Number Of Weeks Research Articles

Postoperative psychological factors and quality of life but not shoulder brace adherence affect clinical outcomes after arthroscopic rotator cuff repair.

Despite the high prevalence, there is no consensus for postsurgical management after rotator cuff repair. We aimed to assess the impact of psychological well-being on patients who underwent rotator cuff repair. We also investigated correlations and possible predictors between patient demographics and adherence to the use of the shoulder brace and outcomes in terms of shoulder functionality and quality of life. We conducted a retrospective study with prospective data collection enrolling 120 consecutive patients who underwent shoulder arthroscopy for rotator cuff tear repair. Each patient was clinically evaluated after a mean follow-up of 24.2 (±9.8) months using (1)the Disability of the Arm, Shoulder and Hand (DASH) scale, (2) the Hospital Anxiety and Depression Scale (HADS), (3) the Rotator Cuff Quality of Life (RC-QoL), (4) the visual analog scale, and (5) the Medical Adherence Measure. The final sample consisted of 100 patients (45 females, 45%) averaging 60.9 (±8.5) years. The average brace wearing time was 3.4 (±0.6) weeks, with an adherence superior to 80% in 84% of cases, and 96% of patients were living with family members. The mean postoperative DASH scores were 20.1 (±16.7), 23.4 (±25), and 18.9 (±21.5) for the general, work, and sport sections, respectively. The mean Medical Adherence Measure score reached 72.5 (±14.2) points, and the RC-QoL mean score was 30.4% (±20.5). The Hospital Anxiety and Depression Scale-Anxiety and Hospital Anxiety and Depression Scale-Depression scores' continuous mean values were 5.1 (±3.4) and 3.9 (±3.6), respectively. The DASH, Hospital Anxiety and Depression Scale-Anxiety, Hospital Anxiety and Depression Scale-Depression, and RC-QoL scores directly correlated with each other, and all these questionnaires directly correlated with the visual analog scale scores. Moreover, we found a direct correlation (r=0.204, P=.033) between the female sex and adherence to the brace and a direct correlation (r=0.242, P=.015) between adherence to the brace and the number of weeks it was worn according to the medical recommendation. A correlation between lower educational qualifications and poorer outcomes was found. No correlation emerged between adherence to the brace and functional results. According to the regression analysis, diabetes was found to be a predictor of worse postoperative DASH scores (β=0.245, P=0.28). A lower perceived quality of life was associated with worse functional results, anxiety and depression symptoms, and pain after rotator cuff repair surgery. The adherence to the use of the shoulder brace was associated with the female sex and a longer prognosis, but no correlation emerged between adherence to the brace and functional outcomes.

Soilless Culture Applications for Early Development of Soybean Crop (Glycine max L. Merr)

Soilless cultivation systems in a controlled environment are increasingly being used due to several global issues such as climate change, pest and disease problems, declining soil fertility quality and limited agricultural land. Soybean is one of the potential crops that can be grown using the soilless planting system in a controlled environment. Therefore, a study was conducted to investigate the effect of nutrient concentrations on the early development of two soybean varieties. Four different nutrient concentrations (0%, 50%, 100% and 150%) were applied, and two soybean varieties (Martina and Johanna) were tested. This study was designed in a split-plot experimental design where the nutrient concentration was the main plot and the variety was the sub-plot. The data record was started after fertilization. The plant growth data were collected for five weeks. All the data were analyzed statistically using SPSS V.23 software. The results of the study found that the nutrient concentration affected the number of leaves and leaf area. The number of leaves was higher in the treatment using 100% and 150% nutrients. Meanwhile, the leaf area increased with increasing nutrient concentration from 0% to 150%. The nutrient concentration then interacted with the variety in influencing the plant height. The plant height of the Martina variety was higher than the Johanna variety when 0% and 100% nutrients were applied. The variety also affected the leaf area and interacted with the number of weeks in affecting the SPAD readings and number of leaves. Thus, the two tested varieties (Johanna and Martina) have distinct early growth patterns that differ from one another as affected by the nutrient concentrations and plant age (number of weeks).

Effect of ultrasonographic lung consolidation on health and growth in dairy calves: A longitudinal study

Bovine respiratory disease (BRD) is a common and complex disease process in calves. Subclinical disease exists and early detection can be challenging due to inconsistent or nonexistent clinical signs. Thoracic ultrasonography (TUS) is often used and has the potential to improve the identification of respiratory diseases. Combining systematic TUS with clinical examination allows distinguishing BRD, including upper respiratory tract disease (clinical signs of respiratory disease, but no significant lung consolidation), clinical pneumonia (clinical signs of respiratory disease along with lung consolidations), and subclinical pneumonia (no clinical signs, but lung consolidations). Data on subclinical pneumonia are scarce, particularly outside of the North American or European contexts similar to Iran in west Asia with a dry and semi-arid climate and intensive breeding systems similar to North America which breeding calves begin in individual boxes, then moving to group pens, and finally to free stall or open shed housing systems. The first objective of this longitudinal study was to use weekly ultrasonography to monitor calves from birth until weaning in an Iranian dairy herd. The second objective was to look for any association between individual lung consolidation episode or cumulative consolidation episodes on preweaning growth. Thoracic ultrasonography TUS was performed on calves (n = 221) weekly from birth to weaning (8 wk), and scanning occasions for each calf were equally distributed with 1-wk intervals (using consolidation threshold ≥3 cm as a specific lung consolidation definition, and ≥1 cm as a more sensitive threshold). Calf body weights were recorded using a weight tape. Other information recorded were transfer of passive immunity (TPI) using serum Brix (%) ≥8.4% as adequate TPI within the first week after birth and the treatment history of the calves. The main strategy for modeling was to determine how long-term lung consolidation affects average daily gain (ADG) during the preweaning period. A linear model was used to determine the effect of the number of weeks with consolidation on ADG. Using consolidation threshold of ≥3 cm, the mean (±SD) of total ADG for calves with no consolidation episode, one consolidation episode, and 2 or more consolidation episodes were: 0.45 (±0.10), 0.39 (±0.10), and 0.38 (±0.11) kg/d, respectively. In the final multivariable regression analysis model and based on consolidation threshold of ≥3 cm, calves with one and 2 or more consolidation episodes had significantly lower ADG ± standard error of 0.04 ± 0.02 kg/d, and 0.06 ± 0.02 kg/d, respectively compared with animals with no consolidation episode. A total of 20% of calves (46/229 calves that entered the study) were treated for respiratory disease based on clinical signs (based on farmer examination). The final model also included specific confounders related to ADG and their interactions with lung consolidation (transfer of passive immunity [TPI] and BRD treatment). An overall of 86% of adequate TPI was obtained. BRD treatment based on farmer diagnosis had a larger negative effect on preweaning ADG than ultrasonography-diagnosed consolidation episodes (lower ADG ± SE of 0.10 ± 0.03 kg/d). When using a more sensitive consolidation threshold (≥1 cm as consolidation), the number of weeks with consolidation was also negatively associated with the ADG in the multivariable linear regression model with significant difference of 0.05 ± 0.02 kg/d for nonconsolidated calves versus calves consolidated for 2 or more weeks and insignificant difference of 0.01 ± 0.02 kg/d for nonconsolidated calves versus calves with 1 consolidation episode.

Time on the crossing: emigrant voyages across the Atlantic, 1853–1913

Abstract I provide a new series of the average duration of emigrant voyages from Liverpool to New York from 1853 to 1913. Time on the crossing fell by 80 percent, from about 40 days to just eight, most of which occurred in the first 2 decades and was associated with the transition from sail to steam. The standard deviation of voyage durations also dramatically decreased. Although average transatlantic fares did not fall, if foregone earnings during the voyage are included, the total cost declined until the early 1900s, and especially so when measured in terms of the number of weeks’ work.

An Automatically Adaptive Digital Health Intervention to Decrease Opioid-Related Risk While Conserving Counselor Time: Quantitative Analysis of Treatment Decisions Based on Artificial Intelligence and Patient-Reported Risk Measures.

Some patients prescribed opioid analgesic (OA) medications for pain experience serious side effects, including dependence, sedation, and overdose. As most patients are at low risk for OA-related harms, risk reduction interventions requiring multiple counseling sessions are impractical on a large scale. This study evaluates whether an intervention based on reinforcement learning (RL), a field of artificial intelligence, learned through experience to personalize interactions with patients with pain discharged from the emergency department (ED) and decreased self-reported OA misuse behaviors while conserving counselors' time. We used data representing 2439 weekly interactions between a digital health intervention ("Prescription Opioid Wellness and Engagement Research in the ED" [PowerED]) and 228 patients with pain discharged from 2 EDs who reported recent opioid misuse. During each patient's 12 weeks of intervention, PowerED used RL to select from 3 treatment options: a brief motivational message delivered via an interactive voice response (IVR) call, a longer motivational IVR call, or a live call from a counselor. The algorithm selected session types for each patient each week, with the goal of minimizing OA risk, defined in terms of a dynamic score reflecting patient reports during IVR monitoring calls. When a live counseling call was predicted to have a similar impact on future risk as an IVR message, the algorithm favored IVR to conserve counselor time. We used logit models to estimate changes in the relative frequency of each session type as PowerED gained experience. Poisson regression was used to examine the changes in self-reported OA risk scores over calendar time, controlling for the ordinal session number (1st to 12th). Participants on average were 40 (SD 12.7) years of age; 66.7% (152/228) were women and 51.3% (117/228) were unemployed. Most participants (175/228, 76.8%) reported chronic pain, and 46.2% (104/225) had moderate to severe depressive symptoms. As PowerED gained experience through interactions over a period of 142 weeks, it delivered fewer live counseling sessions than brief IVR sessions (P=.006) and extended IVR sessions (P<.001). Live counseling sessions were selected 33.5% of the time in the first 5 weeks of interactions (95% CI 27.4%-39.7%) but only for 16.4% of sessions (95% CI 12.7%-20%) after 125 weeks. Controlling for each patient's changes during the course of treatment, this adaptation of treatment-type allocation led to progressively greater improvements in self-reported OA risk scores (P<.001) over calendar time, as measured by the number of weeks since enrollment began. Improvement in risk behaviors over time was especially pronounced among patients with the highest risk at baseline (P=.02). The RL-supported program learned which treatment modalities worked best to improve self-reported OA risk behaviors while conserving counselors' time. RL-supported interventions represent a scalable solution for patients with pain receiving OA prescriptions. Clinicaltrials.gov NCT02990377; https://classic.clinicaltrials.gov/ct2/show/NCT02990377.

The impact of aggregate positive lifestyle behaviors on low back pain resilience and care seeking

BACKGROUND CONTEXTLow back pain (LBP) is a global issue, and the high associated costs are mainly attributed to a small proportion of people with LBP who seek care. Importantly, the impact of aggregate positive lifestyle behaviors on LBP resilience and care seeking is not known. PURPOSEThis study aimed to evaluate the relationship between positive lifestyle behaviors and LBP resilience. STUDY DESIGNThis study was a prospective longitudinal cohort study. PATIENT SAMPLEData was collected as part of the AUstralian Twin BACK Study (AUTBACK). Participants who reported a lifetime previous history of LBP at baseline were included in this analysis (n = 340). OUTCOME MEASURESThe outcomes of interest were the number of weeks without activity limiting LBP and total number of days of healthcare usage, health practitioner care, self-management care, and medication intake. METHODSA lifestyle behavior score was built using variables of body mass index (BMI), physical activity, smoking status, and sleep quality. Negative binomial regression analyses were used to assess the relationship between the positive lifestyle behavior score and the count outcomes of number of weeks without activity limiting LBP and number of days participants used care. RESULTSAfter adjusting for covariates, no association was found between participants’ positive lifestyle behavior score and their number of weeks without activity limiting LBP (IRR: 1.02, 95% CI 1.00–1.05). There was a statistically significant relationship between higher positive lifestyle behavior scores and fewer number of days of participants’ total healthcare usage (IRR:0.69, 95% CI 0.56–0.84), healthcare practitioner visits (IRR:0.62, 95% CI 0.45–0.84), use of self-management strategies (IRR:0.74, 95% CI 0.60–0.91), and use of pain medication (IRR:0.55, 95% CI 0.44–0.68). CONCLUSIONPeople who adopt optimal lifestyle behaviors, such as engaging in adequate physical activity, achieving optimal quality sleep, maintaining an ideal BMI, and not smoking, may not experience less time suffering from activity limiting LBP, but are less likely to use healthcare and pain medication for their LBP.

P15 Progressive papulonodular eruption following COVID-19 infection: a rare diagnosis and review of the literature

Abstract We report a rare case of primary cutaneous CD8+ aggressive epidermotrophic cytotoxic T-cell lymphoma with striking clinical and histopathological features. A 51-year-old man, originally from Cameroon, presented to the department with a 6-week history of a progressive, itchy papulosquamous eruption that started on the lower abdomen shortly following infection with COVID-19. It became widespread over a short number of weeks, with blistering and ulceration in some areas. The patient reported fatigue with an intermittent low-grade pyrexia, but no systemic symptoms otherwise, and he was previously fit and well. Physical examination revealed an extensive, infiltrated papulonodular eruption with thick scale that was more marked in the skinfolds and involving the acral surfaces. Histology from three morphologically different sites showed marked epidermal hyperplasia and a prominent epidermotrophic infiltrate of medium-sized atypical lymphoid cells. There were frequent mitotic figures and evidence of apoptosis. Immunohistochemistry revealed that the atypical lymphoid cells in the epidermis were T cells expressing CD3, CD7 and CD8, together with cytotoxic markers and a high Ki67 proliferation fraction. These features were consistent with a diagnosis of CD8+ aggressive epidermotrophic cytotoxic T-cell lymphoma. Initial bloods and imaging were fairly unremarkable. Since the diagnosis, the patient has been treated with multiple types and courses of chemotherapy, with relapses in between. Most recently, the patient has been referred for total skin electron beam therapy with investigations for allogenic stem cell transplant ongoing. Owing to its rarity, primary cutaneous CD8+ aggressive epidermotrophic cytotoxic T-cell lymphoma is categorized only as a provisional entity in the most recent World Health Organization classification (Gilson D, Whittaker SJ, Child FJ et al. British Association of Dermatologists and U.K. Cutaneous Lymphoma Group Guidelines for the management of primary cutaneous lymphomas 2018. Br J Dermatol 2018; 180:496–526). Despite a variable and polymorphic presentation, the histology is distinctive in showing monomorphous, medium-sized atypical lymphocytes in the epidermis. We discuss the epidemiology of the disease and the paucity of therapeutic guidelines. In addition, our patient’s disease developed soon after COVID-19 infection; hence, we review the growing literature on the association between COVID-19 infection and vaccination and diagnosis, and relapse and remission of cutaneous T-cell lymphoma.

Pericope of the Canaanite Woman (Matthew 15:21–28) in a Byzantine Lectionary of the 12th c. from the IOM RAS Collection

The article describes a liturgical note in the Lectionary D 227 from the IOM RAS collection. The manuscript has an interesting variant reading: instead of the conjunction (for, because) we found the numeral (fifty-four). It can be assumed that the variant is not only a scribal error. It is possible that the original manuscript was corrupt at this point and the scribe instead of the conjunction used the numeral denoting the number of weeks of the liturgical year. The article explains the reason for such use.

New Orleans' school meals distribution in response to the COVID-19 pandemic: operational details and geographic coverage.

To facilitate continuation of school feeding during COVID-19 school lockdowns, U.S. Congress authorized waivers to allow for school meals to be picked up by parents/guardians in non-school settings. We summarized school meals distribution and characterized reach in socially vulnerable neighborhoods in New Orleans, a city prone to environmental disasters, with a city-wide charter school system, and historically high levels of child poverty and food insecurity. School meals operations data were obtained from New Orleans, Louisiana (NOLA) Public Schools for 3/16/2020-5/31/2020. For each pick-up location, we estimated: average meals available (weekly), average meals served (weekly), number of weeks of operation, and rate of meal pick-up ([meals served/meals available]*100). These characteristics were mapped in QGIS v3.28.3, along with neighborhoods' Social Vulnerability Index (SVI). Pearson correlation and ANOVA were run to assess differences between operations characteristics and neighborhood SVI. From 38 meal sites, 884,929 meals were available for pick-up; 74% of pick-up sites were in moderately/highly socially vulnerable areas. Correlations between average meals available and served, weeks of operation, rate of meal pick-up, and SVI were weak and not statistically significant. SVI was associated with average rate of meal pick-up but not other operations characteristics. Despite the disaggregated nature of the charter school system, NOLA Public Schools successfully pivoted to providing children with pick-up meals due to COVID-19 lockdowns, with 74% of sites located in socially vulnerable neighborhoods. Future studies should describe the types of meals provided to students during COVID-19, in terms of diet quality and nutrient adequacy.

Predictors of Participation in the U.S. Department of Agriculture Summer Meal Programs: An Examination of Outreach Strategies and Meal Distribution Methods During COVID-19

Significantly fewer children participate in the U.S. Department of Agriculture-sponsored summer meal programs than in the federal school meal programs during the academic year. During the summer of 2021, several pandemic-related waivers supported more flexible operations for summer meal programs, such as allowing grab-and-go meals and the distribution of meals for multiple days at once. This study assessed how summer meal site characteristics and geographically targeted outreach methods were associated with summer meals served in 2021 in Connecticut. Weekly meal count data were requested from all sponsors of the Summer Food Service Program and the National School Lunch Program Seamless Summer Option. Data were received from 78 sponsors with 763 sites. Geographically targeted outreach (e.g., billboards, bus ads, and flyers) was tracked by location each week. Mixed methods ANOVA was used to examine the predictive value of outreach efforts, program characteristics, and meal distribution methods on meals served each week. The program characteristics examined included the hours open per week, the number of weeks serving meals, the maximum number of meals distributed at one time, and the number of open and closed sites in a school district. Between June 21 and August 20, 2021, a total of 1,188,669 breakfasts and 1,389,347 lunches were served. Sites that were open more hours per week (mean=7.60 hours per week; range=0.17-35) and gave multiple meals to parents at each visit (mean=4.68 meals; range=1-15) reported greater rates of meal distribution. The outreach efforts assessed were not significantly associated with changes in meal distribution at nearby sites. The U.S. Department of Agriculture's waivers in response to COVID-19 permitted extended operating hours and multiple-meal distribution. These operational flexibilities should be considered for permanent regulation changes owing to their positive association with summer meal participation.

Are Local Drug Delivery Systems a Challenge in Clinical Periodontology?

Placing antimicrobial treatments directly in periodontal pockets is an example of the local administration of antimicrobial drugs to treat periodontitis. This method of therapy is advantageous since the drug concentration after application far surpasses the minimum inhibitory concentration (MIC) and lasts for a number of weeks. As a result, numerous local drug delivery systems (LDDSs) utilizing various antibiotics or antiseptics have been created. There is constant effort to develop novel formulations for the localized administration of periodontitis treatments, some of which have failed to show any efficacy while others show promise. Thus, future research should focus on the way LDDSs can be personalized in order to optimize future clinical protocols in periodontal therapy.

Feasibility and Acceptability of Community-Based Telehealth to Prevent Long-Term Care Readmission.

Transitioning to community living after long-term care requires multiple complex individualized interventions to prevent readmission. The current focus of home and community-based services (HCBS) is on increasing consumer engagement and individualizing care. Telehealth interventions provide additional services without the burden of face-to-face encounters and have yet to be evaluated for feasibility and acceptability in rural HCBS. West Virginia Bureau for Medical Services and West Virginia University implemented and evaluated a telehealth intervention with 26 Aged and Disabled Waiver or Traumatic Brain Injury Waiver participants who were transitioning back into their communities from a long-term care facility. Feasibility was assessed through recruitment process, fidelity to planned intervention, number of people eligible for participation, number of individuals enrolling in the intervention, enrollment process, completed enrollment, engagement in the intervention, number of weeks participating in the intervention, type of devices provided, attrition, and fidelity to original intervention. Satisfaction with services was used as a marker of acceptability for both participants and providers. Half (n = 12) of the enrolled population completed the full 24-week telehealth monitoring period and modification of the original intervention was necessary for most. Provider and participant satisfaction was high. Recruitment and enrollment may have been affected by COVID-19. Future implementation will continue to track recruitment and retention efforts. Individualized care plans, demonstration and practice with equipment, family or direct-care worker presence, and live technical support through the phone are needed. Primary care provider and in-home direct-care worker satisfaction workflow planning and evaluation are required.

Trends in Northern Hemispheric Snow Presence

Abstract This paper develops a mathematical model and statistical methods to quantify trends in presence/absence observations of snow cover (not depths) and applies these in an analysis of Northern Hemispheric observations extracted from satellite flyovers during 1967–2021. A two-state Markov chain model with periodic dynamics is introduced to analyze changes in the data in a cell by cell fashion. Trends, converted to the number of weeks of snow cover lost/gained per century, are estimated for each study cell. Uncertainty margins for these trends are developed from the model and used to assess the significance of the trend estimates. Cells with questionable data quality are explicitly identified. Among trustworthy cells, snow presence is seen to be declining in almost twice as many cells as it is advancing. While Arctic and southern latitude snow presence is found to be rapidly receding, other locations, such as eastern Canada, are experiencing advancing snow cover. Significance Statement This project quantifies how the Northern Hemisphere’s snow cover has recently changed. Snow cover plays a critical role in the global energy balance due to its high albedo and insulating characteristics and is therefore a prominent indicator of climate change. On a regional scale, the spatial consistency of snow cover influences surface temperatures via variations in absorbed solar radiation, while continental-scale snow cover acts to maintain thermal stability in the Arctic and subarctic regions, leading to spatial and temporal impacts on global circulation patterns. Changing snow presence in Arctic regions could influence large-scale releases of carbon and methane gas. Given the importance of snow cover, understanding its trends enhances our understanding of climate change.

Evaluation of FTO polymorphism in 6-mercaptopurine related intolerance in children with acute lymphoblastic leukemia.

Thiopurine drugs like 6-Mercaptopurine (6MP) are the cornerstone of maintenance therapy in acute lymphoblastic leukemia (ALL). A recently described variant in alpha-ketoglutarate dependent dioxygenase (FTO) gene has been reported to play an important role in thiopurine induced myelosuppression. In this study, we genotyped a coding variant (p.Ala134Thr, rs79206939) and an intronic variant (rs16952570) of FTO in 174 Indian children (age ≤ 12years) with ALL on maintenance phase of chemotherapy and examined correlation with the risk of thiopurine induced myelosuppression and hepatic toxicity. The prevalence of FTO-rs16952570 polymorphism was 18.4% (32/174) with 142 (82%) cases having TT genotype, 26 (15%) cases with TC genotype and 6 (3.4%) cases having CC genotype. FTO-rs79206939 was absent and non-polymorphic in our study group. The mean dose of 6-MP during 36weeks of maintenance of TT, TC and CC carriers of FTO-rs16952570 was 53.7, 53.6 and 54.1mg/m2/day. Number of patients tolerating starting dose of 60mg/m2/day was significantly higher in CC (50%) than TT/TC (14%) genotype carrying cases (p = 0.014). However, no statistical significance was observed for total leukocyte count (TLC), absolute neutrophil count (ANC) as well as for platelets counts in patients harboring FTO-rs16952570 TT/TC/CC genotype at 4, 8, 12, 24 and 36weeks after start of thiopurine therapy. Further, no significant correlation was noted between number of weeks of chemotherapy interruptions or episodes of febrile neutropenia and no evidence of hepatotoxicity was found with the genotype studied. Polymorphism in FTO-rs16952570 did not show any correlation with thiopurine related toxicity in ALL patients.

Romiplostim in primary immune thrombocytopenia that is persistent or chronic: phase III multicenter, randomized, placebo-controlled clinical trial in China

BackgroundMultiple trials have confirmed that romiplostim could increase platelet count in individuals with primary immune thrombocytopenia (ITP), but no related study has assessed Chinese patients. ObjectivesTo assess the effectiveness of romiplostim as a second-line treatment of persistent or chronic ITP in Chinese adults. MethodsThis phase III multicenter, randomized, placebo-controlled, double-blind, then open-label clinical trial (NCT02868099, CTR20150395) was conducted at 28 investigational sites in China. The patients were randomly assigned (3:1) to romiplostim (starting and maximum doses of 1 and 10 μg/kg, respectively) or placebo for 9 weeks (double-blind period), followed by the open-label period (both groups administered romiplostim) to week 22. The primary endpoint was the time (in weeks) during which platelet counts were ≥50 × 109/L in the double-blind period. ResultsIn this study, 202 patients (romiplostim, n = 151; placebo, n = 51) started the treatment. The median (range) numbers of weeks with platelet response after 6 weeks of treatment were 2 (0-6) and 0 (0-2) in patients administered romiplostim and placebo, respectively (P < .001). During the double-blind period, the proportions of patients with treatment-emergent adverse events were comparable between the romiplostim and placebo groups (82.8% vs 82.4%). The treatment-emergent adverse event with ≥10% difference in incidence between these 2 groups was injection site bleeding (1.3% vs 11.8%). ConclusionRomiplostim significantly increased the time with maintained platelet response in patients with persistent or chronic ITP in comparison with placebo. No new safety signal was observed. Trial registrationClinicalTrials.gov, NCT02868099. www.chinadrugtrials.org.cn/clinicaltrials.searchlist.dhtml, CTR20150395

Can exercise prevent the age‐related decline in adaptive homeostasis? Evidence across organisms and tissues

Can exercise prevent the age‐related decline in adaptive homeostasis? Evidence across organisms and tissues

How do Risk Perceptions Drive Smokers to Completely Switch to a Smoke-Free Tobacco Product (IQOS ™)? A Four-Country Cohort Study

SUMMARY Background The perceived reduced formation of harmful chemicals (RF) or perceived reduced risk of harm (RH) of a smoke-free tobacco product relative to combustible tobacco products may influence its acceptance and use patterns among adult smokers and therefore impact public health. We analyzed whether and how the RF and/or RH of the heated tobacco product (HTP) IQOS ™ impacted “exclusive” (100%) IQOS ™ use in Japan, Italy, Germany, and Russia. Methods Between 2016 and 2020, adult participants from longitudinal IQOS ™ user cohorts in Japan (N = 6257), Italy (N = 8137), Germany (N = 8474), and Russia (N = 7231) repeatedly indicated the reasons for using IQOS ™, including reasons referring to RF and RH, during their first 48 weeks in the cohort. Logistic and Cox regression were used to analyze the relationships between RF and/or RH indications for using IQOS ™ and exclusive or stable exclusive IQOS ™ use. Results At week 48, exclusive IQOS ™ use in Japan (odds ratio [OR] = 1.89), Italy (OR = 3.35), Germany (OR = 3.48), and Russia (OR = 3.05) was more likely among participants who more frequently (highest vs. lowest category of number of RF and/or RH indications) indicated RF and/or RH as a reason for using IQOS ™. In Japan, where other HTPs were also marketed, this was also true for the overall HTP category. Also, in Japan where RF and RH could be indicated separately as reasons for using IQOS ™, indicating RH (OR = 2.92) compared to RF (OR = 1.81) resulted in a greater likelihood of exclusive IQOS ™ use within the highest category of RF or RH indications. In Japan (hazard ratio [HR] = 0.74), Italy (HR = 0.80), Germany (HR = 0.72), and Russia (HR = 0.85), IQOS ™ users who indicated RF and/or RH as a reason for using IQOS ™ had a lower risk of becoming a stable nonexclusive than stable exclusive IQOS ™ user as well as a 10–25% lower number of weeks until reaching stable exclusive IQOS ™ use. Conclusions Perceived reduced formation of harmful chemicals (RF) or perceived reduced risk of harm (RH) of IQOS ™ have a significant impact on IQOS ™ users’ switching to exclusive IQOS ™ use and the acceleration of stable exclusive IQOS ™ use. This may also be true for the overall HTP category. Moreover, perceived RH of IQOS ™ seems to be a stronger driver for exclusive IQOS ™ use than perceived RF. [Contrib. Tob. Nicotine Res. 32 (2023) 50–64]

Facilitated subcutaneous immunoglobulin 10% at a target dose of 0.4 g/kg/infusion is well tolerated with accelerated or no dose ramp-up in healthy participants

IntroductionTransitioning to recombinant human hyaluronidase-facilitated subcutaneous immunoglobulin (fSCIG) infusions from intravenous immunoglobulin therapies in primary immunodeficiency disease (PID) is implemented using a gradual dose ramp-up schedule, whereby infusion volumes are increased over a number of weeks to achieve the target dose level (TDL). This study investigated the tolerability and safety of fSCIG 10% at a TDL of 0.4 g/kg/infusion (i.e. 4 mL/kg/infusion) with accelerated and no dose ramp-up schedules in comparison with conventional dose ramp-up. MethodsThis was a phase 1, open-label, single-center trial (NCT04578535). This analysis compared three fSCIG 10% treatment arms at a TDL of 0.4 g/kg/infusion: (i) conventional dose ramp-up from 0.1 g/kg/infusion at Week 1 increasing to the TDL at Week 8; (ii) accelerated dose ramp-up from 0.2 g/kg/infusion at Week 1 increasing to the TDL at Week 5; (iii) the TDL administered without dose ramp-up. Participants were healthy adults aged 19–50 years. The primary endpoint was the tolerability of fSCIG 10% infusions, assessed as the proportion of participants who completed all initiated infusions without interruptions, stoppages or reductions in infusion rate due to treatment-emergent adverse events (TEAEs). Safety was assessed as a secondary endpoint. ResultsTwenty-four participants (mean [standard deviation] age 35.3 [8.6] years; 62.5% female) were assigned equally to the three treatment arms. All participants completed all initiated infusions except for one participant who experienced a headache resulting in an infusion rate reduction in the conventional dose ramp-up arm. All participants experienced local TEAEs, including infusion site swelling, erythema, pain and pruritus. Systemic TEAEs were experienced by 1/8 (12.5%), 2/8 (25.0%) and 2/8 (25.0%) participants in the conventional, accelerated and no dose ramp-up arms, respectively. All TEAEs were mild in severity. ConclusionsfSCIG 10% at a target dose of 0.4 g/kg/infusion showed a favorable safety and tolerability profile in healthy adults, with comparable tolerability and safety outcomes between the dose ramp-up treatment arms. Accelerated and no dose ramp-up schedules could be considered as potential alternatives to conventional dose ramp-up.Takeda Development Center Americas, Inc. funded this study. Takeda Pharmaceuticals International AG funded writing support.

Group-Based Patterns of Life Satisfaction and Functional Independence over the 10 Years after Traumatic Brain Injury in Older Adults: A Model Systems Study.

Older adults who sustain a traumatic brain injury (TBI) have been shown to have reduced functional independence and life satisfaction relative to younger individuals with TBI. The purpose of this study was to examine the covarying patterns of functional independence and life satisfaction over the 10 years after TBI in adults who were 60 years of age or older upon injury. Participants were 1841 individuals aged 60 or older at the time of TBI, were enrolled in the longitudinal TBI Model Systems database, and had Functional Independence Measure and Satisfaction with Life Scale scores during at least one time point at 1, 2, 5, and 10 years after TBI. A k-means cluster analysis identified four distinct group-based longitudinal patterns of these two variables. Three cluster groups suggested that functional independence and life satisfaction generally traveled together over time, with one group showing relatively high functional independence and life satisfaction over time (Cluster 2), one group showing relatively moderate functional independence and life satisfaction (Cluster 4), and one group showing relatively low functional independence and life satisfaction (Cluster 1). Cluster 3 had relatively high functional independence over time but, nonetheless, relatively low life satisfaction; they were also the youngest group upon injury. Participants in Cluster 2 generally had the highest number of weeks of paid competitive employment but lower percentages of underrepresented racial/ethnic minority participants, particularly Black and Hispanic individuals. Women were more likely to be in the cluster with the lowest life satisfaction and functional independence (Cluster 1). Functional independence and life satisfaction generally accompany one another over time in older adults, although this does not always occur, as life satisfaction can still be low in a subgroup of older individuals after TBI with higher functioning. These findings contribute to a better understanding of post-TBI recovery patterns in older adults over time that may inform treatment considerations to improve age-related discrepancies in rehabilitation outcomes.

Childhood Trauma and Substance Use Treatment Length of Stay and Completion

ABSTRACT Using clinical data mining (CDM) methodology, this study evaluates the relationship between childhood trauma and treatment outcomes among adults with substance use disorders. Data come from three substance use treatment facilities operating under the same agency using the same treatment program (N = 444). We examined the influence of childhood trauma, neglect, and school violence on substance use treatment completion and length of stay. We also looked at the connection between client’s family history of substance use and their experience of neglect and childhood trauma. We found that family history of substance use was significantly related to both neglect and childhood trauma. We also found that the number of weeks a client spent in treatment was associated treatment location. Furthermore, client age at admission and program completion were significantly related. Marital status, sex, and number of diagnoses significantly related to childhood trauma. These findings suggest that comprehensive assessments that focus on understanding client demographics and history of family substance use can guide effective intervention. Further research on how childhood trauma influences substance use treatment outcomes can also help improve treatment.