No-treatment Group Research Articles

500. Impact of an iron chelator on in vitro and in vivo growth of A. baumannii

Abstract Background Acinetobacter baumannii (AB) has become multidrug-resistant in recent years and currently there is no consensus on the optimal treatment for these infections. To combat this urgent threat, novel treatment options are needed to minimize spread and lower mortality rates. Nutrient metals (e.g., iron) are essential to the metabolic functions of AB. If the bioavailability of essential nutrients is restricted, this can cause a bacterial stress response and alter their ability to multiply. Methods The objective of the study was to examine the impact of iron chelation on the growth of AB in vitro and in vivo. MDR AB bloodstream isolates (n=4) were recovered from unique patients between 2011 and 2018. Clonal diversity was ascertained by Fourier Transform Infrared Spectroscopy. In vitro bacterial densities were measured longitudinally over 20-hours to determine the growth profile. Isolates were started at a baseline concentration of approximately 5.5 log CFU/mL in tryptic soy broth. Variable amounts of an iron chelating agent (deferiprone, 0.2-2mM) were added to create a concentration gradient. Galleria mellonella larvae (100-150mg) were inoculated with approximately 5 log CFU of an isolate, with and without deferiprone (10mM). Quantitative culture was used to ascertain the bacterial burden of aggregate larvae (n=10) immediately and 4h post infection. Additional infected larvae (n=20 in each group) were incubated at 35°C and monitored hourly for 24h. Results Time to mortality was compared using Kaplan-Meier survival analysis and log-rank test. Increasing concentrations of the chelating agent caused a transient and concentration-dependent hindrance of in vitro bacterial growth, compared to the no-treatment group. Bacterial burden immediately post-infection of the control and treatment group were comparable at 6.4 log CFU/g. After 4 hours the bacterial burden was much higher in the control group than the treatment group, 8.7 and 6.7 log CFU/g respectively. A trend of delayed mortality was shown in the iron chelator group (median survival 6.5 vs 10 hours, p=0.15). Conclusion These results support that micro-nutrient limitation has the potential to be a novel approach for treating high-risk infections due to MDR AB. Future studies are warranted to further define its optimal place in therapy. Disclosures All Authors: No reported disclosures.

REBACIN® inhibits E6/E7 oncogenes in clearance of human papillomavirus infection.

http://www.chictr.org.cn/historyversionpuben.aspx?regno=ChiCTR2100045911, identifier ChiCTR2100045911.

Career counseling for college students: Assessment of an online and group intervention

There has been a growing demand for evidence-based interventions to help students prepare for the transition between university and the world of work. The aim of this study was to investigate the effects of a career counseling intervention, in groups and online, on the career adaptability resources and perceptions of professional development and employability of college students in the final stage of their undergraduate courses. The study was based on career construction theory and the theoretical model for professional development of college students. As a preliminary activity, the intervention was performed with a pilot group (n = 20), followed by the actual experiment with an IG (n = 14) and an N-TG (n = 14). Based on a detailed protocol, the intervention was applied for three months, with six weekly sessions and a follow-up session one month after the end of the intervention. Between the sessions, the participants were expected to accomplish directed tasks. Two observers were part of the experiment and elaborated reports of each session. The Linear Mixed Regression Model (LMM) and the Jacobson and Truax (JT) Method were used to evaluate the effectiveness of the intervention, comparing each participant with themself before and after the intervention. The results show that career counseling with graduating college students expands their career adaptability resources, and their perceptions of professional development and employability. The no-treatment group did not present an increase in the score's dimensions over time. Therefore, based on the study, career counseling interventions can be recommended for college students to promote proactive action to anticipate barriers and increase awareness of possibilities and work interests among participants.

Differential hemodynamics between arteriovenous fistulas with or without intervention before successful use.

A significant number of arteriovenous fistulas (AVFs) fail to maturate for dialysis. Although interventions promote maturation, functional primary patency loss is higher for AVFs with interventions (assisted maturation) than AVFs without interventions (un-assisted maturation). Although blood flow-associated hemodynamics have long been proposed to affect AVF remodeling, the optimal hemodynamic parameters for un-assisted maturation are unclear. Additionally, AVF maturation progress is generally not investigated until 6 weeks after AVF creation, and the examination is focused on the AVF's venous limb. In this exploratory study, patients (n = 6) underwent magnetic resonance imaging (MRI) at 1 day, 6 weeks, and 6 months after AVF creation surgery. Before successful use for hemodialysis, three AVFs required intervention and three did not. MRI of the AVFs were used to calculate lumen cross-sectional area (CSA) and perform computational fluid dynamics (CFD) to analyze hemodynamics, including velocity, wall shear stress (WSS), and vorticity. For the venous limb, the no-intervention group and intervention group had similar pre-surgery vein diameter and 1-day post-surgery venous CSA. However, the no-intervention group had statistically larger 1-day venous velocity (0.97 ± 0.67 m/s; mean ± SD), WSS (333 ± 336 dyne/cm2) and vorticity (1709 ± 1290 1/s) than the intervention group (velocity = 0.23 ± 0.10 m/s; WSS = 49 ± 40 dyne/cm2; vorticity = 493.1 ± 227 1/s) (P < 0.05). At 6 months, the no-intervention group had statistically larger venous CSA (43.5 ± 27.4 mm2) than the intervention group (15.1 ± 6.2 mm2) (P < 0.05). Regarding the arterial limb, no-intervention AVF arteries also had statistically larger 1-day velocity (1.17 ± 1.0 m/s), WSS (340 ± 423 dyne/cm2), vorticity (1787 ± 1694 1/s), and 6-month CSA (22.6 ± 22.7 mm2) than the intervention group (velocity = 0.64 ± 0.36 m/s; WSS = 104 ± 116 dyne/cm2, P < 0.05; vorticity = 867 ± 4551/s; CSA = 10.7 ± 6.0 mm2, P < 0.05). Larger venous velocity, WSS, and vorticity immediately after AVF creation surgery may be important for later lumen enlargement and AVF maturation, with the potential to be used as a tool to help diagnose poor AVF maturation earlier. However, future studies using a larger cohort are needed to validate this finding and determine cut off values, if any.

Differences in health behavior and nutrient intake status between diabetes-aware and unaware Korean adults based on the Korea national health and nutrition examination survey 2016-18 data: A cross-sectional study.

The aim of this study was to investigate the nutritional intakes and treatment regimens of Korean patients with type 2 diabetes who were aware of their condition. Participants (n = 16582) aged ≥ 19 years from the 2016-18 National Health and Nutrition Survey were divided into diabetes-aware and unaware groups and the variables were compared. Among 1,906 (11.5%) diabetic adults, 1,433 (75.2%) were aware of their condition; 130 (9.1%) had nutrition education, and 1,340 (93.5%) were in the diabetes-aware treatment group. The diabetes-aware group had higher average age (P < 0.0001) and lower average BMI (P = 0.0015) than the unaware group. Intake of total fat (P = 0.0034), saturated fatty acids (P = 0.0021), riboflavin (P = 0.0035) and niacin (P = 0.0228) was significantly higher in the unaware group than in the diabetes-aware group, after adjusting energy intake for age and sex. Current smoking (P = 0.0046) and heavy drinking (P < 0.0001) rates were higher in the unaware group, whereas fiber intake (P = 0.0054) was lower in the unaware group. Higher levels of glycated hemoglobin were found in the group treated for diabetes (7.2%) than in the no-treatment (6.8%) group (P = 0.0048). Diabetes control was significantly better in the high income group. There is a need to strengthen nutritional education to prevent diabetes and improve the health status of diabetic patients in Korea.

Safe and Effective Lip Enhancement with VYC-15L in Chinese Adults.

Hyaluronic acid (HA) soft tissue fillers are used to restore volume loss to the lips and perioral area. Evaluate the safety and effectiveness of the HA filler Juvéderm® Volbella® (VYC-15L) for lip enhancement in Chinese adults. In this multicenter, evaluator-blind study, subjects seeking lip enhancement were randomized 3:1 to VYC-15L or no-treatment control group (with optional treatment delayed by 3 months). Effectiveness endpoints included 1-point improvement on the 5-point Lip Fullness Scale (LFS) assessed by evaluating investigators (EIs) and subjects, and overall volume of lips and change in lip surface area measured from 3-dimensional images. Safety assessments included procedural pain, injection site reactions (ISRs), and adverse events (AEs). The modified intention-to-treat population included 163 subjects (median age, 34 years; 96.9% female). More VYC-15L-treated subjects had a 1-pointreduction in EI-reported LFS score at month 3 versus untreated controls (84.7% vs 0%; p < 0.0001), and 65% of the treated subjects self-reported a 1-point LFS improvement at month 3. Procedural pain during injection was mild. The most common ISRs were swelling, tenderness to touch, and firmness. One treatment-related serious AE (injection site compression arterial ischemia) resolved in 16 days. VYC-15L treatment was superior to no treatment at 3 months and was well tolerated by subjects. NCT03519204.

Impact of margin thermal treatment after EMR of giant (≥40 mm) colorectal lateral spreading lesions

Increasing lesion size is a risk factor for recurrence after piecemeal EMR (pEMR). Snare-tip soft coagulation (STSC) treatment of the normal-appearing margin after pEMR of lesions≥ 20mm has been shown to reduce recurrence rates by 75% to 80%. We sought to evaluate the impact of STSC on giant (≥ 40mm) lateral spreading lesions treated by pEMR. We describe the relative risk and absolute risks of recurrence with and without STSC margin treatment after EMR of≥ 40-mm lesions. We performed a retrospective evaluation of a prospectively collected database on large lesions describing lesion size, location, and methods of resection. We excluded lesions< 40mm in maximum dimension, those that did not undergo follow-up care at our center, and those in which argon plasma coagulation was used for either ablative treatment of residual polyp or margin treatment. Propensity score analysis was used to account for potential differences between patients treated with and without STSC. There were 68 lesions≥ 40mm removed by pEMR without STSC treatment and 133 removed and treated with STSC. There were no differences between groups in demographics, polyp size, location, histologic features, and mean follow-up time. The recurrence rate in the no-treatment group was 35% versus 9% with STSC (P< .00001 by direct comparison and P= .008 by using the propensity score analysis). STSC treatment after pEMR of large lateral spreading lesions in the colorectum reduced recurrences by 75%. However, the absolute recurrence rate of 9% remained clinically significant in the STSC-treated group. Short-term follow-up care after STSC of lesions≥ 40mm is still warranted, and additional study of technical factors that eliminate recurrence after pEMR of giant lateral spreading lesions is warranted.

Assessment of Cognitive Assistive Technologies in Elderly Patients with Dementia Post-COVID-19 Infection: A Research Proposal

Introduction: SARS-CoV-2 infection is thought to be implicated in an increased risk for various neurodegenerative diseases given its role in neuroinflammation. As a result, cognitive assistive technologies to monitor the risk of neurodegenerative diseases in those with prior COVID-19 infection and the regular implementation of practices designed to promote synaptic plasticity may decrease the risk of dementia in susceptible populations. It is hypothesized that incorporating frequent use of a mobile application designed to improve memory five times per week in the daily routines of patients aged 65+ who have survived a COVID-19 infection may decrease the prevalence of subsequent dementia. Methods: The goal of this application would be to (i) deliver interventions related to long-term potentiation, and (ii) centralizing patient health data in a singular domain to improve ease of access for caregivers and medical staff. This may be investigated through a two-pronged randomized controlled trial aimed to compare neural and cognitive functioning through repeat neuropsychological exams, magnetic resonance imaging, and electroencephalogram tests over a 6-year timeframe between no-intervention and intervention groups while collecting caregiver and healthcare worker data regarding its efficacy in improving quality of life. Results: It is expected that patients consistently using cognitive assistive technologies in long-term care facilities will experience lower incidence of cognitive decline compared to the control group due to improved maintenance of mental health and the learning of new skills. In addition, with the use of technology, patients may experience increased autonomy and independence, improving their quality of life while simultaneously providing relief to their families and caregivers. Discussion: Some further considerations may include the degree of technological proficiency of the patients during the development process to ensure that patients reap the maximum benefits. Factors including rapid development and testing, funding, and strong technology support systems must be taken into consideration to ensure a seamless transition to increased reliance on technology in post-COVID-19 patients with dementia. Conclusion: Strong evidence indicates technology-based interventions can be used to by dementia patients and their caretakers overcome physical and environmental challenges normally and during future pandemic waves.

Surgery offers survival advantage over radiotherapy in patients who are 80 years and older with Stage I and II NSCLC: A retrospective cohort study of 7,045 patients.

ObjectiveElderly people are less likely than younger patients to undergo curative surgery for early-stage lung cancer because of the greater risk of surgery and postoperative complications. We investigated the relationship between treatment modality and the risk of all-cause and lung cancer-specific mortality to compare the efficacy of surgical treatment with radiotherapy in patients with stage I and II non-small cell lung cancer (NSCLC) who were ≥80 years old.MethodsWe extracted data from the most recent Surveillance, Epidemiology, and End Results 9 registry study database (2010–2017). We mainly selected patients with stage I and II NSCLC who were ≥80 years old, and after screening, 7,045 cases were selected for our study. We used univariate analysis, stratified analysis, and multiple regression equation analysis to examine all-cause mortality and lung cancer-specific mortality in different treatment modalities. The overall and stratified populations' survival curves were plotted using the Kaplan–Meier method. The competing risk regression method of Fine and Gray was used to estimate mortality specific to lung cancer.ResultsIn the fully adjusted model, all-cause mortality was 1.97 times higher in the radiotherapy-only group (hazard ration (HR) = 1.97, 95% confidence interval (CI) = 1.81–2.14, p < 0.0001) than in the surgery-only group. The lung cancer-specific mortality rate was 1.22 times higher in the radiotherapy-only group (HR = 1.22, 95% CI = 1.13–1.32, p < 0.0001) than in the surgery-only group. The median overall survival (OS) in the surgery-only, radiation therapy-only, surgery plus radiation therapy, and no-treatment groups were 58 months, 31 months, 36 months, and 10 months, respectively. Median lung cancer-specific survival was 61 months, 32 months, 38 months, and 11 months, respectively. The surgery-only group had the highest 1-year OS (0.8679,95% CI = 0.8537–0.8824) and 5-year OS (0.4873, 95% CI = 0.4632–0.5126).ConclusionsSurgery had a higher overall and lung cancer-specific survival rate than radiotherapy and no treatment in the elderly early-stage NSCLC population. For patients with stage I and stage II NSCLC at advanced ages, surgical treatment might have a greater potential survival benefit.

"Making hidden resources visible in a minority serving college context": Correction to Ramirez et al. (2021).

Across 2 large-scale experiments at a minority serving institution, participants watched either resource videos only or resource videos coupled with students' stories. Compared to a no-treatment control group, we found that first-generation-to-college students benefited from receiving both types of resource information. Continuing-generation-to-college students benefited the most when resources were coupled with student stories. We speculate that first-generation students at minority serving institutions have concrete concerns that need to be addressed alongside identity and social belonging needs. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Design and Evaluation of a School-based Sustained Attention Training Program with Parental Involvement for Preschoolers in Rural China

ABSTRACT Research Findings: Sustained attention is a fundamental cognitive function for young children’s development. We investigated the effects of school-based audiovisual game training with parental involvement on sustained attention (SA) in 5–6-year-old Chinese children. Totally 75 children and their parents participated and were assigned into three groups. The School Practice Intervention (SPI) group and the Parental Involvement Intervention (PII) group underwent an eight-week audiovisual game training, while the No Intervention (NI) group participated in regular activities and received no intervention. We tested participants’ visual and auditory sustained attention at four time points, i.e., pretest, middle test, posttest, and follow-up test. Results indicated that (1) children in PII and SPI groups had significantly greater visual and auditory sustained attention than the NI group in posttest and follow-up test; (2) the PII group showed better SA than the SPI group in posttest and follow-up test; (3) visual SA of experimental groups improved significantly since the middle test, while the improvement of auditory SA emerged since posttest. Practice or Policy: The play-based audiovisual training in a school setting effectively enhances SA for 5–6-year-olds, and parental involvement benefits the intervention. More efforts should be made to improve auditory sustained attention. The educational implications of these findings were discussed.

Natural Activators of Autophagy Increase Maximal Walking Distance and Reduce Oxidative Stress in Patients with Peripheral Artery Disease: A Pilot Study.

Trehalose, spermidine, nicotinamide, and polyphenols have been shown to display pro-autophagic and antioxidant properties, eventually reducing cardiovascular and ischemic complications. This study aimed to investigate whether a mixture of these components improves maximal walking distance (MWD) in peripheral artery disease (PAD) patients. Nitrite/nitrate (NOx), endothelin-1, sNOX2-dp, H2O2 production, H2O2 break-down activity (HBA), ATG5 and P62 levels, flow-mediated dilation (FMD), and MWD were evaluated in 20 PAD patients randomly allocated to 10 g of mixture or no-treatment in a single-blind study. The above variables were assessed at baseline and 60 days after mixture ingestion. Compared with baseline, mixture intake significantly increased MWD (+91%; p < 0.01) and serum NOx (+96%; p < 0.001), whereas it significantly reduced endothelin-1 levels (−30%, p < 0.01). Moreover, mixture intake led to a remarkable reduction in sNOX2dp (−31%, p < 0.05) and H2O2 (−40%, p < 0.001) and potentiated antioxidant power (+110%, p < 0.001). Finally, mixture ingestion restored autophagy by increasing ATG5 (+43%, p < 0.01) and decreasing P62 (−29%, p < 0.05). No changes in the above-mentioned variables were observed in the no-treatment group. The treatment with a mixture of trehalose, spermidine, nicotinamide, and polyphenols improves MWD in PAD patients, with a mechanism possibly related to NOX2-mediated oxidative stress downregulation and autophagic flux upregulation. Clinical Trial Registration unique identifier: NCT04061070.

Rational emotive intervention for work-family conflict and female primary school teachers' well-being.

Globally, work and family conflict has been investigated by many researchers. Yet there is an increased prevalence of work-family conflict and its influence on the well-being of the female teaching population, especially Nigerian primary school teachers. This incidence has kept a good proportion of schoolteachers vulnerable to health problems as well as affected their wellbeing. This study evaluates the effect of rational emotive behaviour therapy on improving the well-being of female teachers with irrational behaviours arising from the work-family conflict. This is a randomized study. A total of 69 female primary school teachers in Enugu state Nigeria who met the criteria for inclusion were used as the study participants. Three self-report measures (Work-Family Conflict questionnaire, Multidimensional Health States Scale-Short Form, and Teacher Irrational Belief Scale) were used to collect data. Repeated measures with analysis of variance (ANOVA) were used to determine the effects of the intervention. The findings of the study revealed that REBT had a significant effect on the well-being scores of Nigerian female primary school teachers with work-family conflict when compared to their counterparts in the no-intervention group at Time 2. In addition, the effect of REBT on improving well-being in female teachers with work-family conflict was significantly maintained at the follow-up measurements (Time 3). In conclusion, it is suggested that REBT is an effective intervention for moderating the effect of work-family conflict on the well-being of career female teachers. As such, cognitive behavioural therapists can further examine the effectiveness of REBT using other constructs and cultures.

Postnatal treatment for children with fetal and neonatal alloimmune thrombocytopenia: a multicentre, retrospective, cohort study

Children affected by fetal and neonatal alloimmune thrombocytopenia (FNAIT) are at risk of severe intracranial haemorrhage. Management in the postnatal period is based on sparse evidence. We aimed to describe the contemporary management and outcomes of patients with FNAIT in high-income countries. In this multicentre, retrospective, cohort study, we set up a web-based registry for the collection of deidentified data on the management and course of neonates with FNAIT. Eight centres from seven countries (Australia, Norway, Slovenia, Spain, Sweden, the Netherlands, and the USA) participated. Eligibility criteria comprised neonates with FNAIT being liveborn between Jan 1, 2010, and Jan 1, 2020; anti-human platelet antigen (HPA) alloantibodies in maternal serum; confirmed maternal and fetal HPA incompatibility; and bleeding detected at antenatal ultrasound, neonatal thrombocytopenia (<150 × 109 platelets per L), or both in the current or previous pregnancy. Clinical data were retrieved from local medical records of the first neonatal admission and entered in the registry. The key outcome was the type of postnatal treatment given to neonates with FNAIT. Other outcomes were daily median platelet counts in the first week of life, median platelet count increment after first unmatched versus first matched transfusions, and the proportion of neonates with mild or severe bleeding. 408 liveborn neonates with FNAIT were entered into the FNAIT registry, of whom 389 from Australia (n=74), Norway (n=56), Slovenia (n=19), Spain (n=55), Sweden (n=31), the Netherlands (n=138), and the USA (n=16) were included in our analyses. The median follow-up was 5 days (IQR 2-9). More neonates were male (241 [64%] of 379) than female (138 [36%]). Severe thrombocytopenia (platelet count <50 × 109 platelets per L) was reported in 283 (74%) of 380 neonates, and extreme thrombocytopenia (<10 × 109 platelets per L) was reported in 92 (24%) neonates. Postnatal platelet count nadir was higher in the no-treatment group than in all other groups. 163 (42%) of 389 neonates with FNAIT received no postnatal treatment. 207 (53%) neonates received platelet transfusions, which were either HPA-unmatched (88 [43%] of 207), HPA-matched (84 [41%]), or a combination of both (35 [17%]). The proportion of neonates who received HPA-matched platelet transfusions varied between countries, ranging from 0% (Slovenia) to 63% (35 of 56 neonates; Norway). Postnatal intravenous immunoglobulin treatment was given to 110 (28%) of 389 neonates (alone [n=19] or in combination with platelet transfusions [n=91]), with the proportion receiving it ranging from 12% (17 of 138 neonates; the Netherlands) to 63% (ten of 16 neonates; the USA) across countries. The median platelet increment was 59 × 109 platelets per L (IQR 35-94) after HPA-unmatched platelet transfusions and 98 × 109 platelets per L (67-134) after HPA-matched platelet transfusions (p<0·0001). Severe bleeding was diagnosed in 23 (6%) of 389 liveborn neonates, with one having a severe pulmonary haemorrhage and 22 having severe intracranial haemorrhages. Mild bleeding was diagnosed in 186 (48%) neonates. Postnatal management of FNAIT varies greatly between international centres, highlighting the absence of consensus on optimal treatments. Our data suggest that HPA-matched transfusions lead to a larger median platelet count increment than HPA-unmatched transfusions, but whether HPA matching is also associated with a reduced risk of bleeding remains unknown. Sanquin.

Impact of light therapy on rotating night shift workers: the EuRhythDia study

AimsDisturbances in circadian rhythms may promote cardiometabolic disorders in rotating night shift workers (r-NSWs). We hypothesized that timed light therapy might reverse disrupted circadian rhythms and glucose intolerance observed among r-NSWs).MethodsR-NSWs were randomly assigned to a protocol that included 12 weeks on followed by 12 weeks off light therapy (n = 13; 6 men; mean age, 39.5 ± 7.3 years) or a no-treatment control group (n = 9; 3 men; mean age 41.7 ± 6.3 years). Experimental and control participants underwent identical metabolic evaluations that included anthropometric, metabolic (including oral glucose tolerance tests), lipid, and inflammation-associated parameters together with an assessment of sleep quality and expression of circadian transcription factors REV-ERBα and BMAL1 in peripheral blood mononuclear cells (PBMCs) at baseline, 12 weeks, and 24 weeks of the protocol.ResultsTwelve weeks of warm white-light exposure (10,000 lx at 35 cm for 30 min per day) had no impact on sleep, metabolic, or inflammation-associated parameters among r-NSWs in the experimental group. However, our findings revealed significant decreases in REV-ERBα gene expression (p = 0.048) and increases in the REV-ERBα/BMAL1 ratio (p = 0.040) compared to baseline in PBMCs isolated from this cohort. Diminished expression of REV-ERBα persisted, although the REV-ERBα/BMAL1 ratio returned to baseline levels after the subsequent 12-day wash-out period.ConclusionsOur results revealed that intermittent light therapy had no impact on inflammatory parameters or glucose tolerance in a defined cohort of r-NSWs. However, significant changes in the expression of circadian clock genes were detected in PBMCs of these subjects undergoing light therapy.

Physical Activity and Nutrition Interventions for Type 1 Diabetes: A Meta-analysis.

Current evidence is lacking on physical activity and nutrition-based interventions focusing on the management of type 1 diabetes mellitus (T1DM) and health-related quality of life among children. To assess the effects of physical activity interventions and nutrition-based interventions for children with T1DM. Data sources include the Cochrane Central Register of Controlled Trials, Medline, clinicaltrials.gov, the World Health Organization International Clinical Trials Registry Platform, CINAHL through January 2022. Study selection includes randomized controlled trials of children aged 18 years and below with T1DM comparing either a physical activity intervention, a nutrition-based intervention, or hybrid physical activity and nutrition-based intervention with placebo or no-treatment control. Data were pooled using a random-effects model. Primary outcomes were hemoglobin A1c (HbA1c), and health-related quality of life. Eighteen trials were included. Physical activity compared with the no-treatment group showed a lack of effect on HbA1c (mean difference = -0.58, 95% confidence interval -1.20 to 0.05; P value = .07). Nutrition-based intervention compared with no-treatment control for HbA1c level revealed a lack of effect (mean difference = -0.61, 95% confidence interval -1.48 to 0.26; P value = .17). Limitations include paucity of studies and low quality of evidence caused by the risk of bias. Despite the lack of significant evidence, the generally favorable results highlight the potential of such interventions in enhancing glycemic control and health-related quality of life. Additionally, promising results from a single physical activity-nutrition-based hybrid intervention in terms of glycemic control indicate the plausible effectiveness of a mixed intervention.

The Effectiveness Of Giving Angkak And Bananas Against Anemia In Children

Iron is an important nutrient for making Hb, which is a protein in red blood cells that carries oxygen throughout the body's tissues and organs. Iron deficiency can be treated easily and inexpensively. Consuming two bananas a day is an alternative that can meet the needs of iron intake for anemic patients. This study aims to determine the effectiveness of giving Angkak and bananas to anemia in children at PMB Wati in 2021. The design of this study was a descriptive Quasy Experiment, with a two group only pre-post test design. The study involved 2 groups, namely the no-treatment group (added blood) and the treatment group (given added blood and bananas and Angkak). This research data is primary data. This instrument consists of two parts, namely the procedure sheet for giving bananas and Angkak and the action of checking Hb. In this study, the data analysis technique was carried out in two stages of calculation, successively, namely the normality test of the sample data with the Shapiro-Wilk test, and the faired sample test. All calculations were carried out with the help of SPSS for Windows software. Prior to data analysis, using a test on non-parametric statistics. The normality test of the research data used the Shapiro Wilk test. The results of the study were p-value 0.000 &lt; 0.05, meaning that the addition of blood plus bananas and red rice was more effective in increasing hemoglobin levels in anemic children. The conclusion showed that there was a change (increase) in hemoglobin levels after being given treatment to the two groups, namely the added blood group plus bananas and Angkak.

A Cost-Effectiveness Analysis of Comprehensive Smoking-Cessation Interventions Based on the Community and Hospital Collaboration.

BackgroundThe prevalence of cigarette smoking in China is high and the utilization of smoking cessation clinics is very low. Multicomponent smoking cessation interventions involving community and hospital collaboration have the potential to increase the smoking cessation rate. However, the cost-effectiveness of this intervention model is unknown.MethodsWe conducted a smoking cessation intervention trial in 19 community health service centers in Beijing, China. A cost-effectiveness analysis was performed from a societal perspective to compare three strategies of smoking cessation: no intervention (NI), pharmacological intervention (PI), and comprehensive intervention (CI) (PI plus online health promotion). A Markov model, with a time horizon of 20 years, was used to simulate the natural progression of estimated 10,000 male smokers. A cross-sectional survey was conducted to obtain data on costs and quality-adjusted life years (QALYs) by using the five-level EuroQol-5-dimension (EQ-5D-5L) questionnaire. Probabilistic sensitivity analysis was performed to explore parameters of uncertainty in the model.ResultsA total of 680 participants were included in this study, including 283 in the PI group and 397 in the CI group. After 6 months of follow-up, the smoking cessation rate reached 30.0% in the CI group and 21.2% in the PI group. Using the Markov model, compared with the NI group, the intervention strategies of the PI group and the CI group were found to be cost-effective, with an incremental cost-effectiveness ratio (ICER) of $535.62/QALY and $366.19/QALY, respectively. The probabilistic sensitivity analysis indicated that the CI strategy was always the most cost-effective intervention.ConclusionCI for smoking cessation, based in hospital and community in China, is more cost-effective than PI alone. Therefore, this smoking cessation model should be considered to be implemented in healthcare settings.

Dry preserved multilayered fibroblast cell sheets are a new manageable tool for regenerative medicine to promote wound healing

This study investigated the therapeutic effects of dry-preserved multi-layered fibroblast cell sheets (dry sheets) on cutaneous ulcers. Dry sheets were prepared by air-drying multi-layered fibroblast cell sheets (living sheets) to cease their life activities. Before in vivo application, we tested the release of growth factors into the medium to examine the mechanisms of dry sheets in wound healing. Vascular endothelial growth factor (VEGF) and hepatocyte growth factor (HGF) were released from both dry and living sheets, while high levels of fibroblast growth factor-2 (FGF-2) and high mobility group box 1 (HMGB1) protein were only from dry sheets. An in vitro fibroblast proliferation assay revealed that the dry sheet eluate significantly enhanced cell proliferation and VEGF and HGF production compared with living sheet eluate. FGF-2-neutralizing antibodies significantly blocked this proliferative response. In wounds created on diabetic mice, the dry sheet-treatment groups using autologous or allogeneic cells showed significantly accelerated wound closure compared with that in the no-treatment group. The storage stability of the dry sheet was better at refrigeration temperature than at room temperature and remained stable for at least 4 weeks. Our data indicated that allogeneic dry sheets represent a promising new tool for regenerative medicine that promotes wound healing.

Examining the Impact of a First Grade Whole Number Intervention by Group Size

This study utilized a partially nested randomized control design to investigate the impact of Fusion, a first-grade math intervention. Blocking on classrooms, students were randomly assigned to one of the three conditions: a Fusion two-student group, a Fusion five student group, or a no-treatment control group. Two primary research questions were examined: What was the overall impact of the Fusion intervention as compared to a business-as-usual comparison condition? and Was there a differential impact on student outcomes between the 2:1 Fusion and the 5:1 Fusion conditions? Analyses found a positive effects on four outcome measures favoring Fusion groups over control with two of the differences statistically significant. Results between Fusion groups found positive effects favoring the Fusion 2:1 group compared to the Fusion 5:1 group on all four outcome measures with two of the differences statistically significant. On a second-grade follow-up measure, no difference was found between Fusion groups and control, but a statistically significant difference was found between Fusion groups favoring the 2:1 Fusion group. Future research directions and implications for practice are discussed.