Long-term Studies Research Articles

Evaluation of mandibular condyle position in Class III patients after bimaxillary orthognathic surgery: A cone-beam computed tomography study.

This retrospective study evaluated the mandibular condyle position before and after bimaxillary orthognathic surgery performed with the mandibular condyle positioned manually in patients with mandibular prognathism using cone-beam computed tomography. Overall, 88 mandibular condyles from 44 adult patients (20 female and 24 male) diagnosed with mandibular prognathism due to skeletal Class III malocclusion who underwent bilateral sagittal split ramus osteotomy (BSSRO) and Le Fort I performed using the manual condyle positioning method were included. Cone-beam computed tomography images obtained 1-2 weeks before (T0) and approximately 6 months after (T1) surgery were analyzed in three planes using 3D Slicer software. Statistical significance was set at P < 0.05 level. Significant inward rotation of the left mandibular condyle and significant outward rotation of the right mandibular condyle were observed in the axial and coronal planes (P < 0.05). The positions of the right and left condyles in the sagittal plane and the distance between the most medial points of the condyles in the coronal plane did not differ significantly (P > 0.05). While the change in the sagittal plane can be maintained as before surgery with manual positioning during the BSSRO procedure, significant inward and outward rotation was observed in the axial and coronal planes, respectively, even in the absence of concomitant temporomandibular joint disorder before or after the operation. Further long-term studies are needed to correlate these findings with possible clinical consequences.

The majority of patients report satisfaction more than 24years after temporomandibular joint discectomy.

To retrospectively evaluate long-term outcomes after temporomandibular joint (TMJ) discectomy. Included patients (n = 64) had undergone discectomy during 1989-1998 at Umeå University Hospital. A questionnaire was used to evaluate pre- and postoperative symptoms, postoperative complications, general pain, and subjective opinion about the outcome of the surgery. The results are based on responses from 47 patients (40 women/7 men), including 36 (30 women/6 men) who completed the questionnaire and 11 (10 women/1 man) who were contacted by telephone and answered selected questions. Seventeen patients were excluded because of death, a move abroad, declining to participate, or no available patient information. Among the respondents, 41 (87%) were satisfied with the results, five (11%) were unsatisfied, and one (2%) patient did not answer the question. The results showed a significant long-term improvement in locking, clicking/crepitation, and pain when chewing or opening the jaw (p = 0.001). The prevalence of headaches had decreased significantly at follow-up (p = 0.001). Reported impaired jaw-opening capacity showed no significant improvement (p = 0.08). Of the 47 respondents, 19(40%) had asked for additional treatment after the discectomy, and six of the 19 patients (13%) had undergone more surgery of the joint. The results of this retrospective long-term follow-up study indicate that TMJ discectomy has a high success rate, as most patients were satisfied with the postoperative results. Discectomy is thus an effective surgical intervention for patients with disabling TMJ pain and dysfunction when conservative interventions have been unsuccessful.

Vitamin D deficiency and effect of treatment on seizure frequency and quality of life parameters in patients with drug-resistant epilepsy: A randomized clinical trial.

This study was undertaken to assess the effect of treatment of vitamin D deficiency in drug-resistant epilepsy. We conducted a multicenter, double-blind, placebo-controlled, randomized clinical trial, including patients aged ≥15 years with drug-resistant focal or generalized epilepsy. Patients with 25-hydroxyvitamin D (25[OH]D) < 30 ng/mL were randomized to an experimental group (EG) receiving vitamin D3 (cholecalciferol, 100 000 IU, five doses in 3 months) or a control group (CG) receiving matched placebo. During the open-label study, EG patients received 100 000 IU/month for 6 months, whereas CG patients received five doses in 3 months then 1/month for 3 months. Monitoring included seizure frequency (SF), 25(OH)D, calcium, albumin, creatinine assays, and standardized scales for fatigue, anxiety-depression, and quality of life (Modified Fatigue Impact Scale [M-FIS], Hospital Anxiety and Depression Scale, Quality of Life in Epilepsy [QOLIE-31]) at 3, 6, and 12 months. The primary efficacy outcome was the percentage of SF reduction compared to the reference period and CG at 3 months. Secondary outcomes were SF and bilateral tonic-clonic seizure (BTCS) reduction, scale score changes, and correlations with 25(OH)D during the follow-up. Eighty-eight patients were enrolled in the study (56 females, aged 17-74 years), with median baseline SF per 3 months = 16.5 and ≥2 antiseizure medications in 88.6%. In 75 patients (85%), 25(OH)D was <30 ng/mL; 40 of them were randomly assigned to EG and 34 to CG. After the 3-month blinded period, SF reduction did not significantly differ between groups. However, during the open-label period, SF significantly decreased (30% median SF reduction, 33% responder rate at 12 months). BTCSs were reduced by 52%. M-FIS and QOLIE-31 scores were significantly improved at the whole group level. SF reduction correlated with 25(OH)D > 30 ng/mL for >6 months. Despite no proven effect after the 3-month blinded period, the open-label study suggests that long-term vitamin D3 supplementation with optimal 25(OH)D may reduce SF and BTCSs, with a positive effect on fatigue and quality of life. These findings need to be confirmed by further long-term studies. ClinicalTrials.gov identifier: NCT03475225 (03-22-2018).

Advances in clinical research on ultrasound-guided radiofrequency ablation for papillary thyroid microcarcinoma

Ultrasound-guided radiofrequency ablation (RFA) emerges as a minimally invasive strategy for papillary thyroid microcarcinoma (PTMC), offering advantages over traditional surgical approaches. RFA employs high-frequency electric currents under precise ultrasound guidance to ablate cancerous tissue. Clinical trials consistently demonstrate RFA’s efficacy in tumor control and patient-reported outcomes. However, long-term studies are essential to validate its durability and monitor for potential complications. Collaborative efforts among various medical disciplines ensure procedural accuracy and comprehensive postoperative care. Technological innovations, such as enhanced ultrasound imaging and temperature control, promise to refine RFA’s precision and effectiveness. Nevertheless, challenges persist, including the need for standardized protocols and comparative studies with traditional treatments. Future research should focus on long-term outcomes, patient selection criteria, and optimization of procedural techniques to solidify RFA’s role in PTMC management. RFA presents a promising avenue for PTMC treatment, warranting further investigation and refinement in clinical practice.

Effects of Immersive Technology-based Education for Undergraduate Nursing Students: A Systematic Review and Meta-Analysis using the GRADE approach.

The adoption of immersive technology in simulation-based nursing education has grown significantly, offering a solution to resource limitations and enabling safe access to clinical environments. Despite its advantages, there are still diverse reports regarding the effectiveness of immersive technology. It is crucial to verify the effectiveness of immersive technology in nursing education to inform future educational programs. This systematic review aimed to identify the contents of immersive technology-based education for undergraduate nursing students and evaluate the effectiveness of immersive technology compared to traditional teaching methods. A literature search was performed using four databases: PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase, and Web of Science, with the latest search completed on January 19, 2023. The inclusion criteria were as follows: participants were undergraduate nursing students; studies were published in Korean or English; designs included randomized controlled trials (RCTs) or non-randomized studies; and interventions involved virtual reality (VR), augmented reality (AR), mixed reality (MR), or extended reality (XR). Quality assessment was conducted using Version 2 of the Cochrane risk of bias tool (RoB 2) for RCTs and the Risk of Bias Assessment Tool for Non-Randomized Studies (RoBANS). The main outcomes of the included studies were classified according to the New World Kirkpatrick Model (NWKM), ranging from Level 1 (Reaction) to Level 4 (Results). Meta-analysis was conducted using RevMan 5.4 software, and subgroup analysis was conducted due to heterogeneity of the results of meta-analysis. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach was adopted for assessing certainty and synthesizing results of the relevant literature. A total of 23 studies were included, with participants numbers ranging from 33 to 289. Nineteen studies adopted VR to simulate various nursing scenarios, including disaster training, resuscitation, health assessments, and home healthcare. Four studies utilized AR technologies. Fifteen studies involved virtual patients in their scenarios. Based on NWKM, the main outcome variables were classified as Level 1 (usability and satisfaction), Level 2 (knowledge, motivation, confidence, performance, attitude, and self-efficacy), and Level 3 (clinical reasoning). Level 4 outcomes were not found in selected studies. Results of the subgroup analysis of meta-analysis showed that immersive technology-based nursing education was more effective than traditional education on knowledge attainment (standard mean difference (SMD)=0.59, 95% confidence interval (CI)=0.28-0.90, P<.001, I2=49%). Additionally, there were significant difference differences between the experimental groups and the control groups in confidence (SMD=0.70, 95% CI= 0.05-1.35, P=.03, I2=82%), and self-efficacy (SMD=0.86, 95% CI= 0.42-1.30; P<.001, I2=63%). These findings support the effectiveness of immersive technology-based education for undergraduate nursing students, despite heterogeneity in methods and interventions. We suggest that long-term cohort studies should be conducted to evaluate the effects of immersive technology-based nursing education on the NWKM Level 4.

Use and Design of Virtual Reality-Supported Learning Scenarios in the Vocational Qualification of Nursing Professionals: Scoping Review.

Numerous reviews advocate using virtual reality (VR) in educational contexts. This medium allows learners to test experiences in realistic environments. Virtually supported scenarios offer a safe and motivating way to explore, practice, and consolidate nursing skills in rare and critical nursing tasks. This is also cited as one of the reasons why VR can significantly increase the knowledge acquisition of nursing students. Nevertheless, studies are limited in their significance owing to the chosen design. Despite great interest, this results in a low level of confidence in VR as a curricular teaching method for nursing education. Therefore, defining concrete design and didactic-methodological parameters that support teachers in the use and implementation of VR is more relevant. This scoping review aims to provide an overview of significant design aspects for VR scenario conception and its transfer to generalist nursing education to generate value for the development of teaching scenarios and their sustainable implementation in teaching. A comprehensive literature search was performed using the MEDLINE (via PubMed) and CINAHL databases, and the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) checklist was applied. The search was conducted from May to July 2022, using a specific search principle corresponding to the focus and the growing study corpus. A previously defined "population, concept, and context" scheme was employed as the basis for the double-blind review of all relevant international German and English publications released up to May 1, 2022. In accordance with the predefined selection procedure, 22 publications were identified. The identified aspects aided in the development of design, didactic, and research recommendations. The intuitive operation of realistically designed VR scenarios, which are standardized, reliable, and modifiable, as well as clear instructions and specific multimodal feedback functions were described positively. The same applied to the linear structure of the sequences with graduated demands and high image quality for increased immersion with low sensory overload. Changes in perspectives, multiuser options, dialogs, and recording functions can contribute to an interactive care practice. On the research side, it is advisable to define VR terminologies. In addition to considering larger samples, varying settings, and financial issues, it is recommended to conduct long-term studies on knowledge acquisition or improved patient outcomes. VR scenarios offer high potential in the context of nursing education if teachers and learners develop them co-creatively according to design features and implement them by means of a well-conceived concept. VR enables trainees to develop practical skills continuously in a standardized way. In addition, its deployment supports the sensitization of trainees to digital nursing technologies and the expansion of their digital skills in a practical setting. Furthermore, it allows sustainability issues to be addressed.

Impact of lifestyle interventions targeting physical activity and healthy diet on treatment of Obstructive Sleep Apnea (OSA)

Introduction and purpose: Obstructive Sleep Apnea Syndrome (OSAS) is a worldwide prevalent sleep-related medical condition characterised by upper airway collapse, leading to hypoxia and hypercapnia. Excess body weight is the risk factor of OSAS. Lifestyle interventions, particularly targeting weight loss, have emerged as potential management strategies for OSAS. The purpose of this review is to compile the information about the effectiveness of different forms of lifestyle interventions in the treatment of OSA. Brief description of the state of knowledge: While CPAP remains the current “gold standard” treatment of Obstructive Sleep Apnea, it’s not always well-tolerated. Consequently, lifestyle interventions such as dietary modifications, exercise programs, and behavioural therapies have emerged as important components in the management of this disease. The research has shown that these strategies not only reduce the severity of OSA but also improve quality of life. Summary: Lifestyle interventions, including dietary modifications, exercise programs, and behavioral therapies targeting weight loss, have demonstrated promising results in reducing the severity of obstructive sleep apnea (OSA) and alleviating associated symptoms. However, further large-scale, long-term studies are necessary to validate their efficacy and understand their broader impact on OSA management.

Radon Dynamics in Granite and Calcareous Soils: Long-Term Experiments in a Semi-Arid Context

Radon in soil poses a significant health risk when it accumulates inside dwellings. The estimation of radon potential is a difficult task due to the complex dynamics of radon within soil and its relations with the weather. This research focuses on the variability of radon activity, driven by environmental changes, assessed in two loam soils (loamy sand–granite soil and silty clay loam-calcareous soil) with different radium contents. We conducted an experiment with teow soil columns in a semi-controlled outdoor laboratory, in a warm semi-arid climate. We also examined the consequences of abundant rainfall on radon activity through artificial soil water content (SWC) experiment conditions. Statistical analyses reveal that SWC is the most significant parameter influencing radon activity in these experiments. Radon is proportional to SWC and inversely proportional to temperature, evapotranspiration, and pressure in both soils, while wind is negatively related only in the loamy sand soil. Based on our findings, we modelled radon potential considering different soils and climatic contexts. SWC influences radon potential by changing radon emanation, activity, and permeability, depending on the local soil texture and radium concentration.

Efficacy and safety of BaitouWeng decoction for ulcerative colitis: A meta-analysis of randomized and controlled trials.

To systematically evaluate the therapeutic effect of BaitouWeng Decoction in patients with ulcerative colitis (UC), evaluate its safety and effectiveness, and provide a reference for clinical medication. The research literature on the treatment of UC with BaitouWeng Decoction was searched in databases such as China National Knowledge Infrastructure, Wanfang Data, VIP database for Chinese Technical Periodicals, Chinese BioMedical Literature Database, and PubMed. The literature was screened by setting inclusion and exclusion criteria, strictly following the inclusion and exclusion criteria, and following the search strategy for literature screening, data extraction, and methodological quality evaluation. According to the Cochrane System Evaluation Manual, methodological quality evaluation was conducted on the included studies using the bias risk assessment tool for randomized controlled trials. For meta-analysis, Review Manager software was used. A total of 24 articles were included, including 2131 patients. Meta-analysis showed that compared with conventional Western medicine, BaitouWeng Decoction can significantly improve the effective rate (odds ratio = 5.10, 95% confidence interval [CI] [3.74-6.96], P < .00001), reduce the traditional Chinese medicine syndrome score (mean difference [MD] = -4.23, 95% CI [-5.17--3.30], P < .00001), Baron endoscopic score (MD = -0.68, 95% CI [-0.78--0.58], P < .00001), and intestinal lesion activity score (MD = -2.29, 95% CI [-1.15--1.03], P < .00001); improve serum factors and reduce serum tumor necrosis factor α levels (MD = -16.84, 95% CI [-19.92--13.76], P < .00001), serum interleukin-8 levels (MD = -10.41, 95% CI [-10.87--9.95], P < .00001), and increased serum interleukin-10 levels (MD = 4.96, 95% CI [2.76-7.16], P < .00001). BaitouWeng Decoction has good efficacy and safety in treating UC. BaitouWeng Decoction improved the symptoms of colitis injury and inhibited inflammatory response. However, more rigorously designed randomized controlled trials with blinding, concealment, and placebo controls should be conducted on Baitouweng decoction to generate higher quality evidence and longer-term studies on sustained benefits are needed.

Carbon-phosphorus cycle models overestimate CO2 enrichment response in a mature Eucalyptus forest.

The importance of phosphorus (P) in regulating ecosystem responses to climate change has fostered P-cycle implementation in land surface models, but their CO2 effects predictions have not been evaluated against measurements. Here, we perform a data-driven model evaluation where simulations of eight widely used P-enabled models were confronted with observations from a long-term free-air CO2 enrichment experiment in a mature, P-limited Eucalyptus forest. We show that most models predicted the correct sign and magnitude of the CO2 effect on ecosystem carbon (C) sequestration, but they generally overestimated the effects on plant C uptake and growth. We identify leaf-to-canopy scaling of photosynthesis, plant tissue stoichiometry, plant belowground C allocation, and the subsequent consequences for plant-microbial interaction as key areas in which models of ecosystem C-P interaction can be improved. Together, this data-model intercomparison reveals data-driven insights into the performance and functionality of P-enabled models and adds to the existing evidence that the global CO2-driven carbon sink is overestimated by models.

Prospective Clinical Trial Demonstrating the Efficacy of Hyaluronic Acid Filler for the Improvement of Atrophic Facial Scars up to 2 years.

Hyaluronic acid (HA) filler longevity has been studied for wrinkles. However, its long-term use for treating atrophic facial scars has not yet been analyzed in long-term prospective studies. Analyze the safety and duration of a HA filler for the use in atrophic scars. Fifteen subjects received VYC-17.5L in atrophic scars on 1 randomized cheek and saline on the other, with 1 optional touch-up treatment and crossover after the short-term trial. Grading for this long-term extension was done on Day 720, using the Global Aesthetic Improvement Scale (GAIS) and the Quantitative Global Scarring Grading System. On Day 720, a live blind evaluator rated the VYC-17.5L assigned side as having significant reduction in scar severity (-7.2 [t(22) = -6.01, p = .00009]) and number of scars (-8.8 [t(22) = -6.25, p = .00006]) as compared with baseline. There was no significant difference in the results from Day 120 to Day 720. Ninety-two percent (11/12) of subjects reported improvement (GAIS), were satisfied with the treatment, thought it looked natural, and had fewer side effects than expected. There were no persistent or late-onset side effects. VYC-17.5L improved rolling atrophic facial scars, and the results were sustained throughout the 2-year trial without side effects.

A 10-Year Longitudinal Study of Brain Cortical Thickness in People with First-Episode Psychosis Using Normative Models.

Clinical forecasting models have potential to optimize treatment and improve outcomes in psychosis, but predicting long-term outcomes is challenging and long-term follow-up data are scarce. In this 10-year longitudinal study, we aimed to characterize the temporal evolution of cortical correlates of psychosis and their associations with symptoms. Structural magnetic resonance imaging (MRI) from people with first-episode psychosis and controls (n = 79 and 218) were obtained at enrollment, after 12 months (n = 67 and 197), and 10 years (n = 23 and 77), within the Thematically Organized Psychosis (TOP) study. Normative models for cortical thickness estimated on public MRI datasets (n = 42 983) were applied to TOP data to obtain deviation scores for each region and timepoint. Positive and Negative Syndrome Scale (PANSS) scores were acquired at each timepoint along with registry data. Linear mixed effects models assessed effects of diagnosis, time, and their interactions on cortical deviations plus associations with symptoms. LMEs revealed conditional main effects of diagnosis and time × diagnosis interactions in a distributed cortical network, where negative deviations in patients attenuate over time. In patients, symptoms also attenuate over time. LMEs revealed effects of anterior cingulate on PANSS total, and insular and orbitofrontal regions on PANSS negative scores. This long-term longitudinal study revealed a distributed pattern of cortical differences which attenuated over time together with a reduction in symptoms. These findings are not in line with a simple neurodegenerative account of schizophrenia, and deviations from normative models offer a promising avenue to develop biomarkers to track clinical trajectories over time.

Long-term study of spatial and temporal variations in biomass burning over the Indian region using MODIS products

Long-term study of spatial and temporal variations in biomass burning over the Indian region using MODIS products

Induction cyclophosphamide with maintenance immunosuppression in high-risk myasthenia gravis: long-term follow-up and safety profile

BackgroundPatients with refractory or high-risk myasthenia gravis (MG) respond poorly to conventional immunosuppressive therapy, requiring rescue therapies and often experiencing treatment toxicity. Rescue and injectable therapies do not induce remission...

Development and validation of stability-indicating method of etrasimod by HPLC/DAD/MS/MS technique with greenness profiling

Etrasimod, a novel selective sphingosine-1-phosphate receptor modulator, was recently approved by the U.S. Food and Drug Administration and the European Medicinal Agency for the treatment of moderately to severely active ulcerative colitis in adults. In this research, the forced degradation study as an integral part of drug product and packaging development, which generates data on degradation mechanisms, is published. The development and validation of the stability-indicating method using a superior high-performance liquid chromatography technique coupled with a diode array detector and tandem mass spectrometer was performed to support the forced degradation study and monitor the formation of degradation products. Etrasimod demonstrated good stability under elevated temperature and basic stress conditions, while acidic hydrolysis, oxidative, and photolytic degradation produced eight degradation products. The knowledge of degradation products will be useful in the long-term stability study for establishing the acceptance criteria of etrasimod as a drug substance and dosage form during quality control and stability assessment. The eco-friendliness of the developed forced degradation procedure was evaluated using various greenness appraisal tools. The green metric tools showed that the forced degradation procedure obeys eco-friendly conditions.

Usefulness of Mirogabalin in Central Neuropathic Pain After Stroke: Post Hoc Analysis of a Phase3 Study by Stroke Type and Location.

Central post-stroke pain (CPSP) is a common type of central neuropathic pain (CNeP) that can occur following the onset of stroke. The oral gabapentinoid mirogabalin besylate (mirogabalin) is a selective α2δ ligand that is effective for the treatment of CNeP, including CPSP. However, it is unknown whether the analgesic effect of mirogabalin on CPSP varies in patients with different background factors. This was a post hoc subgroup analysis of a multinational, open-label, long-term phase3 study of mirogabalin for the treatment of CNeP conducted between March 2019 and December 2020. Data from patients with CPSP were stratified by type of stroke (ischemic or hemorrhagic), stroke location (thalamus, putamen, brainstem, or other), presence/absence of motor weakness, median time since stroke (≥ 59 or < 59months), and median duration of CPSP (≥ 55.5 or < 55.5months). Efficacy was assessed with the short-form McGill Pain Questionnaire (SF-MPQ), and treatment-emergent adverse events (TEAEs) and adverse drug reactions (ADRs) were recorded. This subanalysis included all 94 patients with CPSP from the phase3 study; all were Japanese, and the mean age was 65.3years. The least squares mean change [95% confidence interval] in SF-MPQ visual analog scale (VAS) score from baseline at week52 (last observation carried forward) was - 17.0 [- 22.1, - 11.9] mm. Among the subgroups, least squares mean changes in SF-MPQ VAS scores were not different. Most TEAEs were mild or moderate; severe TEAEs occurred in six patients (6.4%). Somnolence (25.5%), peripheral edema (13.8%), dizziness (11.7%), and weight gain (6.4%) were the most common ADRs, and the types and frequencies of ADRs were similar among subgroups. Mirogabalin was generally effective and well tolerated in patients with CPSP, regardless of background factors such as stroke type or location, presence/absence of motor weakness, time since stroke, and duration of CPSP. Trial registration number NCT03901352.

The burden of secrecy in the management of multimorbidity in older people living with HIV aged 70 and over

ABSTRACT The secrecy surrounding HIV continues to be a major concern for older people living with HIV (OPWH) despite their long-term experience of HIV and the presence of other chronic diseases. Our study aims to highlight how the secrecy surrounding HIV can affect the management of the other conditions. The results of this socio-anthropological sub-study of the ANRS EP66 SEPTAVIH study, which assesses frailty in OPWH, are based on in-depth interviews conducted with 20 OPWH with multimorbidities aged 70 years and over and 9 caregivers. Based on a cross-sectional thematic analysis, this study shows that HIV infection differs from other chronic diseases due to the secrecy and stigma associated with HIV. These specific issues associated with HIV complicate the lives of OPWH, depriving them of support from loved ones and forcing them to exclude their general practitioner from their care system. This then causes OPWH with multiple chronic diseases to become socially vulnerable and isolated. Interventions that support the sharing of information on HIV among OPWH and also among caregivers need to be identified as a matter of urgency in order to improve the lives and management of OPWH with multimorbidities. Trial Registration: ClinicalTrials.gov identifier: NCT03958786.

Human Factors in AI-Driven Digital Solutions for Increasing Physical Activity: Scoping Review.

Artificial intelligence (AI) has the potential to enhance physical activity (PA) interventions. However, human factors (HFs) play a pivotal role in the successful integration of AI into mobile health (mHealth) solutions for promoting PA. Understanding and optimizing the interaction between individuals and AI-driven mHealth apps is essential for achieving the desired outcomes. This study aims to review and describe the current evidence on the HFs in AI-driven digital solutions for increasing PA. We conducted a scoping review by searching for publications containing terms related to PA, HFs, and AI in the titles and abstracts across 3 databases-PubMed, Embase, and IEEE Xplore-and Google Scholar. Studies were included if they were primary studies describing an AI-based solution aimed at increasing PA, and results from testing the solution were reported. Studies that did not meet these criteria were excluded. Additionally, we searched the references in the included articles for relevant research. The following data were extracted from included studies and incorporated into a qualitative synthesis: bibliographic information, study characteristics, population, intervention, comparison, outcomes, and AI-related information. The certainty of the evidence in the included studies was evaluated using GRADE (Grading of Recommendations Assessment, Development, and Evaluation). A total of 15 studies published between 2015 and 2023 involving 899 participants aged approximately between 19 and 84 years, 60.7% (546/899) of whom were female participants, were included in this review. The interventions lasted between 2 and 26 weeks in the included studies. Recommender systems were the most commonly used AI technology in digital solutions for PA (10/15 studies), followed by conversational agents (4/15 studies). User acceptability and satisfaction were the HFs most frequently evaluated (5/15 studies each), followed by usability (4/15 studies). Regarding automated data collection for personalization and recommendation, most systems involved fitness trackers (5/15 studies). The certainty of the evidence analysis indicates moderate certainty of the effectiveness of AI-driven digital technologies in increasing PA (eg, number of steps, distance walked, or time spent on PA). Furthermore, AI-driven technology, particularly recommender systems, seems to positively influence changes in PA behavior, although with very low certainty evidence. Current research highlights the potential of AI-driven technologies to enhance PA, though the evidence remains limited. Longer-term studies are necessary to assess the sustained impact of AI-driven technologies on behavior change and habit formation. While AI-driven digital solutions for PA hold significant promise, further exploration into optimizing AI's impact on PA and effectively integrating AI and HFs is crucial for broader benefits. Thus, the implications for innovation management involve conducting long-term studies, prioritizing diversity, ensuring research quality, focusing on user experience, and understanding the evolving role of AI in PA promotion.

P-617 The investigation of the shared genetic architecture between hypothyroidism and age at menopause

Abstract Study question Is there a shared genetic architecture and a putative causal association between hypothyroidism and age at menopause (AM)? Summary answer There is a genetic correlation and a causal relationship between Hypothyroidism and AM. What is known already Thyroid disease is more common in women. The interplay between thyroid function and the gonadal axes remains interconnected throughout a woman’s reproductive cycle. Notably, the menopausal phase represents a critical period for metabolic alterations, wherein thyroid hormones and metabolic status are intricately intertwined. Study design, size, duration Data from publicly available genome-wide association study (GWAS) summary statistics of hypothyroidism (European-based: 51,194 hypothyroidism cases and 443,383 controls) and AM (European-based: N = 141,926) were used to investigate shared genetic assosiation. Participants/materials, setting, methods Shared genetics between hypothyroidism and AM were explored using linkage disequilibrium score regression, ρ-HESS, cross-trait meta-analysis, colocalization analysis and summary data-based Mendelian randomization, and investigated causal associations using Mendelian randomization. Main results and the role of chance The estimated liability scale of the single nucleotide polymorphisms (SNPs) heritability for AM and hypothyroidism was 13.0% and 5.1%, respectively. A substantial negative genetic association (rg = -0.081, P = 0.0055) was found by bivariate LDSC between hypothyroidism and AM. Local Genetic Correlations identified a strong local signal at 6p21.32-21.33 (chromosome 6: 31571218-32682664) (P = 1.39E-5). Ten important common SNPs were found. Hypothyroidism had a causal effect on AM, but not vice versa. Genetic association between hypothyroidism and AM in blood were enriched in Genotype-Tissue Expression (GTEx) data. In addition, two potentially functional genes, PPM1F and RPL23AP1, were identified to be associated with both hypothyroidism and AM. Limitations, reasons for caution Hypothyroidism encompasses primary and secondary forms, and due to limited data availability, our study could not perform phenotype-specific analyses. Second, even though our research identified genes associated with hypothyroidism and AM, more experimental research and long-term studies are required to fully understand the biological mechanisms underlying the observed genetic relationships. Wider implications of the findings Our study, thorough genome-wide cross-trait analysis, reveals a shared genetic architecture and causal relationship between hypothyroidism and AM. These may open up a new avenue for future research between hypothyroidism and AM. Trial registration number Not applicable

Drug Survival, Safety, and Effectiveness of Secukinumab for up to 5 Years in Patients with Psoriasis and Psoriatic Arthritis: A Long-Term Real-Life Experience

Introduction: the selective IL-17 inhibitor secukinumab has demonstrated efficacy and safety in the treatment of moderate–severe psoriasis in recent years. Objective: evaluate effectiveness and drug survival (DS) of secukinumab in patients with psoriasis for up to 5 years. Methods: This is a retrospective study on a monocentric cohort of patients with psoriasis on secukinumab evaluating the achievement of PASI100, PASI90, and PASI ≤ 3 and DS analysis up to 260 weeks. DS multivariate analysis was carried out considering sex, age, age of onset of the disease, obesity, cardiovascular comorbidities, diabetes, involvement of difficult-to-treat sites, psoriatic arthritis, treatment-naïve status, and mean baseline PASI. Results: At baseline, we evaluated 255 patients on secukinumab. PASI100 was reached by 41.7% and 70.6% of patients at weeks 16 and 260, respectively. PASI90 showed a similar trend with 46.5% of patients achieving it at week 16 and 88.2% at week 260. Non-obese patients showed a faster response than patients with obesity in achieving PASI100, PASI90, and PASI ≤ 3, with significant differences at 28 weeks [55% vs. 40% (p = 0.033), 64% vs. 49% (p = 0.038), and 76% vs. 62% (p = 0.036), respectively]. The estimated DS for secukinumab was 84.3% at 12 and 48% at 60 months. Obesity and smoking habits were associated with a higher risk of discontinuation in multivariate models (HR 1.6 CI 1.05–2.45, p = 0.028; HR 1.48 CI 1.01–2.17, p = 0.043, respectively). Conclusions: Secukinumab showed effectiveness for up to 5 years of treatment, with a high DS and achievement of PASI100, PASI90, and PASI &lt; 3 at these time points. Only obesity reduced the response and maintenance of DS.