Maintenance Of Status Research Articles

DOP084 Development of a core outcome set for Inflammatory Bowel Disease patients with stomas

Abstract Background A significant number of patients with Inflammatory Bowel Disease (IBD) undergo surgery resulting in a stoma. For many, an ostomy is not curative. Patients may continue to experience disease exacerbations and require continued medical therapies. Despite this, patients with IBD and stomas are excluded from clinical trials, largely due to the heterogeneity in outcomes and the lack of validated measurement tools for this cohort. The TOAST-IBD project aimed to address this issue by developing a Core Outcome Set (COS) for IBD patients with stomas. Methods A long-list of candidate outcomes was generated through a systematic review and patient focus groups. Consensus was established via a two-round Delphi process using a 9-point Likert scale based on how important candidates felt it was in determining treatment success. This was followed by a final consensus meeting. Stakeholders were recruited internationally and grouped into 4 panels (patients, specialist and research nurses, colorectal surgeons, and gastroenterologists). Participants received feedback from their panel in the first round and from all participants in the second round to allow refinement of their scores. Results A total of 68 outcomes were extracted via a systematic review of the existing literature and an additional 11 unique outcomes were added from 4 90-minute online patient focus groups. A further 9 outcomes were proposed by the study working group, generating a total of 88 outcomes to be included in the voting process. 76 stakeholders (73.1% response rate) from 17 countries carried forward 37 outcomes through a two-round Delphi process. The final consensus meeting of 37 experts and patients agreed on a six domain COS. The COS included the maintenance of hydration and volume status, the maintenance of nutritional status, symptom-based clinical activity, objective marker-based disease activity and two quality of life (QOL) domains (IBD-related QOL and stoma-specific QOL). Adverse effects from treatment did not reach a consensus to be included in the core outcome set but was considered important to be captured where applicable. Conclusion An IBD Stoma COS has been produced by all key stakeholders. This COS will serve as the foundation for development of relevant measurement instruments for IBD patients with stomas so as to include this underrepresented cohort in future clinical trials.

P0407 Use of social listening to explore diet-related commentary from Inflammatory Bowel Disease social media groups

Abstract Background People with inflammatory bowel disease (IBD) desire dietary information1 and use social media to fill the information gap.2 We aimed to capitalise on the large volume of commentary available in social media groups to determine frequently asked dietary questions and nutrition-related topics regarding this condition, utilising the Chat Generative Pre-trained Transformer 4 model (ChatGPT-4) to facilitate social listening analysis. Methods Following ethical guidelines and the approval of Facebook group administrators, social listening techniques were used to extract 11,945 online community comments (2021-2023). All data was deidentified and cleaned according to ethical standards, ensuring only context-specific comments were included for analysis. The data was analysed using content and thematic analysis and ChatGPT-4. Duplicate thematic analysis explored the meaning of the comments. The ChatGPT-4 large language model was trained on 10% of manually coded data using the few-shot learning technique.3 Results from both manual and ChatGPT-4 coding were manually reviewed for congruence to ensure the model’s analysis was suitable and could then be applied to all data. Results Moderate percentage agreement existed between manual and model coded data (75%). Medical therapy (31.2%) and diet-related comments (37.5%) dominated the conversations. A total of 350 unique diet-related queries emerged. Content analysis of these indicated the most commonly mentioned diet-related topics were management of gastrointestinal/extraintestinal symptoms (37.8%), natural therapies/dietary approaches to manage symptoms (20%) and maintenance of nutritional status (5.6%). Thematic analysis indicated five interrelated themes: desire for support and connection; exasperation and desire for information; open to considering advice from non-experts; desire for food to be thy medicine and IBD holds me back. Conclusion Using ChatGPT-4-enabled social listening of IBD Facebook groups, verified with traditional qualitative techniques, improved efficiency in handling large volumes of qualitative information and identified key dietary concerns prevalent in online discussions. Future studies should establish methodological and reporting standards for artificial intelligence-enabled social listening to ensure comparability between studies. With respect to individuals with IBD, Facebook groups provided immediate access to information and connection, compensating for the perceived lack of timely access to a knowledgeable and empathetic multidisciplinary care team. Improving access to specialized professionals, including dietitians well-versed in IBD, could reduce reliance on these platforms as a primary source of information.

Randomized trial investigating the utility of a liver tissue transcriptional biomarker in identifying adult liver transplant recipients not requiring maintenance immunosuppression.

The maintenance of stable allograft status in the absence of immunosuppression, known as operational tolerance, can be achieved in a small proportion of liver transplant recipients, but we lack reliable tools to predict its spontaneous development. We conducted a prospective, multi-center, biomarker-strategy design, immunosuppression withdrawal clinical trial to determine the utility of a predictive biomarker of operational tolerance. The biomarker test, originally identified in a patient cohort with high operational tolerance prevalence, consisted of a 5-gene transcriptional signature measured in liver tissue collected before initiating immunosuppression weaning. 116 adult stable liver transplant recipients were randomized 1:1 to either Arm A (immunosuppression withdrawal regardless of biomarker status) or Arm B (immunosuppression withdrawal in biomarker-positive recipients). Immunosuppression withdrawal was initiated in 82 participants, rejection occurred in 54 (67.5%), successful discontinuation of immunosuppression was achieved in 22 (27.5%), but only 13 (16.3%) met operational tolerance histological criteria (10 in Arm A, 3 in Arm B). The biomarker test did not yield useful information in selecting patients able to successfully discontinue immunosuppression. Operational tolerance was associated with time post-transplantation, recipient age, presence of circulating exhausted CD8+ T cells, and a reduced number of immune synapses within the graft. TRIAL REGISTRATION: ISRCTN 47808000 and EudraCT 2014-004557-14.

‘Unwilling to awaken’: The special status of the Poland-China route and Polish-Sino shipping cooperation in the early 1950s

ABSTRACT The Poland-China route, initiated in the early 1950s, marked the People’s Republic of China’s first ocean shipping route spanning Europe and Asia. Leveraging the distinctive position of this route, Poland emerged as a key transportation intermediary for trade between the PRC and Europe. However, the unique status of this route faced challenges with the East-West trade relaxation in 1952. This article contends that Poland’s pursuit and maintenance of the special status of this maritime route reveal significant correlations between its economic strength, political standing within the Socialist Bloc and the diplomatic choices available to the Warsaw government.

Identification of sensitive periods of weight status transition over the lifespan in Chinese population

BackgroundThe prevalence of high body mass index (BMI) is increasing in both children and adults worldwide. However, it is unclear whether vulnerabilities to maintenance and transition of weight status vary throughout the lifespan.ObjectiveWe aimed to characterize dynamic transitions of weight statuses across different life stages and to identify the sensitive periods for maintenance, onset, and resolution of obesity.MethodsThis longitudinal study included a total of 23,179 participants aged 6–80 years with 95,994 BMI measurements from the China Health and Nutrition Survey 1989–2015. To examine the heterogeneity in transitions of weight statuses across different life stages, we divided participants into 8 sub-cohorts based on baseline ages by 10-year intervals, i.e., 6–10 years, 11–20 years, 21–30 years, 31–40 years, 41–50 years, 51–60 years, 61–70 years, and 71–80 years. We estimated the probabilities of transitioning between weight statuses at a given follow-up year by baseline age using generalized linear mixed-effects models.ResultsThe predicted prevalence of obesity decreased from 6 years, bottomed at around 20 years, increased thereafter, peaked at around 55 years, and then decreased gradually. In general, participants with underweight had lower probabilities of maintaining the same status compared to those with normal weight, overweight, or obesity for all age groups. For 10-year follow-up, individuals aged 21–30 years had the highest probabilities of transitioning from normal weight to obesity and transitioning from overweight to obesity compared to those in other age groups. Individuals aged 6–20 years had the highest probabilities of transitioning from obesity to normal weight and transitioning from overweight to normal weight. Individuals in all adult age groups had higher probabilities of maintaining obesity status than children and adolescents.ConclusionsYoung adulthood is the most sensitive period for obesity onset, whereas childhood and adolescence are the most sensitive periods for obesity resolution. The findings suggest the heterogeneity of susceptibilities to weight status transitions across different life stages and highlight the importance of the development of age-appropriate approaches for the prevention and intervention of obesity.

Establishing Clinically Significant Improvement for Patients After Arthroscopic Surgery for Shoulder Instability With Large Labral Tears.

Patients with large labral tears represent a subset of traumatic shoulder instability cases. Outcomes after arthroscopic stabilization in these patients have been studied less compared with other tears. To establish minimal clinically important difference (MCID), Patient Acceptable Symptom State (PASS), and substantial clinical benefit (SCB) thresholds for patients after arthroscopic repair of labral tears ≥270°. Patient-reported outcome measures (PROMs) included the Rowe instability score, American Shoulder and Elbow Surgeons (ASES) score, Single Assessment Numeric Evaluation (SANE), and visual analog scale (VAS) for pain. Case-control study; Level of evidence, 3. A total of 52 arthroscopic large labral repairs (52 patients, mean age 28.7 years) performed in male active-duty military patients with a mean follow-up of 79.2 months (range, 24-117 months) met inclusion criteria and were included in the final analysis. All included patients completed the Rowe, ASES, SANE, and VAS pain preoperatively and at final follow-up, and the MCID, PASS, and SCB were calculated for each PROM score. Factors associated with achieving clinically relevant improvement were also calculated. The MCID, PASS, and SCB, respectively, for each PROM were as follows: 10.4 points, 90, and 35 points for the Rowe; 9.7 points, 80, and 43 points for the ASES; 9.9 points, 87, and 65 points for the SANE; and 1.1 points, 3, and 6 points for VAS pain. More than 90% of patients improved according to the MCID for each PROM, while >75% achieved the PASS threshold for each score. The percentage of patients who improved according to the SCB ranged from 9.6% for the ASES to 75% for the SANE. Maintenance of active-duty status was associated with achieving the MCID for the ASES and SANE, while recurrent instability was associated with lower rates of Rowe MCID achievement and SANE PASS achievement. Higher preoperative scores were also associated with lower rates of achieving clinical improvement. Thresholds found for the MCID, PASS, and SCB in active-duty patients undergoing surgery for shoulder instability with labral tears ≥270° were similar to those for all-comers with anterior instability. Factors associated with achieving success or lack thereof on PROMs included maintenance of active-duty status and lower preoperative PROM scores.

THE RELATIONSHIP OF PREGNANT WOMEN'S KNOWLEDGE OF DENTAL AND ORAL HEATH MAINTENANCE WITH GINGIVITIS STATUS

Pregnant women are a group that requires special attention to their oral heath. Pregnant women often neglect their oral hygiene which wil cause plaque buildup on the teeth and gingival margin, this can cause gingival inflammation or gingivitis. One of the efforts that can be done to prevent gingivitis is to reduce eating cariogenic foods and brushing teeth properly and regulaly and what can be done by heath workers by providing education to increase their knowledge about gingivitis. Problems: The status of gingivitis among pregnant women at BPS (Private Practice Midwife). Objective: To know the relationship between knowledge of oral heath maintenance of pregnant women and gingivitis status. Method: This type of research is analytic research with cross sectional method, with a sample of 56 pregnant women. The data analysis technique uses a normality test, namely Kolmogorov-Smirnov after the Chi-Square test. Result: There is no relationship between the knowledge of dental and oral heath maintenance of pregnant women with gingivitis status.

Development of Intelligent Testing and Evaluation System for Fracturing Pump

Abstract Fracturing truck is the key technical equipment for oil and gas production stimulation. Fracturing pump of fracturing truck is subjected to high pressure load for a long time during use. Due to the influence of many factors such as transportation and equipment aging, the performance of fracturing pump in field use is reduced and the output power is insufficient. In order to realize the on-site inspection of fracturing pump, a set of intelligent inspection and evaluation system of fracturing pump is developed. Through the establishment of the hardware test platform and the development of the software system, the intelligent inspection and evaluation system of fracturing pump with the features of one-click automatic detection, automatic analysis of performance indicators, intelligent prediction and maintenance of health status is realized. The system can support the static pressure test, water power test and overpressure protection test of 140MPa ultra-high pressure fracturing pump. Experimental tests show that the test accuracy of the equipment can effectively meet the detection and evaluation needs of the field fracturing truck, ensure the normal function through static pressure and water power detection, and determine the safety of the equipment through overpressure protection detection, which greatly improves the effect and efficiency of fracturing operations.

Influence of Different Rates of Salinity on Flowering, Yield and Fruit Nutritional Value of Three Okra [<i>Abelmoschus esculentus </i>(L.) Moench] Cultivars in far North Region of Cameroon

<i>Context: </i>Salinity is in coastal, arid and semi-arid regions a major constraint in the productivity and agricultural development around the world. <i>Objectifs: </i>The objective of this study is to evaluate the effect of salinity on the growth, the nutritional value of the fruits of three okra (<i>Abelmoschus esculentus </i>L.) cultivars including two local (Javia and Parkwa) and a hybrid variety (Hire). <i>Methodology: </i>This is how four solutions of different NaCl concentrations from 0, 60, 120 to 240 mM were used to water okra plants at the four-leaves stage and this for two months in completely randomized device with four repetitions. <i>Results: </i>The results have differneces and similarities between the three varities during saline treatments. Salinity causes a decrease in growth, performance yield (from 0 to 240 mM NaCl to 28%, 23.6% and 22% in Parkwa, Hire, Javia cultivars respectively), mineral elements, antioxidants components and accumulation of Na content (to 45% in Parkwa, 23% in Hire and 18.4% in Javia from 0 to 240 mM NaCl) and flowering period (from 0 to 240 mM NaCl to 27.5%, 23.1% et 21.9% in Parkwa, Hire, Javia respectively). The reductions generated by salt have been less strong in Javia and Hire cultivars while the reductions were stronger at Parkwa cultivar. In addition, NaCl, at high concentrations, advantage of osmoticum accumulation involved in the osmotic ajustement mechanisms and would also serve as osmoprotector. Accumulation of osmolytes is salinity tolerance index that explains the maintenance of good water status in okra.<i> Conclusion:</i> Cultivars Javia and Hire were the most salt tolerant while the Parkwa was the most sensitive. The good behaviour of Javia and Hire varieties in the face of salinity can be considered for their use to better enhance the sahelian and coastal areas.

Do Preventive Programs Reduce the Need for New Sedations for the Treatment of Oral Pathologies in Healthy and Special Health Care Needs Children?

Background: The goal is to analyze the need for reinterventions under deep sedation to treat oral pathologies in a population of children with special health care needs (SHCNs) and healthy children who followed a prevention program and to study the influence of parental motivation and child collaboration on the need for reinterventions under deep sedation. Methods: A retrospective study was carried out in a private clinic in Cartagena (Murcia, Spain), with patients treated under deep sedation from 2006 to 2018, both years included, following the Strobe statement. Results: In this study with 230 children who were treated under deep sedation, 23.92% underwent two or more sedations. The mean time elapsed between the first and the second sedations was 21.64 ± 15.87 months, and the main cause for reinterventions was the occurrence of new pathologies. Significantly more pulp treatments were performed in the first sedation than in the second (p = 0.013) and in the third (p = 0.007). Healthy children required fewer reinterventions under deep sedation than children with special needs (6.42% vs. 39.67%). Similarly, patients who followed the preventive program and required some type of dental treatment were reoperated fewer times than those who did not follow the preventive program (35.8 vs. 50%); than "cooperative" children as opposed to "non-cooperative" (12.12% vs. 60.93%) and than patients with "motivated" parents as opposed to those with "non-motivated" parents (20.83% vs. 46.34%). A total of 50% of the children who participated in the preventive program became "cooperative", and 100% were able to receive some treatment in the dental chair. Conclusions: Prevention programs, including motivational interviewing, are essential to improve children's behavior in the dental chair and reduce the need for reinterventions under general anesthesia or deep sedation. Although patients with special needs do require more sedation during their lifetime due to their inability to cooperate, these programs are necessary for the maintenance of oral health status and for the early diagnosis of caries lesions. Pediatric dentists should implement a quarterly preventive program because it improves patient collaboration. It is essential to achieve the motivation of parents in the oral care of their children.

RELATIONSHIP OF PREGNANT WOMEN'S KNOWLEDGE OF DENTAL AND ORAL HEATH MAINTENANCE WITH GINGIVITIS STATUS

Pregnant women are a group that requires special attention to their oral heath. Pregnant women often neglect their oral hygiene which wil cause plaque buildup on the teeth and gingival margin, this can cause gingival inflammation or gingivitis. One of the efforts that can be done to prevent gingivitis is to reduce eating cariogenic foods and brushing teeth properly and regulaly and what can be done by heath workers by providing education to increase their knowledge about gingivitis. Problems: The status of gingivitis among pregnant women at BPS (Private Practice Midwife). Objective: To know the relationship between knowledge of oral heath maintenance of pregnant women and gingivitis status. Method: This type of research is analytic research with cross sectional method, with a sample of 56 pregnant women. The data analysis technique uses a normality test, namely Kolmogorov-Smirnov after the Chi-Square test. Result: There is no relationship between the knowledge of dental and oral heath maintenance of pregnant women with gingivitis status.

Impact and management of integrated dysphagia rehabilitation within cardiac care programs for older patients with cardiovascular disease

This study assessed the characteristics, management, and outcomes of dysphagia rehabilitation in older patients withCVD in a super-aged society, highlighting the need for comprehensive management strategies in community hospital settings. It aimed to uncover valuable insights into the benefits of integrating dysphagia rehabilitation with cardiac care in patient management. We conducted a retrospective review of patients with CVD aged ≥ 65years who were admitted to Niigata Minami Hospital between January 2019 and December 2021. We focused on patients requiring dysphagia rehabilitation and assessing the effects of these interventions on recovery. The study included 732 participants with an average age of 86.0 ± 7.8years, of whom 41.9% were male. Approximately 55.1% required dysphagia rehabilitation. Dysphagia rehabilitation significantly improved oral caloric intake and BMI in patients who underwent rehabilitation, and these improvements were comparable to those in patients who did not require dysphagia rehabilitation. Significant enhancement in the ADL of patients was observed at discharge. Patients who required dysphagia rehabilitation also had longer hospital stays and were more likely to be discharged to nursing facilities. Dysphagia is common in older patients with CVD, and dysphagia rehabilitation positively affects the maintenance of nutritional status and helps patients achieve ADL independence at discharge. This study highlights the importance of integrating dysphagia rehabilitation into ordinary cardiac rehabilitation programs for older patients with CVD to improve their QOL.

Water relations and photosystem II efficiency of the intertidal macroalga Fucus virsoides

Intertidal macroalgae are sessile poikilohydric organisms exposed to desiccation stress during emersion. Water relations parameters are useful tools to evaluate an organism's capacity to withstand water scarcity conditions, but such information on marine intertidal macroalgae is scarce. We assessed the water relations of the intertidal relict Fucus virsoides, the unique Fucus species endemic to the Mediterranean. We combined measurements of water potential (Ψ) parameters derived from pressure-volume curves and chlorophyll a fluorescence (Fv/Fm) in juvenile and adult thalli sampled in three different dates between March and April 2023. F. virsoides exhibited remarkable water stress tolerance, as evidenced by the low water potential at turgor loss point (Ψtlp, -7.0 MPa on average), and the maintenance of high Fv/Fm at low water potentials indicating a prolonged maintenance of healthy physiological status. While no differences were observed between growth stages, Ψtlp, capacitance (C) and the bulk modulus of elasticity (ε) varied significantly according to the sampling dates, whereas the osmotic potential at full turgor did not significantly change. Ψ measured on thalli collected after a typical prolonged emersion period was markedly lower (−12.3 MPa on average) than the estimated Ψtlp, suggesting that the population is frequently undergoing turgor loss. Further investigations are required to determine environmental tolerance ranges based on water status characteristics to enhance our understanding of F. virsoides responses and vulnerability to climate change, thus providing insight into the possible causes of its widespread decline.

Altered S-AdenosylMethionine availability impacts dNTP pools in Saccharomyces cerevisiae.

Saccharomyces cerevisiae has long been used as a model organism to study genome instability. The SAM1 and SAM2 genes encode AdoMet synthetases, which generate S-AdenosylMethionine (AdoMet) from Methionine (Met) and ATP. Previous work from our group has shown that deletions of the SAM1 and SAM2 genes cause changes to AdoMet levels and impact genome instability in opposite manners. AdoMet is a key product of methionine metabolism and the major methyl donor for methylation events of proteins, RNAs, small molecules, and lipids. The methyl cycle is interrelated to the folate cycle which is involved in de novo synthesis of purine and pyrimidine deoxyribonucleotides (dATP, dTTP, dCTP, and dGTP). AdoMet also plays a role in polyamine production, essential for cell growth and used in detoxification of reactive oxygen species (ROS) and maintenance of the redox status in cells. This is also impacted by the methyl cycle's role in production of glutathione, another ROS scavenger and cellular protectant. We show here that sam2∆/sam2∆ cells, previously characterized with lower levels of AdoMet and higher genome instability, have a higher level of each dNTP (except dTTP), contributing to a higher overall dNTP pool level when compared to wildtype. Unchecked, these increased levels can lead to multiple types of DNA damage which could account for the genome instability increases in these cells.

Adenovirus 36 seropositivity is related to the expression of anti-adipogenic lncRNAs GAS5 and MEG3 in adipose tissue obtained from subjects with obesity.

Human Adenovirus D-36 (HAdV-D36) promotes adipogenesis in cellular and animal models and may contribute to the development of human obesity. Induction of PPARγ by HAdV-D36 seems to have a central role in the maintenance of adipogenic status. There is limited information about epigenetic mechanisms contributing to this process in human adipose tissue. This study evaluated the expression of lncRNAs (ADINR, GAS5 and MEG3) and miRNAs (miR-18a and miR-140) involved in the adipogenic process in visceral adipose tissue (VAT) of subjects with obesity with previous HAdV-D36 infection (seropositive) and unexposed (seronegative) subjects with obesity. Individuals with obesity were grouped according to the presence of antibodies against HAdV-D36 (Seropositive: HAdV-D36[+], n = 29; and Seronegative: HAdV-D36[-], n = 28). Additionally, a group of individuals without obesity (n = 17) was selected as a control group. The HAdV-D36 serology was carried out by ELISA. Biopsies of VAT were obtained during an elective and clinically indicated surgery (bariatric or cholecystectomy). RNA extraction from VAT was performed and the expression of PPARG and non-coding RNAs was evaluated by qPCR. HAdV-D36[+] individuals had lower expression of anti-adipogenic lncRNAs GAS5 (p = 0.016) and MEG3 (p = 0.035) compared with HAdV-D36[-] subjects with obesity. HAdV-D36[+] subjects also presented increased expression of the adipogenic miRNA miR-18a (p = 0.042), which has been reported to be modulated by GAS5 through a RNA sponging mechanism during adipogenic differentiation. Additionally, an inverse correlation of GAS5 with PPARG expression was observed (r = -0.917, p = 0.01). Our results suggest that HAdV-D36 is related to non-coding RNAs implicated in adipogenesis, representing a potential mechanism by which previous HAdV-D36 infection could be associated with the long-term maintenance of adipogenic status, probably through the GAS5/miR-18a axis.

The virility-fertility tradeoff: effects of fatherhood on (precarious) masculinity, sexual esteem, and sexual depression

ABSTRACT The stress, exhaustion, and negative impacts on sexual relationships associated with parenthood are well documented, but father’s perceptions of these changes are underexplored. Since sexuality and physicality are cornerstones of traditional/hegemonic masculine norms, changes in these domains resulting from fatherhood may produce concerns about masculinity maintenance and loss of masculine status. However, fatherhood provides clear evidence of a man’s sexual capability and virility – highly valued masculine traits. Therefore, fatherhood could theoretically make perceptions of masculinity more stable. The present study compared fathers and non-fathers on perceptions of masculinity and sexuality, and explored potential predictors of sexual esteem versus sexual depression during fatherhood. A sample of primarily heterosexual, White North American fathers and non-fathers participated in an online survey (N = 564) including measures of sexual esteem, sexual depression, and precarious manhood belief. Fathers were also asked to report their perceptions surrounding parenthood. Fathers endorsed precarious manhood beliefs less than non-fathers, and reported higher levels of both sexual esteem and sexual depression. Among fathers, a high personal sex drive predicted sexual esteem, while parental stress, low partner sex drive, and low self-perceived masculinity after parenthood predicted fathers’ sexual depression.

Taste assessment as a part of geriatric nutritional care: Potential implications for clinical practice

IntroductionAging is related to decrease in taste perception. As appetite is considered crucial for maintenance of proper nutritional status of older adults, its decrease during aging raises questions about its relation to gustatory functions and further prevention possibilities. Aim of the studyThe aim was to assess the characteristics and eating behaviors of the patients who reported a self-perceived reduction in taste perception in the context of appetite. Material and methodsThis semi-qualitative study was conducted between November 2021 and March 2022 in the Department of Internal Medicine and Geriatrics of the University Hospital in Krakow. Patients were assessed using an original appetite assessment scale, which allowed for an in-depth interview on areas related to the decline in gustatory function. Additionally, nutritional assessment was performed using Mini Nutritional Assessment and Council on Nutrition Appetite Questionnaire (CNAQ) and anthropometric measurements. ResultsThe most common characteristics of patients with gustatory dysfunction were early satiety, decreased appetite in the three months prior to the study and polypharmacy. A significant difference was observed in the CNAQ scores between the group of patients with and without gustatory dysfunction. ConclusionCareful identification of patients presenting with gustatory dysfunction can provide an important cue for an individualised approach aimed at preventing malnutrition. In our work, we suggest the areas that can be addressed during a nutritional interview to enable the selection of an optimal approach.

Use of a novel bluetooth-connected device to measure handgrip strength: A practical tool to help healthcare professionals identify adults at nutritional risk

Background and AimsLow muscle strength is strongly tied to poor nutrition status, and nutritional interventions are likewise linked to maintenance and restoration of muscle strength and functional status. Nutrition plays a vital role in muscle mass, strength, and function, and losses in muscle (strength, function, and mass) are associated with poor health outcomes and added costs for healthcare services. For this study of outpatients, the main objective was to identify those at risk for low muscle strength, as evidenced by low handgrip strength (HGS) measures with risk stratified by age and sex. MethodsThis was a two-part study on HGS measures in adults attending outpatient clinics in India. In part one, we conducted HGS tests on dominant and non-dominant hands of patients who qualified for the study. For HGS measures, we used a validated tool, the SQUEGG device, a smart handgrip trainer, along with its companion Bluetooth-connected app, the Muscle Strength Assessment Tool (MSAT) app. In part two, we collected Healthcare Practitioners’ (HCP) feedback via a short digital survey on the use of the SQUEGG device + the MSAT app to do HGS risk screening as an indicator of needed nutritional intervention. ResultsNearly a third of community-living adults in India exhibited low HGS among the 3036 sampled. At each age stratum, dominant-hand HGS in women was lower by 25% to 35% compared to men. Among 353 HCPs, 293 (83%) provided insights via survey, and 85% of surveyed HCPs (n=249) strongly agreed or agreed that the SQUEGG device + MSAT app helped them identify HGS issues among their patients, and 85% (n=248) agreed or strongly agreed they would like to continue using the SQUEGG device + MSAT app to inform their practice. Nearly all surveyed HCPs (98%, n=288) recommended an oral nutritional supplement (ONS) to their patients with identified low HGS. ConclusionsOur findings demonstrate that HCPs would like to continue use of the SQUEGG device + MSAT app as it helped them identify adult patients who had decreased HGS (about 30% of the study population), in turn identifying opportunities to use nutritional interventions such as ONS to address nutrition shortfalls and to restore functional status.

Comparing the Effectiveness of Octenidine Hydrochloride and Chlorhexidine Gluconate Mouthrinses in Reducing Plaque and Oxidative Stress in Institutionalized Children with Down Syndrome.

Due to decreased manual dexterity, a lack of motivation, and difficulty on the part of the caregiver conducting efficient oral hygiene measures at home, patients with Down syndrome (DS) are badly affected. The objective of this study is to compare the efficacy of 0.1% octenidine (OCT) hydrochloride and 0.12% chlorhexidine (CHX) gluconate on plaque control and oxidative stress in institutionalized children with DS. In 20 children, salivary samples were collected for analysis of the inflammatory marker high-sensitive C-reactive protein (hsCRP) and oxidative stress markers, specifically malondialdehyde (MDA). Plaque index (PlI) and gingival index (GI) were scored. After oral prophylaxis, the participants were randomly assigned to two groups, each consisting of 10 individuals (octenidol and CHX). Salivary oxidative stress marker assays were carried out using a modified version of Yagi's (1984) method, and absorbance was measured at 540 nm using an ultraviolet-visible spectrophotometer at 535 nm. hsCRP assays were conducted via latex turbidimetric immunoassay. On comparison between the two groups, the OCT group showed a statistically significant reduction in GI, PlI, and MDA values (p < 0.05). It was seen that the use of 0.1% OCT hydrochloride could facilitate the maintenance of good oral hygiene and periodontal status, especially in patients with motor difficulties. PMS/IEC/2016/02. Raj AS, George S, S A, et al. Comparing the Effectiveness of Octenidine Hydrochloride and Chlorhexidine Gluconate Mouthrinses in Reducing Plaque and Oxidative Stress in Institutionalized Children with Down Syndrome. Int J Clin Pediatr Dent 2024;17(4):437-441.

Effect of smoking cessation on psoriasis vulgaris, palmoplantar pustulosis and generalized pustularpsoriasis.

Smoking is a known risk factor for psoriasis; however, the impact of smoking cessation on psoriasis has seldom been evaluated. We aimed to examine the effects of smoking cessation on the development of psoriasis vulgaris (PsV), palmoplantar pustulosis (PPP) and generalized pustular psoriasis (GPP). Using the Korean National Health Insurance Service database, we retrospectively compiled a cohort of 5 784 973 participants without psoriasis, analysed their changes in smoking status from 2004 to 2007 and followed up new cases of psoriasis until 2021. The psoriasis risks were compared with those of sustained smokers, smoking quitters, sustained ex-smokers and never smokers using multivariate Cox proportional hazard models. The mean age of the participants was 47.1 years (SD 13.5) and 3 092 426 (53.5%) were male. During 77 990 688 person-years, 67 364 psoriasis cases were identified. Compared with sustained smokers, smoking quitters showed a reduced risk of developing psoriasis [adjusted hazard ratio (aHR) 0.91; 95% confidence interval (CI) 0.87-0.95], specifically PsV (aHR 0.92; 95% CI 0.88-0.97) and PPP (aHR 0.71; 95% CI 0.63-0.79). The reduction in risk due to smoking cessation was more prominent in sustained ex-smokers (psoriasis: aHR 0.77, 95% CI 0.74-0.79; PsV: aHR 0.76, 95% CI 0.73-0.79; PPP: aHR 0.56, 95% CI 0.51-0.61; GPP: aHR 0.64; 95% CI 0.52-0.78). When conducting sensitivity analyses to address the potential for changes in smoking habits after 2007, the results and trends were consistent with the main findings, and a more pronounced significance was observed. Compared with continuous smoking, smoking cessation was associated with a decreased risk of developing psoriasis. The risk-reducing effect of smoking cessation was more pronounced in those maintaining a smoke-free status. Smoking cessation and the maintenance of a smoke-free status should be encouraged to prevent the development of psoriasis and all other smoking-related diseases.