Study Participants Research Articles

Clinical effectiveness of a standardized community-based supervised post-acute rehabilitation model after total knee arthropathy: A pilot study

Background: Hospital-based outpatient physiotherapy is the standard of care for subacute rehabilitation after total knee arthroplasty (TKA) in Singapore. This study explores the clinical effectiveness of a standardized rehabilitation model at community-based rehabilitation centers to align the appropriate utilization of tertiary and community rehabilitative resources. Methods: In this pilot study, patients who had undergone TKA were assigned to either control group (n=30) or to intervention group (n=29). The control group received usual hospital-based outpatient physiotherapy, while the intervention group received rehabilitation at a community-based rehabilitation center based on standardized institution protocol. Primary and secondary outcomes were assessed at baseline and at 3 months post TKA. Results: Baseline characteristics in both groups were not significantly different. All patients completed the study. At 3 months, there were no significant differences in the Time Up and Go test (P<0.853), median 30 s chair rise (P=0.347), knee flexion passive range of motion (P=0.933), knee extension passive range of motion (P=0.409), and presence of knee extension lag (P=0.360). There was a lower pain intensity in the intervention group compared with the control group (P=0.003). Conclusions: A community-based post-acute TKA rehabilitative model demonstrated improvements in functional outcomes, and reduced pain intensity in study participants, with these findings being similar to that of standard of care hospital-based outpatient physiotherapy. This model of care warrants further evaluation in larger clinical trials.

Features of hematological indices in cataract in the dynamics of surgical treatment

BACKGROUND: Cataract is one of the most common ophthalmologic diseases leading to blindness. AIM: To study the features of hematological indices in men over 40 years old with different types of cataract before and after surgical treatment. MATERIAL AND METHODS: The examination groups included 25 patients (25 eyes) with opacities localized in the cortical substance of the lens, 19 (19 eyes) with total opacities, 26 (26 eyes) with nuclear opacities, 30 (30 eyes) with subcapsular opacities; of these, 43 patients (43 eyes) had initial cataract, 39 (39 eyes) — immature, 18 (18 eyes) — mature cataract. The control group consisted of 30 people. All study participants underwent a complete ophthalmologic examination and assessment of hematological indices. The following integral hematological indices were calculated using generally accepted formulas: lymphocyte index (lymphocytes/neutrophils); leukocyte intoxication index; neutrophil/lymphocyte ratio index; neutrophil/monocyte ratio index; lymphocyte/monocyte ratio index; lymphocyte/eosinophil ratio index; leukocyte ratio and erythrocyte sedimentation rate index. Statistical analysis was performed using the Statistica 10 package. The Kruskal–Wallis and Mann–Whitney nonparametric tests were used to assess differences in the groups. The critical level of statistical significance when testing scientific hypotheses was p 0.05. RESULTS: At all stages of cataract maturity, before and after surgery, unidirectional changes in the hematological indices were revealed: the lymphocyte and eosinophil ratio decreased (1.4–2.0; p=0.01), the neutrophils and monocytes (1.3–2.1; p=0.04), lymphocytes and monocytes (1.4–2.5; p=0.02) ratios, leukocytes and erythrocyte sedimentation rate (2.9–6.8; p=0.01) increased. In immature cataract, the intoxication index according to the hematological indices increased by 2 times in the dynamics of surgical treatment. At the same time, multidirectional changes in the hematological indices were revealed in cortical and subcapsular opacities of the lens, unidirectional changes — in nuclear and total opacities. CONCLUSION: Patients with nuclear and total cataracts have the greatest number of disturbances in the ratio of cell populations according to hematological indices, therefore they constitute a risk group for the development of complications.

Adverse Childhood Experiences are associated with Mental Health Problems later in life: An Umbrella Review of Systematic Review and Meta-analysis

Introduction: Evidence suggested a link between early adversity and mental health problems. However, it is unclear how much adverse childhood experiences (ACEs) contribute to mental health problems because researchers have produced inconsistent findings. Therefore, the objective of this umbrella review was to combine the contradictory data regarding the effect of ACEs on the development of mental health problems later in life in the global context. Methods: PubMed, Embase, Scopus, Web of Sciences, Cochrane Database of Systematic Reviews, Scopus, and Google Scholar which reported the effect of ACEs on the development of mental health problems were searched. The quality of the included studies was assessed using the Assessment of Multiple Systematic Reviews (AMSTAR). A weighted inverse variance random-effects model was applied to find the pooled estimates. The subgroup analysis, heterogeneity, publication bias, and sensitivity analysis were also assessed. Results: Forty-three SRM with 14707614 study participants were included. The pooled effect of ACEs on the development of mental health problems later in life in the global context is found to be (AOR=1.66 (1.46, 1.87)). Subgroup analysis based on country revealed (AOR=1.67(1.23, 2.11)) in UK, (AOR=0.61(0.41, 0.81)) in Canada, (AOR=1.55(1.40, 1.69)) in Brazil, (AOR=5.65(4.12, 7.18)) in Ethiopia, (AOR=1.92(1.45, 2.38)) in USA, (AOR=2.30(1.89, 2.72)) in Australia and (AOR=1.66(1.46, 1.87)) in irland. While subgroup analysis based on types of adverse childhood adverse experience: domestic violence ((AOR=4.13(1.96, 6.30)), maltreatment (AOR=1.5(0.79, 2.21)), physical abuse(AOR=1.56(1.43,1.63), sexual abuse (AOR=2.07(1.63, 2.51)), child abuse (AOR=5.66(4.12,7.18)), parental mental health problem (AOR=1.73(1.39,2.08)), bullying (AOR=1.99(1.69, 2.29), neglect(AOR=2.11(1.53,2.69)), and parental divorce (AOR=1.66(1.46,1.87)). Based on the type of mental health problem the pooled effect size is 1.87(1.45, 2.30) for depression and 1.67(1.22, 2.13) for anxiety. Conclusion: This umbrella review revealed that adverse childhood experience is significantly associated (with 66% increased risk) with anxiety and depression later in life in a global context. This association is most noticeable when one is subjected to domestic violence, maltreatment, physical abuse, sexual abuse, child abuse, parental mental health problems, bullying, neglect, and parental divorce. Childhood periods are a critical window of opportunity for reducing the risk of developing mental illness in the future and for implementing intervention measures. Preventing childhood maltreatment and addressing psychiatric risk factors can prevent psychopathology. Longitudinal studies are needed to optimize healthcare responses to ACEs. Increased awareness and public health interventions are needed to prevent childhood adversity and prevent mental problems among these victims. To optimize healthcare responses to unfavorable outcomes of childhood adversities, longitudinal and intervention research findings, more public health initiatives, and awareness are required.

Oral Muvalaplin for Lowering of Lipoprotein(a)

ImportanceMuvalaplin inhibits lipoprotein(a) formation. A 14-day phase 1 study demonstrated that muvalaplin was well tolerated and reduced lipoprotein(a) levels up to 65%. The effect of longer administration of muvalaplin on lipoprotein(a) levels in individuals at high cardiovascular risk remains uncertain.ObjectivesTo determine the effect of muvalaplin on lipoprotein(a) levels and to assess safety and tolerability.Design, Setting, and ParticipantsPhase 2, placebo-controlled, randomized, double-blind trial enrolling 233 participants with lipoprotein(a) concentrations of 175 nmol/L or greater with atherosclerotic cardiovascular disease, diabetes, or familial hypercholesterolemia at 43 sites in Asia, Europe, Australia, Brazil, and the United States between December 10, 2022, and November 22, 2023.InterventionsParticipants were randomized to receive orally administered muvalaplin at dosages of 10 mg/d (n = 34), 60 mg/d (n = 64), or 240 mg/d (n = 68) or placebo (n = 67) for 12 weeks.Main Outcomes and MeasuresThe primary end point was the placebo-adjusted percentage change from baseline in lipoprotein(a) molar concentration at week 12, using an assay to measure intact lipoprotein(a) and a traditional apolipoprotein(a)-based assay. Secondary end points included the percentage change in apolipoprotein B and high-sensitivity C-reactive protein.ResultsThe median age of study participants was 66 years; 33% were female; and 27% identified as Asian, 4% as Black, and 66% as White. Muvalaplin resulted in placebo-adjusted reductions in lipoprotein(a) of 47.6% (95% CI, 35.1%-57.7%), 81.7% (95% CI, 78.1%-84.6%), and 85.8% (95% CI, 83.1%-88.0%) for the 10-mg/d, 60-mg/d, and 240-mg/d dosages, respectively, using an intact lipoprotein(a) assay and 40.4% (95% CI, 28.3%-50.5%), 70.0% (95% CI, 65.0%-74.2%), and 68.9% (95% CI, 63.8%-73.3%) using an apolipoprotein(a)-based assay. Dose-dependent reductions in apolipoprotein B were observed at 8.9% (95% CI, −2.2% to 18.8%), 13.1% (95% CI, 4.4%-20.9%), and 16.1% (95% CI, 7.8%-23.7%) at 10 mg/d, 60 mg/d, and 240 mg/d, respectively. No change in high-sensitivity C-reactive protein was observed. No safety or tolerability concerns were observed at any dosage.Conclusions and RelevanceMuvalaplin reduced lipoprotein(a) measured using intact lipoprotein(a) and apolipoprotein(a)-based assays and was well tolerated. The effect of muvalaplin on cardiovascular events requires further investigation.Trial RegistrationClinicalTrials.gov Identifier: NCT05563246

Participant acceptability and clinician satisfaction of cognitive behavioural therapy and medication management algorithm compared with enhanced standard care for treatment of depression among youth with HIV.

Background: Primary results of the International Maternal Pediatric Adolescent AIDS Clinical Trials Network (IMPAACT) 2002 trial showed that cognitive behavioural therapy (CBT) and medication management algorithm (MMA) (COMB-R) significantly improved depression in youth with HIV (YWH) compared with enhanced standard care (ESC). Acceptability and satisfaction were examined among study participants and clinicians.Method: Between March 2017 and March 2019, 13 U.S. sites enrolled YWH, aged 12-24, diagnosed with nonpsychotic depression. Sites were randomised to either COMB-R (CBT by a therapist and licensed prescriber) or ESC (standard psychotherapy and medication management). After the intervention (week 24), participants, prescribers, and therapists rated acceptability and satisfaction. We compared site-level means using Wilcoxon tests.Results: Both COMB-R (n = 69) and ESC (n = 71) participants had a mean age of 21.4 years, with 53% female, and 54% having acquired HIV perinatally. Baseline age, sex, depression levels, RNA viral load, and CD4 count were comparable between arms. The distribution of site-level mean participant acceptability was greater in COMB-R compared with ESC (p = 0.04). The distribution of site-level mean prescriber satisfaction was greater in COMB-R (p = 0.01). The was no evidence that the site-level mean therapist satisfaction did not differ between arms (p = 0.52).Discussion: Acceptability and satisfaction for participants and licensed prescribers were higher at COMB-R sites compared with standard of care, indicating that this tailored, manual-guided, collaborative, measured care intervention was less burdensome in terms of the number of visits. Patient and medication provider satisfaction rates were higher than standard of care.Conclusion: While these results support the use of CBT and MMA in treating depression among YWH, further research is required to determine generalisability.

Investigating the role of the principal's individualized consideration and intellectual stimulation in shaping the academic performance of students in the secondary schools of Sidama Region, Ethiopia

The study sought to investigate the principal's perceptions and actions regarding individualized consideration and intellectual stimulation and their implications for students' academic progress. The study was guided by the following research question: How do school principals' transformational leadership strategies improve students' academic progress in Ethiopia's Sidama region? The study used a convergent parallel mixed research design. The data collection strategy was sound, with a modified questionnaire based on the MLQ used in the quantitative phase and an open-ended semi-structured interview in the qualitative phase. The study's dependent variable was student academic performance, while the independent variable was transformational leadership's individualized consideration (IC) and intellectual stimulation (IS) behaviors. The study's target participants were 95 principals and 5956 teachers. The survey used an appropriate sample approach, with 362 teachers and 91 principals from 24 public secondary schools. The qualitative phase involved ten principals and twenty teachers. The acquired data was analyzed using descriptive and inferential statistics. The study found that principals comprehend and practice transformational leadership behaviors. The study also revealed that the principal's individualized consideration and intellectual stimulation practices significantly impacted students' academic progress. The principal's self-assessment was r =.760 (p<.01), whereas the teachers' perception was r =.583 (p<.01).

Understanding 'quality' in adult traumatic brain injury rehabilitation from the perspectives of different stakeholders: a participatory mixed methods study.

The purpose of this study was to explore how 'quality' is understood for traumatic brain injury (TBI) rehabilitation from the perspectives of the rehabilitation recipients, their families and the providing clinicians. A participatory study using a mixed-methods, triangulation design. The study involved 1. a systematic literature search; 2. Individual semi-structured interviews with people with TBI and/or their caregivers and TBI rehabilitation clinicians, and 3. an online consensus process. 22 participants (7 people with TBI, 8 caregivers, 7 clinicians) participated in individual interviews. Their transcribed data were coded into broad categories via in-depth reflexive, thematic analysis; these categories were then mapped to 13 quality domains extracted from the literature. The emergent themes were then presented to the individuals, via an electronic consensus tool in two rounds. This resulted in 12 prioritized domains of quality that encompass service features, staff qualities and effectiveness. These evidence-informed and consensus-agreed indicators for quality may help guide both the provision and evaluation of TBI rehabilitation, that is valued and meaningful.

Validity of Mehrviru® and Sacace® in molecular detection of HPV: a latent class analysis.

Valid diagnostic tests for human papillomavirus (HPV) detection are crucial to identify individuals at high risk of cervical cancer. We assessed and compared the validity of Mehrviru HPV genotyping and Sacace (HPV Genotypes 14 Real-TM Quant) for molecular detection of 14 high-risk human papillomaviruses. We used three HPV test results to identify HPV-positive individuals (14 high-risk genotypes) in a specialist gynecology clinic. The HPV test results were collected using Mehrviru®, Sacace®, and a third kit from the clinical diagnostic laboratory. We used Latent class analysis to determine the actual status of HPV infection in study participants. The sensitivity, specificity, positive and negative predictive values, positive and negative likelihood ratios, Youden, and area under the ROC curve indices of each diagnostic kit and their 95% confidence intervals were calculated. The agreement between the Mehrviru and Sacace kits was determined using the Kappa statistic. We examined 117 women at high risk of HPV infection. The mean age (SD) was 37.2 (9.1). According to LCA, 28.6% of participants had an HPV infection. The sensitivity and specificity (95% CI) of the Mehrviru were 90.8% (73.7-97.2%) and 90.9% (82.1-95.6%), and corresponding figures for Sacace were 92.0% (72.3-98.1%) and 97.4% (90.2-99.3%). The kappa index between the Mehrviru and Sacace kits was 69.7% (55.6-83.9%). The area under the ROC curve for Mehrviru and Sacace test were 91.4% (85.7-97.1%) and 94.4% (89.3-99.5%). There is an excellent agreement between Mehrviru and Sacace test results, and the diagnostic accuracy indices were similar.

The Impact of Incentivization on Recruitment, Retention, Data Quality, and Participant Characteristics in Ecological Momentary Assessments

Ecological Momentary Assessment (EMA) study participation is usually incentivized using monetary (e.g., fixed or performance-contingent payment) or non-monetary (e.g., feedback) compensation. This study investigates the impact of this incentivization on recruitment, retention, data quality, and participant characteristics in a sample of 74 students. For this purpose, an EMA study (time-based sampling) was conducted in participants’ daily life using a 2 Payment (fixed/ performance-contingent) x 2 Feedback (yes/ no) experimental between-subjects design. Offering feedback increased the likelihood of participation and reduced the likelihood of participants receiving fixed payment to drop out. Offering feedback additionally improved data quality. Furthermore, offering feedback attracted participants with higher interest in research and the study topic. Offering fixed vs performance-contingent payment had little effect on the outcomes of interest. Offering feedback as compensation in EMA studies may facilitate recruitment and increase data quality; however, it may also risk higher selection bias. Conclusions are drawn from a relatively small student sample; the results thus need to be replicated in larger and more diverse samples.

Fraudulent Participation in Online Qualitative Studies: Practical Recommendations on an Emerging Phenomenon.

Fraudulent participation is defined in the following as participation in research by individuals who, for one reason or another, intentionally provide false responses. Qualitative studies are at an increased risk of fraudulent participation when online recruitment and participation are used, and monetary incentives offered. Fraudulent participation threatens data quality and subsequent evidence-based practice, yet validated guidance on how to tackle it is lacking. This paper offers a critical reflection thereon by three separate qualitative research groups that experienced fraudulent participation in collaboration with a patient representative, a bioethicist, a legal expert, a journal deputy editor, and a chief executive of a national charity. The Prevent FRaudulent Online STudy participation (P-FROST) recommendations provide advice on (1) Study set-up (including team members and study design), (2) Monetary incentives and recruitment, (3) Data collection (screening and interview considerations), and (4) Analysis, reporting, and support. The reflection which balances the diverse perspectives of patients, researchers, funders, ethics boards, and legal teams puts forward the P-FROST recommendations to identify and prevent fraudulent participation throughout the design, ethical approval, and implementation of online qualitative research.

O trabalho na Educação Ambiental Crítica

An environmental education (EE) system that does not analyze social and political issues cannot contribute to understanding the roots of problems involving the environment. The study of social relations and the production of life through work is fundamental to understanding the historical connection that human beings establish with nature and to pointing out ways to confront the environmental crisis - a symptom of a broader, civilizing crisis. More specifically in teacher training programs – essential subjects to the EE approach at school – it is important to not be fragmented and disconnected from the reality into which teachers and students are immersed. Therefore, analyzing and understanding the historical relationship between school, community, and their surrounding environment, especially regarding the concept of labor, is one of our bets for the training of critical and engaged teachers and citizens. In view of these concerns, we aim at describing and analyzing part of a teacher training program (initial and continuing) for members of a Pedagogical Residency Project, which occurred through the elaboration and carrying out of a participatory research study – an environmental mapping – with the community surrounding a local partnering school in Lavras-MG. Through this participatory research, content analysis, and the interviews with community members, we observed that the study of working relations, as well as other particularities of the local community, can bring elements of great relevance to the exercise of critical EE, especially in this context of teacher training.

Intimate Partner Violence during the Index Pregnancy and its correlates among a panel of pregnant women in Ethiopia, evidence from performance, and monitoring for action (PMA) 2021 cohort two baseline survey.

Current intimate partner violence (IPV) in Ethiopia is considerably high. This study aimed at determining the prevalence of IPV among a panel of pregnant women during their index pregnancy and identify its correlates using Performance Monitoring for action (PMA) cohort 2 baseline data. Documenting the magnitude of IPV thus far during the index pregnancy and identifying factors affecting it contributes its share for the ministry and relevant developmental partners in tracking progress towards eliminating all forms of violence against women and girls by 2030. We conducted a further analysis of national level follow up secondary data sets from Performance Monitoring for action Ethiopian (E_PMA). This study used PMA cohort two baseline data which enrolled pregnant and recently postpartum women and collected real time data on various sexual, reproductive, maternal and new born nationwide priority indicators using customized Open Data Kit Mobile application. These data were collected using standard pretested questionnaire prepared in three local languages (Amharic, Afan Oromo and Tigrigna) by well experienced resident enumerators. This study was restricted to 1,796 pregnant women at the enrollment. Frequency was computed to describe the study participant's characteristics, and chi-square statistics was used to assess cell sample size adequacy. Multilevel binary logistics regression model building process was employed to identify correlates of IPV. Results were presented in the form percentages and odds ratio with 95% Confidence Intervals. Candidate variables were selected using p-value of 0.25. Statistical significance was declared at p-value of 0.05. One in six; 16.7% (14.81%, 18.76%) pregnant women have reported experiencing at least one form of physical and/or sexual IPV thus far in their index pregnancy. The prevalence of encountering at least one form of sexual violence was 12.53% (10.91%, 14.35%) while 7% (5.5%, 8.3%) of them experienced at least one form physical intimate partner violence thus far during their index pregnancy. Women perceived risk about contraceptive use ((AOR: 95% CI: 1.66 (1.10, 2.47)), higher birth order ((AOR: 95% CI: 1.88 (1.05, 3.34)), unhappy emotional fertility intention when learned their index pregnancy ((AOR: 95% CI: 1.7 (1.02, 2.84)) and a family size of 4to 5 ((AOR: 95% CI: 1.87 (1.11. 3.14)) were the fixed effects factors found to increase the odds of IPV significantly and positively. On the contrary, being in the third trimester of gestation at enrollment was another fixed effect variable which contributed for the 44% lower odds ((AOR: 95% CI: 0.56 (0.34, 0.92)) of experiencing IPV thus far in their index pregnancy. The overall burden of IPV reported was high; with nearly double the percentage of women experiencing sexual violence during the index pregnancy compared to physical IPV. More work needs to be done to achieve zero tolerance against any form of violence among women and girls in general and among pregnant women in particular. Efforts targeted in improving women perception on issue related with their contraceptive use, counseling women on how to prevent IPV during their antenatal care (ANC) visit along with advising the use of inter pregnancy contraception and empowering them to control on their fertility are hoped to mitigate such considerably higher odds of IPV among pregnant women. Further programs and intervention on awareness creation towards the misconception that women held about contraceptive use would contribute much. These activities and efforts need to target younger women. The implication of the findings calls key actors and the Federal Democratic Republic of Ethiopia Health Minster to design and implement programs on women emotional fertility readiness and empowering them to control over their fertility through diversified contraceptive provision which is critical in combating the reported substantial IPV experience during pregnancy. Creating institutional capacity in the health system through strengthening and expanding one stop centers to provide medical treatment, care, and psychosocial support for victims and survivors could play a pivotal role. In addition, installing rapid referral system and linkage to the legal system could play a vital role. Moreover, working on early marriage and counseling on childbirth; and spaced pregnancy for those young couples is imperative. Further implication of this study was installing contraceptive and violence related preconception care packages in the health system is very critical in the combat against IPV and any form of gender based violence.

Tubal pathologies in benign hysterectomies

Fallopian tube is a pair of hollow, muscular tubes that are located at the upper margin of the uterus's broad ligament on each side of the uterus. The most frequent illness among women in the reproductive age range is salpingitis, where about 11% of females are affected. Para tubal cysts, hydrosalpinx, endometriosis and walthard cell nests are one of the common lesions of the fallopian tubes. To evaluate the tubal pathologies in benign hysterectomies done in a tertiary care hospital. We conducted a retrospective observational study for 15 months from October 2022 to December 2023 on 110 women who underwent hysterectomies along with salpingectomies or undertook the procedure as a part of tuboovarian masses in our hospital. These surgically resected specimens of fallopian tube which were received during the study period were included. Haemotoxylin and eosin stained histopathology slides of these cases were examined for a detailed analysis of histological patterns of various fallopian tube lesions. The data was represented in percentages and frequencies.: Among the 110 study participants, the minimum age of the women were 35 years and the maximum age was 64 years. The most common diagnosis in our study was Abnormal uterine bleeding (AUB) which was among 87 (78.8%) of the patients, followed by ovarian cyst (8.1%) and fibroid (6.3%). The tubal pathology was abnormal in 54.5% of the study participants. Majority of the abnormal tubal pathology was found to be paratubal cyst corresponding to 30.6% and 18% in the right and left fallopian tubes respectively followed by hydrosalphinx in the right fallopian tubes corresponding to 10.8%. This study concluded that more than 50% of fallopian tubes had aberrant diseases. Thus, a salpingectomy along with hysterectomy is beneficial to the patient in order to prevent further morbidity.

Clinical and laboratory antenatal profile screening and its associate factors among pastoralist women in Northern Part of Kenya

IntroductionAll pregnant women are encouraged to visit Antenatal Care (ANC) during pregnancy to ensure their wellbeing and that of their unborn baby. World Health Organization (WHO) recommends that all pregnant women attend antenatal clinics for care at least eight times during pregnancy. During antenatal care a series of essential tests are done for pregnant women, both clinical examination and laboratory screenings to detect potential issues which will guide clinicians on management. This study aims to investigate the clinical examination and laboratory screening profile results of pastoralist pregnant women and its associated factors during their first ANC visit in Marsabit County, Kenya.MethodsA cross-sectional study was conducted among pregnant women who attended Integrated Maternal Mobile (IMMH) outreach clinics for ANC in 10 mobile pastoralist communities. Data were collected on demographic information, clinical examination information, and laboratory profile screening outcomes. Frequency and percentages were used to describe the categorical variables and means and standard deviations were used to describe the continuous variables. Bivariate and multivariate analysis was conducted using IBM SPPS 27.0 following STROBE guidelines. The level of significance was set at p < 0.05.ResultsData (N = 237) were extracted, the mean age was 26.62 ± 5.371, of which the majority were in the age group of 20–29, 212 (89.5%) were married 180 (75.9%) and multigravida, 27 (11.4%) visited ANC and 121 (51.1%) traveling more than 15 km to seek healthcare services. The mean weight was 55.56 ± 9.019 kg, mean blood pressure systolic was 118.94 ± 19.95 mmHg, and diastolic was 73.87 ± 13.46 mmHg. Out of all specimens processed and tested, 135 (57%) were anaemic with Hgb <11.5 g/dL), 6 (2.5%) had malaria, 8 (3.4%) were hepatitis B positive, and 21 (8.9%) showed intestinal infection. Those women who are illiterate displayed a 12-fold higher likelihood of becoming anaemic during pregnancy (OR 11.50, 95% CI: 2.47–53.47), and those who didn’t attend ANC also have a 5-fold higher likelihood of being anaemic (OR 5.43, 95% CI: 2.52–11.70).ConclusionAnaemia, hepatitis B, syphilis, malaria parasites, intestinal parasites, and urinary tract infections were observed among the study participants. Integrated outreach programs with laboratory screening and health education should be enhanced, and women within pastoralist communities should be empowered through health education.

Retinal blood vessel diameter changes with 60-day head-down bedrest are unaffected by antioxidant nutritional cocktail.

Long-term human spaceflight can lead to cardiovascular deconditioning, but little is known about how weightlessness affects microcirculation. In this study, we examined how the retinal microvessels and cerebrovascular regulation of 19 healthy male participants responded to long-term head-down bedrest (HDBR), an earth-based analog for weightlessness. In addition, we examined whether an anti-inflammatory/antioxidant cocktail could prevent the vascular changes caused by HDBR. In all study participants, we found a decrease in retinal arteriolar diameter by HDBR day 8 and an increase in retinal venular diameter by HDBR day 16. Concurrently, blood pressure at the level of the middle cerebral artery and the cerebrovascular resistance index were higher during HDBR, while cerebral blood flow velocity was lower. None of these changes were reversed in participants receiving the anti-inflammatory/antioxidant cocktail, indicating that this cocktail was insufficient to restore the microvascular and cerebral blood flow changes induced by HDBR.

Influence of impaired glucose tolerance and type 2 diabetes on the multimorbidity cluster of cardiovascular disease and cancer: a post hoc analysis of the Da Qing Diabetes Prevention Outcome Study.

This study explored the influence of type 2 diabetes and impaired glucose tolerance (IGT) on the risk of the multimorbidity cluster of cardiovascular disease (CVD) and cancer. A total of 1629 participants in the Da Qing Diabetes Prevention Outcome Study were recruited in the present analysis, including normal glucose tolerance (NGT, N = 492), IGT (N = 540), and newly diagnosed type 2 diabetes (N = 597) groups. Cox proportional hazards analyses were performed to assess the relationship between NGT, IGT, and newly diagnosed type 2 diabetes and the risk of the multimorbidity cluster of CVD and cancer. The incidence rates for multimorbidity cluster CVD and cancer were 1.25, 3.17, and 3.23 per 1000 person-years in people with NGT, IGT, and the newly diagnosed type 2 diabetes groups, respectively, over 34-year follow-up. Cox analysis revealed that diabetes status (as time-dependent variable) was significantly associated with the subsequent increased risk of multimorbidity cluster of CVD and cancer compared with non-diabetes (hazard ratios [HR] = 2.55, 95% confidence interval [CI] 1.51-4.31) after adjustment of potential confounders. Similar analysis showed that this risk was significantly higher in the IGT and newly diagnosed type 2 diabetes groups compared with NGT, with HR of 3.28 (95% CI 1.83-5.87) and HR of 3.90 (95% CI 2.14-7.09), respectively. Whereas compared diabetes with IGT group, this risk was not significantly different. Similar to newly diagnosed type 2 diabetes, IGT is significantly associated with an increased risk of the multimorbidity cluster of CVD and cancer compared with NGT. This finding highlights the urgent need for an active detection of IGT and effective prevention and management of diabetes.

Human Factors, Human-Centered Design, and Usability of Sensor-Based Digital Health Technologies: Scoping Review.

Increasing adoption of sensor-based digital health technologies (sDHTs) in recent years has cast light on the many challenges in implementing these tools into clinical trials and patient care at scale across diverse patient populations; however, the methodological approaches taken toward sDHT usability evaluation have varied markedly. This review aims to explore the current landscape of studies reporting data related to sDHT human factors, human-centered design, and usability, to inform our concurrent work on developing an evaluation framework for sDHT usability. We conducted a scoping review of studies published between 2013 and 2023 and indexed in PubMed, in which data related to sDHT human factors, human-centered design, and usability were reported. Following a systematic screening process, we extracted the study design, participant sample, the sDHT or sDHTs used, the methods of data capture, and the types of usability-related data captured. Our literature search returned 442 papers, of which 85 papers were found to be eligible and 83 papers were available for data extraction and not under embargo. In total, 164 sDHTs were evaluated; 141 (86%) sDHTs were wearable tools while the remaining 23 (14%) sDHTs were ambient tools. The majority of studies (55/83, 66%) reported summative evaluations of final-design sDHTs. Almost all studies (82/83, 99%) captured data from targeted end users, but only 18 (22%) out of 83 studies captured data from additional users such as care partners or clinicians. User satisfaction and ease of use were evaluated for 83% (136/164) and 91% (150/164) of sDHTs, respectively; however, learnability, efficiency, and memorability were reported for only 11 (7%), 4 (2%), and 2 (1%) out of 164 sDHTs, respectively. A total of 14 (9%) out of 164 sDHTs were evaluated according to the extent to which users were able to understand the clinical data or other information presented to them (understandability) or the actions or tasks they should complete in response (actionability). Notable gaps in reporting included the absence of a sample size rationale (reported for 21/83, 25% of all studies and 17/55, 31% of summative studies) and incomplete sociodemographic descriptive data (complete age, sex/gender, and race/ethnicity reported for 14/83, 17% of studies). Based on our findings, we suggest four actionable recommendations for future studies that will help to advance the implementation of sDHTs: (1) consider an in-depth assessment of technology usability beyond user satisfaction and ease of use, (2) expand recruitment to include important user groups such as clinicians and care partners, (3) report the rationale for key study design considerations including the sample size, and (4) provide rich descriptive statistics regarding the study sample to allow a complete understanding of generalizability to other patient populations and contexts of use.

Autistic adults exhibit a typical search advantage for facing dyads.

Recent findings obtained with non-autistic participants indicate that pairs of facing individuals (face-to-face dyadic targets) are found faster than pairs of non-facing individuals (back-to-back dyadic targets) when hidden among distractor pairings (e.g., pairs of individuals arranged face-to-back) in visual search displays. These results suggest that facing dyads may compete for observers' attention more effectively than non-facing dyads. In principle, such an advantage might aid the detection of social interactions and facilitate social learning. Autistic individuals are known to exhibit differences in visual processing that impede their perception of other individuals. At present, however, little is known about multi-actor visual processing in autism. Here, we sought to determine whether autistic individuals show a typical search advantage for facing dyads. In an online study, autistic and non-autistic participants were tasked with finding target dyads (pairs of faces arranged face-to-face or back-to-back) embedded among distractor dyads (pairs of faces arranged face-to-back). Relative to the non-autistic controls, the autistic participants took slightly longer to locate target dyads. However, a clear and comparable search advantage for facing dyads was seen in both participant groups. This preliminary evidence suggests that multi-actor processing of autistic participants exhibits typical sensitivity to dyadic arrangement.

Evaluation of Proteinuria in Diabetic Patients Attending Gitwe District Hospital

Background: Proteinuria is a serious condition in which body proteins leak into urine due to kidney dysfunction nearly always caused by elevated serum glucose due to prolonged diabetes. Proteinuria occurs and affects individuals with diabetes, approximately 25% of diabetic patients may have proteinuria. Aim: The aim of this study is to assess the levels of serum glucose and proteins in urine and their association in diabetic patients attending Gitwe District Hospital. Methodology: The study population mainly comprised of diabetic patients, 110 study participants were included. Blood was drawn from finger for testing serum glucose using glucometer and urine samples were collected from diabetic patients and samples were analyzed in parasitology service using urine chemistry strips for proteins in urine testing. Results: During data analysis, SPSS version 22 was used, the majority were female with 66.4% while 33.6% were male. The highest frequency of participants presented in this study were 27(24.6%) found in [43-52] years old. The mean age was 53 years ± 13.882 SD (ranged from 23 to 86 years). 53.7% had normal serum glucose level while 46.3% had high serum glucose level. However, 63.6% had no proteinuria while 20.0% had trace, 11.8% had mild and 4.6% had moderate proteinuria levels. Association between serum glucose and proteinuria was analyzed for statistical significance with Chi-square test and it was statistically significant as their p values were below 0.05(P-value of 0.000). Conclusion: The study found that high serum glucose level leads to the presence of proteins in the urine. This study recommends regular monitoring of serum glucose levels, as well as routine urine tests to detect proteinuria as essential components of diabetes management and other researchers to study the effects of proteinuria in diabetic patients. Keywords: Proteinuria, serum glucose, proteins, diabetic patients

Differences in 6-Minute Walk Distance Across Heart Disease Recurrence Risk Levels in Cardiac Rehab Patients

Background/Objectives: Cardiac rehabilitation (CR) programs are multi-component interventions comprising structured strength and cardiovascular exercise training, psychological support, education, and therapies to promote positive lifestyle changes. This study aimed to determine if there are differences in the 6-minute walk distance (6MWD) across risk groups for recurrent heart disease. Methods: This retrospective cohort study used existing data collected from electronic medical records. The 6-minute walk distance was measured at baseline (pre-6MWD) and upon the completion of the CR program (post-6MWD). Short-term cardiac event recurrence risk was determined using a two-year recurrent coronary heart disease (2yRCHD) risk percentage, calculated according to the Framingham 2yRCHD calculator. Risk was then stratified into (1) low, (2) moderate, and (3) high-risk groups. Demographic variables (e.g., age, sex, racial/ethnic group) and clinical variables (e.g., BMI, lipid panels, fasting glucose levels, comorbidities) were collected to describe the study participants and identify potential confounders. An ANOVA and ANCOVA were performed to examine the differences in 6MWD across the 2yRCHD risk groups. Results: A total of 394 CR participants’ data were included in this analysis. Ninety-nine percent of the female participants were classified as low risk for recurrent heart disease, resulting in an extremely small sample size in the moderate-risk (n = 1) and no representation (n = 0) in the high-risk group. This lack of representation made it impossible to conduct comparative analyses across all the participants or to analyze female participants separately by risk category. Consequently, only male participant data were included in the final analysis. The study showed that pre- and post-6MWD measurements were significantly different across the three 2yRCHD risk groups (p = 0.006 for pre-6MWD; p = 0.002 for post-6MWD). The ANCOVA indicated that these differences were independent of the selected covariates. Post hoc analyses revealed significant differences in 6MWDs between the low- and high-risk groups and between the moderate- and high-risk groups, but not between the low- and moderate-risk groups, for both pre- and post-6MWD measurements. Compared to the CR participants in the high-risk group, those in the low- and moderate-risk groups achieved significantly longer distances in the 6-minute walk tests. Conclusions: The observed differences in the 6MWD across short-term cardiac recurrence risk levels suggest its potential as a simple, accessible tool for assessing cardiac recurrence risk levels in community settings. Further research is needed to generalize these findings to more diverse populations and to support aging in place for older adults living with heart disease.