery systems and continuous glucose monitors for better glycaemic control, monoclonal antibodies to delay the onset of disease and increased access to paediatric endocrinologists, among many other noteworthy achievements. Despite these advancements, standard of care approaches to T1DM result in higher than acceptable morbidity and mortality, with a high prevalence of microvascular and macrovascular complications. Insulin resistance in type 1 diabetes is an independent risk factor for adverse outcomes even in well controlled type 1 diabetes. In 2021, only 21% of adults with T1DM in the United States achieved the American Diabetes Association’s (ADA’s) target haemoglobin A1C goal of 7.0%, while data in the paediatric and adolescent population have demonstrated worse glycaemic control. Supported by observational and interventional evidence, the SMHP advocates for the reevaluation of the prevailing nutritional therapy for T1DM with more broad consideration for TCR. The SMHP recommends open access and clinical support for TCR nutrition interventions for individuals with T1DM of all ages and calls upon the medical community to help foster more attention and research on TCR for T1DM.

The effectiveness of non-invasive brain stimulation in treatment of major depressive disorder (MDD): a systematic review and transfer analysis.

This study aimed to analyze the transferability of non-invasive brain stimulation (NIBS) interventions in individuals with major depressive disorder (MDD) based on the FIELD model (Function, Implementation, Ecology, Level, and Duration), encompassing function, implement, ecology, level, and duration. A systematic search of electronic databases yielded a total of 21 eligible studies, comprising 12 transcranial direct current stimulation (tDCS) and 9 transcranial magnetic stimulation (TMS) trials, involving 1029 individuals with MDD. The meta-analysis of effect sizes revealed positive transfer effects across all domains of the FIELD model, suggesting that NIBS interventions have potential efficacy in improving various facets of MDD. The subgroup analysis highlighted that bilateral dlPFC stimulation exhibited the highest effect size for transferability, indicating greater transferability for rTMS, a higher dose of stimulation, and the integration of additional interventions. Additionally, the study discusses the implications of bilateral dorsolateral prefrontal cortex (dlPFC) stimulation and the integration of complementary therapies for optimizing treatment efficacy.

Psychological modalities for the treatment of localized provoked vulvodynia: a scoping review of literature from 2010 to 2023.

Localized provoked vulvodynia is a common sexual health condition for which there is a lack of consensus on effective management, even though it can have a significant negative impact on psychological wellbeing, sexual functioning, and quality of life for women and their partners. To map the research landscape related to the effectiveness/efficacy of psychological treatments for localized provoked vulvodynia, identify gaps, and make recommendations for future research. We used Arksey and O'Malley's approach to conducting a scoping review to identify, organize, and summarize research published between 2010 and 2023 that investigated the efficacy or effectiveness of interventions in the management of localized provoked vulvodynia. Inclusion and exclusion criteria and the search strategy were developed by subject experts in collaboration with a health sciences librarian. A PubMed search used controlled vocabulary and keyword terms relating to vulvodynia, which were then translated into other databases. Studies not published in English or French were excluded. We did not consider other subsets of vulvodynia.Articles were uploaded to Covidence, duplicates removed, and titles and abstracts screened. The remaining articles were subject to a 2-person, independent full-text review followed by a hand search of eligible articles. All intervention studies were included regardless of the study design. Study details were reported narratively and analyzed. Of the 88 included articles published between January 2010 and March 2023, 15 reported on the efficacy/effectiveness of psychological treatments for localized provoked vulvodynia, including group educational seminars, cognitive behavioral therapy, acceptance and commitment therapy, and somatocognitive therapy. Cognitive behavioral therapy was the most common form of psychological treatment studied (n = 7) with interventions for both individuals and couples. Education about the condition and the therapeutic process was a component of many interventions. Psychological therapies may be of some benefit, but only 1 RCT evaluating the efficacy of acceptance and commitment therapy appeared adequately powered to demonstrate improvement in dyspareunia. Studies sampled homogenous patient populations, primarily consisting of White, urban-dwelling, educated, partnered, heterosexual cis-women. Evidence of efficacy/effectiveness, drawn mainly from small studies, is promising and highlights opportunities for more robust studies with heterogeneous populations, more research on the role of education in treatment success, and greater attention to assessing patient-driven outcomes in partnered and unpartnered women.

The role of community health workers in re-entry of people with HIV and substance use disorder released from jail: a mixed methods evaluation of a pilot study

BackgroundIncarcerated individuals face high rates of mental illness, substance use disorders and communicable diseases including HIV, with increased health complications and mortality in the early post-release period. Multiple re-entry interventions linking justice-involved individuals to community resources via peer navigation have emerged, though limited data exist on the mechanics and personal impact of these approaches. This paper quantifies and evaluates a pilot study of a combined Community Health Worker (CHW)-re-entry intervention for individuals released from jail who use substances and have HIV to inform future large-scale applications.MethodsA mixed-methods analysis of a CHW-re-entry intervention utilized in a pilot randomized controlled trial involving people with HIV who have a history of substance (stimulant, opioid or alcohol) use in Dallas, TX was conducted using an explanatory sequential design. Quantitative assessments of the intervention measured interaction types, time spent, and topics discussed and explored associations between the “dose” of intervention and patient outcomes. Qualitative analyses of CHW field notes and end-of-study participant interviews were triangulated with quantitative findings to elucidate the intervention’s impact.ResultsOf the 17/31 participants assigned to the intervention, 16 interacted with the CHW on at least one occasion, and 6 successfully completed a visit with the re-entry organization. Most CHW interactions occurred by phone (66%) or in person (28%). Frequently discussed topics included substance use, housing, and physical health. On average, participants spent 7.65 h (range 0-37.18, SD = 9.33) engaged with the intervention over 6 months. Intervention dose was associated with improved HIV control, decreased stimulant use, higher rates of recidivism, and improved clinical appointment show rate. Qualitative analyses revealed key intervention components, paralleling benefits of study participation alone: outreach, nonjudgmental approach, motivation and accountability.ConclusionsA CHW-re-entry intervention, while resource-intensive, shows preliminary promise in improving HIV and some substance use outcomes. Frequent telephone and in-person contact, with an empathetic yet goal-oriented approach, fostered participant support and motivation to address HIV and substance use. Participants reported that engagement in research provided accountability and a sense of purpose. Future studies should focus on optimizing implementation of CHW-based interventions to enhance impact on vulnerable populations.

Effects of the transtheoretical model-based self-management program on behavioral change in persons with epilepsy: Study protocol for a randomized controlled trial.

Self-management applications are cost-effective and scalable for epilepsy treatment. However, there is a limited long-term quantitative evidence regarding their effectiveness. The Transtheoretical Model (TTM) offers a psychological framework that tailors self-management plans to the individual's stage of behavioral change. This approach aims to address utilization needs, reduce information overload, minimize the adverse effects of self-management, and enhance the overall effectiveness of interventions for individuals with epilepsy. This will be a randomized, double-blind, the clinical trial involving two groups of adults diagnosed with epilepsy. In addition to treatment as usual (TAU), the intervention group will receive an intervention program constructed from TTM combined with self-management as part of the treatment plan. The control group will receive TAU only. Prior to the intervention, the participants will undergo an initial assessment to determine their current stage of behavioral change to facilitate the implementation of targeted behavior support strategies. Additionally, participants will receive weekly 30-minute educational videos on epilepsy. The goal is to enroll 160 adults who have been diagnosed with epilepsy for at least six months and are receiving medication. Data collection will encompass an assessment of C-ESMS, HADS, QOLIE-31, and LSSS. These parameters will be evaluated at baseline, as well as during follow-up periods at 1, 3, and 6 months post-intervention. Existing self-management interventions for people with epilepsy primarily focus on knowledge and psychological factors. Discrepancies in research design, intervention plans, and patient characteristics have contributed to inconsistent outcomes in previous studies. This study seeks to advance the field by integrating the TTM with empirically supported self-management practices. The delineation of behavioral change stages within the TTM framework is expected to form a structured intervention protocol. This study will inform standardized, evidence-based epilepsy care practices.

Feasibility study of the psychosocial effects of an online mindfulness intervention in children and adolescents with achondroplasia and their parents

IntroductionAchondroplasia is a common skeletal dysplasia caused by a mutation in the FGFR3 gene, leading to disproportionate short stature and various clinical features. Despite the absence of definitive pharmacological treatments, mindfulness-based interventions may offer psychosocial benefits for affected individuals and their families. ObjectivesThis study aimed to assess the feasibility and psychosocial effects of an online mindfulness intervention for children and adolescents with achondroplasia and their parents. MethodologyThe intervention was an eight-week, synchronous online program with 15 participants: seven children and adolescents with achondroplasia and eight parents. Quantitative outcomes were assessed pre-and post-intervention using the State-Trait Anxiety Inventory for Children (STAIC) and the Multifactorial Self-Assessment Child Adaptation Test (TAMAI) for the younger participants, along with the Brief Symptom Inventory (BSI-18) for parents. Participant satisfaction was assessed using a customized survey, and qualitative data were collected through semi-structured interviews. ResultsThe study demonstrated high feasibility, with 84.61% adherence and 93.75% participant satisfaction. Average anxiety levels decreased in children and adolescents (30.60 ± 5.12 to 26.80 ± 6.94, p = .285) and parents (3.67 ± 3.98 to 1.00 ± .89, p = .066). Emotional regulation was the most reported improvement category by children and adolescents (31.4%), while general well-being was the most noted by parents (29.63%). ConclusionsThe results support the feasibility of this online mindfulness intervention for individuals with achondroplasia and their parents, indicating benefits for psychosocial well-being. Future studies should address these limitations by expanding sample sizes, exploring hybrid intervention models, and ensuring data anonymity. Integrating mindfulness into comprehensive psychosocial care strategies could enhance the quality of life for these populations.

Effect of Cochlear Implantation on Air Conduction and Bone Conduction Elicited Vestibular Evoked Myogenic Potentials-A Scoping Review.

Background/Objectives: Cochlear implantation (CI) is an effective intervention for individuals with severe to profound hearing loss; however, it may impact vestibular function due to its proximity to related anatomical structures. Vestibular evoked myogenic potentials (VEMPs) assess the function of the saccule and utricle, critical components of the vestibular system. This review examines CI's impact on air conduction (AC) and bone conduction (BC) VEMP responses. Methods: A scoping review was conducted following PRISMA guidelines, using databases such as Medline, Embase, Cochrane Library, Scopus, and ProQuest Dissertations. Studies reporting on AC and/or BC-VEMP in CI recipients were included. Data extraction focused on VEMP response rates, amplitudes, and latencies pre- and post-CI. Risk of bias/quality assessment was performed using the Newcastle-Ottawa Scale. Results: Out of 961 studies identified, 4 met the inclusion criteria, encompassing a total of 245 CI-implanted ears. Results indicated that AC-VEMP responses were often reduced or absent post-CI, reflecting the influence of surgical changes in the middle ear mechanics rather than otolith dysfunction. In contrast, BC-VEMP responses were more consistently preserved, suggesting that BC stimuli bypass the middle ear and more accurately delineate otolith function. Variations in VEMP outcomes were noted depending on the surgical approach and individual patient factors. Conclusions: CI impacts vestibular function as measured by VEMP, with AC-VEMP showing greater susceptibility to postoperative changes compared to BC-VEMP. The presence of preserved BC-VEMP alongside absent AC-VEMP underscores the need to differentiate between these measures in assessing vestibular function.

Relationship between trajectory of Chinese visceral adiposity index and risk of type 2 diabetes mellitus: Evidence from the China-PAR project.

This study aimed to identify the distinct change trajectories of the Chinese visceral adiposity index (CVAI) over time and to investigate their associations with risk of type 2 diabetes mellitus (T2DM). This study included 52 394 participants from the prospective project, the Prediction for Atherosclerotic Cardiovascular Disease Risk in China (China-PAR). The CVAI was calculated using measures of age, body mass index, waist circumference, triglycerides and high-density lipoprotein cholesterol. Latent mixture modelling was conducted to fit distinct trajectory patterns. The logistic regression model was applied to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the risk of T2DM with various CVAI trajectory patterns. Four distinct CVAI trajectory patterns were identified: low-increasing, moderate-increasing, moderate high-increasing and high-increasing. Compared with low-increasing CVAI, participants with moderate-increasing (OR 1.73, 95% CI 1.49-2.00), moderate high-increasing (3.48, 3.01-4.03) and high-increasing CVAI (5.50, 4.67-6.47) had a significantly increased risk of T2DM. Similar trajectory patterns were identified in both men and women. The ORs (95% CI) for moderate-increasing, moderate high-increasing and high-increasing groups were 3.28 (2.56-4.19), 7.85 (6.09-10.13) and 13.21 (9.98-17.49) in women respectively, and 1.20 (0.99-1.45), 2.18 (1.82-2.62) and 3.60 (2.93-4.43) in men respectively, when compared to the low-increasing CVAI group. Further, significant effect modifications for age, smoking and physical activity (all Pinteraction <0.05) were observed in the relationship between CVAI trajectory patterns and T2DM. Initially high and persistently elevated CVAI is significantly associated with an increased risk of T2DM, with a particular focus on women, younger people, nonsmokers and physically inactive individuals. Continuous monitoring of CVAI levels will benefit effective identification, early intervention and management of individuals at high risk of T2DM.

Within-person relationships between catastrophizing and pain intensity during a mind-body intervention to prevent persistent pain and disability after acute traumatic orthopedic injury

Interventions aimed at preventing chronic pain after acute traumatic injury have significant potential to reduce healthcare expenditures and improve quality of life for millions of individuals. Given recent development of such interventions, limited research has examined mechanisms of change using repeated measures (e.g., session-by-session assessments). This study examines within-person relationships between pain catastrophizing and intensity during and after a four-session mind-body intervention for individuals with acute traumatic orthopedic injury (N = 76, T = 445). Random intercept cross-lagged panel models were used to examine within-person autoregressive, contemporaneous, and cross-lagged effects between pain catastrophizing and pain intensity, after accounting for stable between-person differences. Our primary hypothesis that improvements in catastrophizing would be associated with subsequent reductions in pain intensity was partially supported by a significant within-person cross-lagged effect between catastrophizing at post-test and pain with activity reported at three-month follow-up (β = 0.421, SE = 0.099, p < .001). Improvement in catastrophizing was also associated with same-session improvement in pain intensity midway through the intervention. Importantly, bidirectional within-person analyses allowed us to rule out the possibility that improvements in pain were responsible for subsequent improvements in catastrophizing, but not vice versa. Together, these findings suggest improvements in catastrophizing during psychosocial intervention may prevent transition from acute to chronic pain after injury. Future research with larger between-person sample sizes, more frequent within-person assessment, and comparable control group data is necessary to facilitate greater understanding of psychosocial mechanisms for preventing chronic pain after injury. PerspectiveThis study examines within-person relationships between pain catastrophizing and intensity during and after a four-session mind-body intervention to prevent persistent pain after acute traumatic orthopedic injury. Improved catastrophizing at post-test was associated with reduced pain with activity at three-month follow-up. Within-person analyses enhance understanding of psychosocial mechanisms for preventing chronic pain after injury.

Impact of baseline dietary quality on the efficacy of a dietitian-guided weight reduction program

AimThis pre-post intervention study aimed to assess the relationship between baseline dietary quality and the efficacy of a dietitian-guided weight reduction program, which has not been thoroughly documented to date.MethodsNinety-two consecutive obese or overweight patients visiting a tertiary center clinic for weight reduction were enrolled in this study. Participants received a dietitian-guided weight reduction education program aimed at reducing daily caloric intake by 500 kcal and improving adherence to the Mediterranean diet for 3 months. Baseline dietary quality was assessed using the 14-item Taiwanese Mediterranean Diet Adherence Screener (T-MEDAS), where a higher T-MEDAS score reflects greater adherence to the Mediterranean diet. Additional covariates, including dietary behaviors, lifestyle factors, and comorbidities were also recorded. The primary outcome was the percentage of weight reduction at 3 months, analyzed using restricted cubic spline models and generalized estimating equations (GEE) to account for the correlation between weight change and the baseline T-MEDAS scores.ResultsThirty-nine participants were excluded due to major illnesses, use of anti-obesity medications, or loss to follow-up. Among the remaining 53 participants (mean age 41.2 ± 12.8 years, 56.6% female), the average weight reduction was 3.9 ± 3.3% from a baseline weight of 98.5 ± 12.8 kg. Participants who did not achieve a weight reduction of more than 5% had higher baseline T-MEDAS scores compared to those who did (5.4 ± 1.7 vs. 4.1 ± 1.8, p = 0.026). A restricted cubic spline model, adjusted for covariates including age, gender, diabetes mellitus (DM), dyslipidemia, and smoking, revealed a significant inverse relationship between higher baseline T-MEDAS scores and weight loss. After controlling for various confounders, GEE analysis demonstrated that higher baseline T-MEDAS scores were significantly associated with less weight loss (beta: -4.1, 95% CI: -5.6 to -2.6, p < 0.001).ConclusionsHigher baseline dietary quality was associated with reduced effectiveness of a dietitian-guided weight reduction program. This suggests that additional strategies may be required to improve the success of weight loss interventions in individuals with higher baseline dietary quality.

Impact of a digital relationship intervention for jailed individuals.

Not surprisingly, incarceration's extreme separation and stress have significant negative effects on romantic relationships. Unfortunately, few programs have been developed to improve jailed individuals' romantic relationship with their non-incarcerated partner. The present study investigated the effectiveness of the individual version of the digital OurRelationship program for incarcerated individuals. The current study is a program evaluation of services provided by PayTel Inc. (a provider of eLearning and communication devices in US jails) between June 2020 and November 2021. Of the 5411 individuals in a romantic relationship who started the program, 3034 completed it. Following completion of the program, 78% reported feeling "Mostly" or "Very Satisfied" with the program, and 77% reported "Slight" to "Strong" agreement that their relationship benefited from the program. Individuals' relationship confidence (d = 0.36) and relationship knowledge (d = 0.33) significantly improved during the program. Women and Latino/Hispanic and Asian/PI individuals experienced the largest pre-post gains in relationship functioning. Furthermore, racial/ethnic minority groups tended to report higher satisfaction with the program. Overall, the high rates of program satisfaction and significant pre-post changes-combined with their reduced barriers to dissemination-support the delivery of digital relationship programs for jailed individuals interested in strengthening their relationship.

Anti-saccade can be used as a screening tool for early cognitive impairment: a correlation study based on anti-saccade parameters and cognitive function.

Eye movement tasks, especially anti-saccade tasks, have been used to assess cognitive function in patients with neuropsychiatric disorders. Although it has been shown that individuals with cognitive impairment perform worse on anti-saccades tasks, there is a lack of systematic evaluation of the sensitivity of parameters of anti-saccades to assess different subtypes of cognitive impairment. A total of 158 participants were enrolled in this study, consisting of 66 men and 92 women, with an average age of 50.2 ± 10 years. The comparison of pro-saccade reaction time, anti-saccade reaction time, and error rates in the saccade task between individuals with cognitive impairments and a normal group was conducted. Furthermore, we systematically analyzed the correlations between the performance in neurological function tests (Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Stroop) and these anti-saccade parameters. Especially, the correlation between these parameters and cognitive function in different domains of the MoCA task were also evaluated. The pro-saccade reaction time, anti-saccade reaction time and error rate were negatively correlated with the MMSE and MoCA scores (P < 0.001), and positively correlated with the time used in Stroop tasks. Among them, the error rate had the strongest correlation with the performance of MMSE, MoCA and Stroop tasks (MoCA: P < 0.0001, r2 = -0.608; MMSE: P < 0.0001, r2 = -0.344; Stroop: P < 0.0001, r2 = 0.455). Among the seven cognitive domains examined by the MoCA task, error rates had relatively high correlations with visuospatial/executive (P < 0.0001, r2 = -0.4660) and delayed recall (P < 0.0001, r2 = -0.4228) compared to naming, language (P = 0.0004, r2 = -0.0788), attention (P = 0.0004, r2 = -0.0780), abstraction (P < 0.0001, r2 = -0.1515), orientation (P < 0.0001, r2 = -0.1075). Moreover, pro-saccade reaction time, anti-saccade reaction time and error rate of people with high MoCA scores were significantly higher than those of people with low MoCA scores, which can be used to identify people with mild cognitive impairment. Our study's results provide valuable clinical evidence supporting the effectiveness of anti-saccades in assessing cognitive impairment, which is beneficial for screening and timely clinical intervention in individuals with specific cognitive impairment.