Significant Average Decrease Research Articles

Analysis of the epidemiological trends of Tuberculosis in China from 2000 to 2021 based on the joinpoint regression model

BackgroundChina is ranked third globally in terms of burden and has a moderately high to high prevalence of tuberculosis (TB). This study meticulously investigated the notification rates of TB and assessed the epidemic in China from 2000 to 2021. The aim of the study was to provide robust supporting data that is crucial for enhancing TB prevention and control strategies.MethodsExtensive data regarding TB notification rates in China between 2000 and 2021 was collected. The joinpoint regression model was subsequently utilized to assess the temporal trends in the notification rates of TB, which were analyzed through the annual percentage change (APC) and the average annual percentage change (AAPC).ResultsDuring the study period (2000–2021), the standardized notification rates of TB in China ranged from 38.89/100,000 to 101.15/100,000, with a significant annual average decrease of 4.43% (P < 0.05). Before the COVID-19 pandemic, a marked acceleration in this decline was observed from 2006 to 2015, with an APC of 4.62% (P < 0.05). Stratified by age and sex, the age group with the most significant annual decline in overall standardized notification rates of TB among males in China was < 15 years old, followed by 55–64 years old, and the group with the least decrease was 25–44 years old. Similarly, the age group with the most significant annual decline in standardized notification rates of TB among females was < 15 years old.ConclusionsThe epidemic of TB in China exhibited a downward trajectory between 2000 and 2021. However, it is imperative to prioritize the attention given to males and older adults, and to promote specific and effective prevention and control strategies for these populations.

A Resident-Led Quality Improvement Project in a Community Based Hospital Emergency Department - The Benefits of Simplified Plan-Do-Study-Act/Patient-Safety Quality Improvement Projects Regardless of Staffing Levels.

An emergency department (ED) resident believed ED patients, who needed a simple laceration repair, would be better served if the ED used a laceration cart for supplies, as opposed to the hunt-and-gather method for collecting needed supplies. To address this issue, a two-step Plan-Do-Study-Act/Patient-Safety quality improvement (PDSA/PS QI) project was initiated, with the intent that the project could be completed in a timely manner regardless of staffing levels. The primary purpose of the project was two-fold: 1) to explore the possible time-to-repair benefits of using a laceration repair supply cart in the emergency department and 2) to determine the feasibility of conducting a simple multi-cycle PDSA/PS QI project in a potential staffing-shortage environment. A prospective study using a simple 2-cycle PDSA/PS QI procedure was initiated. During cycle 1, baseline data, to determine the time to complete simple-laceration repairs using a hunt-and-gather supply process, was collected in the form of sign-out/return sheets located next to a laceration repair kit. Cycle 2 introduced the use of a simple-laceration supply cart in the ED, with data collected in the form of a sign-out/return sheet located on the supply cart. Data analysis included a two-sample Wilcoxon rank-sum (Mann-Whitney) test to assess the effectiveness of the suture cart implementation. Pre-intervention. Twelve valid cases were recorded on the sign-out/return sheets. The baseline time range to complete a simple laceration repair varied from 26 minutes to 151 minutes, with an average of 68.3 minutes (SD=40.8).Post-intervention. Twenty-nine valid cases were recorded on the revised sign-out/return sheet. The time to complete a simple laceration repair, using the supply cart, varied from 10 minutes to 116 minutes, with a mean of 36.9 minutes (SD=25.0), a statistically significant average decrease (p = 0.005) of 31.4 minutes. The use of a suture repair cart in the ED reduced the time required for physicians to perform a simple laceration repair. A minimal 2-cycle PDSA/PS QI process allowed residents and staff to participate in a quality-improvement project, even in a potential staffing-shortage environment.

The Processing Spatial Data for Statistical Modeling and Visualization Case study: INLA model for COVID-19 in Alabama, USA

This research emphasizes the visualization of spatial data for statistical modelling and analysis of the relative risk associated with the COVID-19 pandemic in Alabama, USA. We used Bayesian analysis and the Integrated Nested Laplace Approximation (INLA) approach on data ranging from March 11, 2020, to December 31, 2022, which included observed COVID-19 cases, the population for each of the Alabama counties, and a Geographical map of the state. The geographical distribution of COVID-19’s relative risk was determined using various spatial statistical techniques, indicating high-risk locations. The study used Besag-York-Mollié (BYM) models to assess the posterior relative risk of COVID-19, and it found a statistically significant average decrease in COVID-19 case rates across the 67 counties evaluated. These findings have practical implications for evidence-based policymaking in pandemic prevention, mitigation, and preparation.

Clinical and Radiologic Outcomes after Cryoablation of Desmoid Tumors

Abstract Purpose This study aims to evaluate the impact of cryoablation on patients with desmoid tumors, considering both pain and functional impairment. Cryoablation has emerged as a promising intervention, primarily recognized for its ability to reduce radiological evidence of the neoplasm. However, the focus of this research is on assessing the clinical outcomes, recognizing the importance of improving patient-reported symptoms as additional evidence is required in this area to strengthen previous findings. Methods A retrospective study of 18 patients treated with cryoablation for desmoid tumors were included in this study. The evaluation of clinical status involved structured interviews to capture changes in pain and functional impairment. Pain scores and functional impairment scores were recorded on a 10-point Likert scale before and after the treatment. The correlation between these clinical findings and imaging was a key aspect of the investigation. Results Following cryoablation treatment, the average pain scores exhibited a notable decrease of 4.75 points on the 10-point Likert scale. Similarly, functional impairment scores demonstrated a significant average decrease of 4.0 points. Additionally, there was an overall decrease in viable tumor volume after ablation, correlating with the above findings. Conclusion This study provides evidence that cryoablation is effective in achieving clinically significant improvement in patients with desmoid tumors. While the reduction in radiological evidence is recognized, the emphasis of this study was on patient-reported outcomes, particularly in pain and functional impairment. These findings underscore that cryoablation is a valuable intervention in the comprehensive management of desmoid tumors improving overall quality of life.

Assessment of Popcorn's Bioactive Status in Response to Popping.

Popcorn is a specialty maize variety with popping abilities. Although considered a snack, popcorn flakes provide a variety of benefits for the human diet. To evaluate the change in content of bioactive compounds in response to microwave popping, the kernels and flakes of twelve popcorn hybrids were assayed. Accordingly, the content of phytic acid, glutathione, phenolic compounds, carotenoids, and tocopherols, as well as the antioxidant activity, were evaluated. In all evaluated popcorn hybrids, the most pronounced significant average decrease of 71.94% was observed for GSH content, followed by 57.72% and 16.12% decreases for lutein + zeaxanthin and phytic acid content, respectively. In response to popping, in the majority of the evaluated hybrids, the most pronounced significant average changes of a 63.42% increase and a 27.61% decrease were observed for DPPH, followed by a 51.52% increase and a 24.48% decrease for β-carotene, as well as, a 48.62% increase and a 16.71% decrease for α-Tocopherol content, respectively. The applied principal component and hierarchical cluster analyses revealed the distinct separation of popcorn hybrids' kernels and flakes, indicating the existence of a unique linkage of changes in bioactive compound content in response to popping.

Italian multicenter mid-term analysis of laparoscopic lateral suspension in women with pelvic organ prolapse: clinical, sexual and Quality of Life assessment after surgical intervention.

The aim of this study was to evaluate effectiveness and safety of laparoscopic lateral suspension in women affected by high grade uterine prolapse associated to anterior defect. The secondary endpoint is to evaluate mid-term impact on Quality of Life and sexual function. A multicenter retrospective study on women undergoing laparoscopic lateral suspension for uterine prolapse ≥III stage was performed. We included 174 women, but due to exclusion criteria, 134 patients were enrolled for this study. Preoperative evaluation consisted of an urogynecological interview, clinical exam, 3-day voiding diary and urodynamic testing; the prolapse Quality of Life Questionnaire was used to quantify the impact of prolapse symptoms on Quality of Life and the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire short form, the Female Sexual Function Index and the Female Sexual Distress Scale were administered to evaluate sexual function before surgical intervention and at median follow-up of 3.8 years. We included 134 women with uterine prolapse ≥III stage. All patients underwent laparoscopic lateral suspension, 8 also posterior colporrhaphy and 5 also transobturator tape insertion. POP-Q classification score for anterior and apical compartment showed a significant average decrease. The surveys administered to patients showed an improvement in Quality of Life, an increase in the number of monthly intercourses and a significant improvement in sexual life after surgery. Laparoscopic lateral suspension for pelvic organ prolapse correction is a safe and effective technique for uterine and anterior associated defect. Quality of Life and sexual function significantly improved after surgery.

Trends in Diffuse Large B-Cell Lymphoma Mortality in the United States: A Comprehensive Review from 2000 to 2020

Introduction: Diffuse large B-cell lymphoma (DLBCL) is the most common subtype of Non-Hodgkin Lymphoma (NHL), accounting for approximately 30% of all cases. While NHL mortality rates have shown a downward trend over the last two decades, comprehensive investigations into DLBCL mortality trends and disparities across racial, ethnic, gender, and geographical categories in the United States are notably scarce. Methods: Utilizing the Centers for Disease Control and Prevention's (CDC) WONDER database we identified all patients who died from NHL and DLBCL from 2000 to 2020. Age-adjusted mortality rates per 100,000 persons (AAMR) were calculated and standardized to the 2000 US census data. The National Cancer Institute (NCI) Joinpoint Regression Program was used to analyze these data to calculate annual percent changes (APCs) and average annual percent changes (AAPCs). Statistically significant changes were confirmed when the confidence interval for the APC or AAPC did not encompass zero. Additionally, subgroup analyses were conducted based on race, ethnicity, gender, and geographic location. Results: The study identified 434,419 NHL and 46,252 DLBCL deaths. NHL mortality showed a statistically significant average annual decrease of 2.5% (95% CI: -2.7 to -2.4). DLBCL mortality trends varied, initially decreasing from 2000 to 2008, then notably increasing from 2008 to 2011, and subsequently rising moderately from 2011 to 2020. This pattern culminated in a statistically significant overall average annual increase of 3.5% (95% CI: 0.4 to 6.7) in DLBCL mortality. Subgroup analyses revealed that males, Blacks, and Asians or Pacific Islanders experienced the most marked upward trends in DLBCL mortality. Both metropolitan and non-metropolitan areas reported an increase in DLBCL mortality, with metropolitan areas showing a more pronounced rise. Conclusion: Representing the most comprehensive analysis of DLBCL mortality trends to date, our study revealed intriguing disparities among the subgroups we investigated, along with an upward trend in mortality rates that departs from previously reported data. The divergence could be attributed, in part, to the expansive population coverage of the database we utilized and the use of death certificates, which may present discrepant results from other cancer registries. These findings underscore the necessity for ongoing research, guiding the development of targeted intervention strategies for DLBCL and informing efforts to bridge the identified disparities.

The potency of Berastagi sweet orange (Citrus sinensis) peel extract for obesity treatment: An experimental study in male rats

Abstract. Batubara WRP, Susilawati TN, Indarto D. 2023. The potency of Berastagi sweet orange (Citrus sinensis) peel extract for obesity treatment: A study in the rats. Nusantara Bioscience 15: 251-257. Obesity is an abnormal accumulation of body fat and is a trigger factor for various degenerative diseases. Obese continues to grow every year in the world. This study aimed to investigate the effects of Orange Peel Extract (OPE) on Body Weight (BW), obesity index (Lee Index), Body Fat Percentage (BFP) and visceral fat in obese-model rats. Thirty male Wistar rats were divided into 5 groups: controls (negative/NC given aquadest and positive/PC given orlistat 12.3 mg/kgBW/day) and interventions (OPE 1-3) given OPE 250, 500 and 750 mg/kgBW/day, respectively. All rats were fed a high-fat, high-fructose (HFHFr) diet for 28 days. Statistical analysis was performed using ANOVA and Friedman test with p&lt;0.05. The average BW in all groups increased significantly after 14 and 28 days of the intervention (p=0.005). A significant decrease in the obesity index average was found in the OPE 2 and 3 groups (p=0.028 and p=0.034) compared to the NC group. The OPE 1-3 and PC group significantly decreased in average BFP compared with the NC group on the 28th day of intervention (p&lt;0.05). In conclusion, OPE can reduce obesity induced by HFHFr. Future research could be directed to evaluate the OPE side effects for obesity treatment.

Telehealth use and its impact on clinical outcomes in patients with type 2 diabetes during the COVID-19 pandemic.

To evaluate the impact of telehealth use during the COVID-19 pandemic on glycaemic control and other clinical outcomes among patients with type 2 diabetes. We used electronic health records from the Research Action for Health Network (REACHnet) database for patients with type 2 diabetes who had telehealth visits and those who only received in-person care during the pandemic. A quasi-experimental method of difference-in-difference with propensity-score weighting was implemented to mitigate selection bias and to control for observed factors related to telehealth use. Outcomes included glycated haemoglobin (HbA1c) and other clinical measures (low-density lipoprotein [LDL] cholesterol, blood pressure [BP], and body mass index [BMI]). Patients using telehealth had better HbA1c control compared to those receiving in-person care only during the pandemic. The telehealth group saw a significant average decrease of 0.146% (95% confidence interval [CI] -0.178% to -0.1145%; P < 0.001) in HbA1c levels over time. The proportion of patients with average HbA1c levels >7% decreased by 0.023 (95% CI -0.034, -0.011; P < 0.001) in the treatment group relative to the comparison group. Modest benefits in the control of LDL cholesterol levels, diastolic BP, and BMI were found in association with telehealth use. Our findings suggest that telehealth services contributed to better glycaemic control and management of other clinical outcomes in patients with type 2 diabetes during the pandemic. Factors unmeasured in this study would need to be further explored to better understand the impact of telehealth.

Assessment of the quality of life of patients with abfraction tooth defects

BACKGROUND: The evaluation of the effectiveness of treatment of abfraction defects with respect to patients quality of life is relevant.&#x0D; AIM: To analyze the results of the treatment of abfraction defects according to quality of life.&#x0D; MATERIALS AND METHODS: A questionnaire survey of 158 people aged 3049 years was conducted. Group 1 (n=34) received the modified adhesive protocol (glutaraldehyde and an adaptive layer of flowable composite) as muscle relaxant mouthguard; group 2 (n=36), modified adhesive protocol, not used a muscle relaxant mouthguard; group 3 (n=31), basic adhesive protocol as muscle relaxant kappa; group 4 (n=27), basic adhesive protocol, did not use a muscle relaxant mouthguard; and group 5 (n=30), patients with intact teeth. The quality of life was assessed before treatment and 6 months and 1 year after tooth restoration. The Oral Health Impact Profile-14 (OHIP-14) Quality of Life Questionnaire was used.&#x0D; RESULTS: A good initial level of quality of life was found in 35.2% of patients with abfraction defects and a satisfactory one in 64.8%. The average quality-of-life score of groups 14 was 12.9 (95%, 12.413.3). Physical pain, with a score of2.73 (95%, 2.632.84), made the greatest contribution to the quality of life. Twelve months after treatment, groups 14 had a significant average decrease in OHIP-14 by 7.7%. The OHIP-14 score on the physical pain scale decreased in group 1 by 28.8%, group 2 by 25.2%, group 3 by 17.5%, and group 4 by 13.2%.&#x0D; CONCLUSIONS: The clinical manifestations of the abfraction defects of teeth significantly affect the quality of life of patients, particularly on physical pain and physical discomfort. The best dynamics of the quality of life was registered in patients who received the modified adhesive protocol and a muscle relaxant mouthguard.

Hybrid modelling to improve operational wave forecasts by combining process-based and machine learning models

Operational wave forecasting plays an important role in ensuring safe navigation and in the prediction of tidal windows for harbour approach channels. The underlying nearshore process-based wave models need to be accurate for a wide range of different conditions, from more common mild wave conditions to the occasional high energy (storm) conditions. In this work, an innovative hybrid modelling approach is proposed to improve the accuracy of operational wave forecasts. An operational wave model is combined with a machine learning model which is trained using wave measurements within the wave model domain. This hybrid modelling approach is applied to the Dutch North Sea, covering four major harbour approach channels.The final hybrid operational wave model results in a significant average error decrease compared to just the process-based model, amounting to 21.7% for the wave energy density and 25.3% for the wave direction. The error reduction for the spectral wave parameters is even larger, with a 33.3% smaller error in spectral wave height and a 38.8% smaller error in spectral wave period. As this approach is generically applicable to spectral wave models, it contains the potential for significant improvements in operational modelling.

S61 Postoperative Ustekinumab Drug Levels and Disease Activity in Patients With Crohn’s Disease

Background: Ustekinumab is a biologic that targets and blocks the IL-12 and IL-23 receptors and effectively reduces clinical and endoscopic activity of Crohn’s Disease (CD) (1-3). Despite advances in CD treatment, including novel biologic therapies, surgical intervention is still common (4). Preventing postoperative recurrence of disease is critical to avoid subsequent procedures as these operations are expensive and invasive with risk for complications. Studies have previously evaluated for the association of postoperative drug levels, specifically of tumor necrosis factor inhibitors in relation to endoscopic disease recurrence (5-6). However, no study has been conducted to explore the association between postoperative ustekinumab levels and both endoscopic and clinical CD activity. Methods: This was a retrospective study of CD patients from a tertiary referral center that had an ustekinumab level taken postoperatively. Thirty-two total patients were identified. Ustekinumab drug levels were taken within 2 years postoperatively. Harvey-bradshaw index (HBI) was used to evaluate clinical disease activity and a combination of Rutgeerts’ and simple endoscopic score (SES) for Crohn’s Disease was used for endoscopic activity. Values for labs, clinical scores, and endoscopic scores were taken closest to surgery preoperatively with at least a one-month delay after surgery for postoperative values. Delta was the numeric difference between pre and postoperative measurements. Surgical procedures included small or large bowel resection, proctectomy, and fistulectomy. Patients were separated into groups depending on if their ustekinumab level was adequate, defined as greater than or equal to 4 μg/mL, or suboptimal, defined as below 4 μg/mL. All statistics were completed using built-in Excel functions for linear regression, linear correlation, and one-tailed t-test for unequal variance. P values of <0.05 and correlations above 0.8 were considered significant. Results: Average time drug levels taken postoperatively was 257 days. Postoperative hemoglobin levels were significantly higher in the adequate level group, 13.3 g/dL compared to 12.0 g/dL (P = 0.028). Hematocrit levels were also higher in the adequate ustekinumab level group, 40.5 versus 37.1 (P = 0.027). Clinically, patients with adequate ustekinumab levels had a greater change of their HBI score compared to preoperatively, delta HBI of -3 compared to 0.4 (P = 0.046). Only the suboptimal group showed a significant average decrease in endoscopic disease activity preoperatively to postoperatively, 85.7% to 37.5% (P = 0.029). No significant linear correlations were observed when comparing ustekinumab level to postoperative lab values, clinical scores, and endoscopic scores or their deltas. Conclusion(s): Adequate levels of ustekinumab yielded higher postoperative hemoglobin and hematocrit levels in addition to a greater reduction in HBI score. Only the suboptimal ustekinumab level group showed a significant reduction in average endoscopic disease activity compared to preoperative scores, which is consistent with findings that HBI does not necessarily correlate to endoscopic disease activity. The data suggests that adequate ustekinumab levels following CD surgery reduces the risk of anemia postoperatively and results in better clinical CD remission (HBI < 5) and response (delta HBI >=3). Future studies are needed to find the optimal ustekinumab levels both pre and postoperatively in order to maintain CD remission.

The Effect of Profitability and Leverage on LQ-45 Indexed Firm Value Before and During the Pandemic

The covid-19 pandemic has had an economic impact, including companies listed on the stock exchange. The purpose of this research is to obtain empirical evidence whether profitability and leverage have a positive effect before and during the covid-19 pandemic. The population of this study are companies listed on the LQ45 index. This study is a quantitative study with 90 observational data with an observation period of 2018 to 2021. The results showed that before the pandemic, profitability had a positive effect on firm value, leverage and firm size had no effect on firm value. During the pandemic, profitability and leverage have a positive effect on firm value, but size has no effect on firm value. In an additional test using the Paired Sample T-Test method, it showed that there was a significant average decrease in profitability, leverage, and firm value. However, in the LQ45 indexed firm size, there was no significant difference before and during the pandemic.

POSTPARTUM BLUES AS A PSYCHOLOGICAL DISORDER IN NEW MOTHER: A CASE REPORT

Background: Postpartum blues is one type of psychological distress. It can happen when a mother fails in taking in phase. It is a normal peripartum occurrence after delivery. Postpartum blues is usually characterized by several clinical symptoms such as irritability, anxiety, fluctuating mood, etc. Early identification can help in proper treatment. Objective: To identify postpartum blues condition and understand the referral system for maternal problems. Methods: This is a qualitative study with a case report method on postpartum mother which assessed with Edinburgh Postnatal Depression Scale (EPDS) and followed up with maternity needs. Results: Evaluation of maternity need by nursing and midwifery concepts bring a significant average decrease in the value of postpartum blues. In the first screening, the score is 11, and now the score showed &lt;9. Conclusion: Early detection and appropriate intervention by healthcare providers to collaborate on mitigating these interrelated risk factors would be more effective in reducing rates of postpartum blues. Keywords: psychiatric syndrome, postpartum blues, depression, EPDS.

Topological dissimilarities of hierarchical resting networks in type 2 diabetes mellitus and obesity

Type 2 diabetes mellitus (T2DM) is reported to cause widespread changes in brain function, leading to cognitive impairments. Research using resting-state functional magnetic resonance imaging data already aims to understand functional changes in complex brain connectivity systems. However, no previous studies with dynamic causal modelling (DCM) tried to investigate large-scale effective connectivity in diabetes. We aimed to examine the differences in large-scale resting state networks in diabetic and obese patients using combined DCM and graph theory methodologies. With the participation of 70 subjects (43 diabetics, 27 obese), we used cross-spectra DCM to estimate connectivity between 36 regions, subdivided into seven resting networks (RSN) commonly recognized in the literature. We assessed group-wise connectivity of T2DM and obesity, as well as group differences, with parametric empirical Bayes and Bayesian model reduction techniques. We analyzed network connectivity globally, between RSNs, and regionally. We found that average connection strength was higher in T2DM globally and between RSNs, as well. On the network level, the salience network shows stronger total within-network connectivity in diabetes (8.07) than in the obese group (4.02). Regionally, we measured the most significant average decrease in the right middle temporal gyrus (-0.013 Hz) and the right inferior parietal lobule (-0.01 Hz) relative to the obese group. In comparison, connectivity increased most notably in the left anterior prefrontal cortex (0.01 Hz) and the medial dorsal thalamus (0.009 Hz). In conclusion, we find the usage of complex analysis of large-scale networks suitable for diabetes instead of focusing on specific changes in brain function.

Sulfite preservatives effects on the mouth microbiome: Changes in viability, diversity and composition of microbiota.

Processed foods make up about 70 percent of the North American diet. Sulfites and other food preservatives are added to these foods largely to limit bacterial contamination. The mouth microbiota and its associated enzymes are the first to encounter food and therefore likely to be the most affected. Eight saliva samples from ten individuals were exposed to two sulfite preservatives, sodium sulfite and sodium bisulfite. One sample set was evaluated for bacteria composition utilizing 16s rRNA sequencing, and the number of viable cells in all sample sets was determined utilizing ATP assays at 10 and 40-minute exposure times. All untreated samples were analyzed for baseline lysozyme activity, and possible correlations between the number of viable cells and lysozyme activity. Sequencing indicated significant increases in alpha diversity with sodium bisulfite exposure and changes in relative abundance of 3 amplicon sequence variants (ASV). Sodium sulfite treated samples showed a significant decrease in the Firmicutes/Bacteroidetes ratio, a marginally significant change in alpha diversity, and a significant change in the relative abundance for Proteobacteria, Firmicutes, Bacteroidetes, and for 6 ASVs. Beta diversity didn't show separation between groups, however, all but one sample set was observed to be moving in the same direction under sodium sulfite treatment. ATP assays indicated a significant and consistent average decrease in activity ranging from 24-46% at both exposure times with both sulfites. Average initial rates of lysozyme activity between all individuals ranged from +/- 76% compared to individual variations of +/- 10-34%. No consistent, significant correlation was found between ATP and lysozyme activity in any sample sets. Sulfite preservatives, at concentrations regarded as safe by the FDA, alter the relative abundance and richness of the microbiota found in saliva, and decrease the number of viable cells, within 10 minutes of exposure.

Mindful eating for overweight and obese women in Brazil: An exploratory mixed-methods pilot study.

Background: Worldwide, approximately 95% of obese people who follow diets for weight loss fail to maintain their weight loss in the long term. To fill this gap, mindfulness-based interventions, with a focus on mindful eating, are promising therapies to address this challenging public health issue. Aim: To verify the effects of the Mindfulness-Based Eating Awareness Training (MB-EAT) protocol by exploring quantitative and qualitative data collected from Brazilian women. Methods: A single-group, mixed-methods trial was conducted at a public university with adult women (n = 34). Four MB-EAT groups were offered weekly for 2.5-h sessions over 12 weeks. Pre- and post-intervention assessments included body mass index (BMI) and self-report measures of anxiety, depression, mindfulness, self-compassion, and eating behaviour. Qualitative information was collected using focus groups in the last session of each group, including both participants and MB-EAT instructors. The qualitative data were examined using thematic analyses and empirical categories. Results: Twenty participants (58.8%) completed both pre- and post-intervention assessments, with adequate attendance (≥4 sessions). There was a significant average decrease in weight of 1.9 ± 0.6 kg from pre- to post-intervention. All participants who had scored at the risk level for eating disorders on the EAT-26 decreased their score below this risk level. Qualitative analysis identified that participants were able to engage a more compassionate perspective on themselves, as well as greater self-awareness and self-acceptance. Conclusion: The MB-EAT showed preliminary efficacy in promoting weight loss and improvements in mindfulness and eating behaviour. This intervention promoted effects beyond those expected, extending to other life contexts.

Longitudinal effect of myocardial fat deposition on left ventricular diastolic function: a retrospective cohort study.

There is a known correlation between myocardial steatosis and heart function, but it is unclear how left ventricular diastolic function worsens over time in the myocardial steatosis setting. We sought to investigate whether intramyocardial fat deposition affects diastolic function over time. This was a retrospective analysis of patients who had undergone 1-3 echocardiography assessments between April 2011 and April 2017. Patients were divided into two groups: those with the presence of myocardial fat deposition in the left ventricular myocardium (assessed by having tissue within any 10-mm2 region with computed tomography values between - 190 and - 30 Hounsfield units; + MF), and those with absence of deposition not meeting the threshold (- MF). The rates of change of the standard early diastolic mitral annulus velocity (e') and the transmitral early peak velocity (E)/e' ratio at the second and third echocardiograph assessments were calculated relative to baseline. In total, 125 patients were eligible (+ MF, n = 39; - MF, n = 86) for inclusion. Compared with the - MF group, e' was significantly lower and E/e' was significantly higher in the + MF group at each scan timepoint, even when adjusted for body mass index and sex. A significant average decrease in e' and increase in E/e' was also observed in the + MF group across all scans compared with the - MF group. Myocardial steatosis was associated with an acceleration of decreased left ventricular diastolic function over time.

Effect of Improved Stoves on Wood Consumption, Particulate Matter and Carbon Monoxide Production in Central America

Biomass is the primary source of energy for cooking in rural Central America. The intensity of labour required to collect wood, levels of pollution resulting from incomplete burning, health problems linked to smoke inhalation, and pressure on forests are among the problems commonly associated with cooking with traditional stoves utilized in the region. Since the 1980s, improved stoves programs have been implemented in the region, but exogenous-developed models have had low adoption rates due to a lack of know-how for construction and repairments, expensive materials, and lack of understanding of local culinary traditions and culture. Sustainable Harvest International (SHI), a non-profit organization, has successfully developed two local improved stoves: the Damak model in Panama and the Mani model in Honduras. In both cases, anecdotal evidence of high rates of long-term adoption has been noted by SHI. Nonetheless, before this study, there has been no systematic evaluation of the efficiency of these two models in respect to 1) daily household wood consumption (kg); 2) particulate matter (PM2.5 ug/m3) concentration in the kitchen, and 3) carbon monoxide (CO ppm) concentration in the kitchen when compared to the traditional stoves used in rural households of both countries. The results presented herein were generated from a study using a random representative sample of 174 stoves and a portable Indoor Air Pollutant Meter manufactured by Aprovecho Research Center (ARC). An analysis of variance processed the data under the general and mixed model frameworks. The results showed that there was a statistically significant average decrease in wood consumption per day per stove for the improved models, as well as a statistically significant average decrease in personal exposure to particulate matter and carbon monoxide for the improved models when compared to those self-same measurements generated by traditional stoves.

Thirty years of hip fracture incidence in Austria: is the worst over?

SummaryNationwide hip fracture incidence in the Austrian population was assessed over a period of 30 years (1989–2018), including 20 years data from a previous study and a recent 10 years follow-up. While absolute numbers in men continued to increase, absolute numbers in women and age-standardized incidences in both men and women decreased.PurposeIn the Austrian population ≥ 50 years, nationwide hip fracture incidences over a period of 20 years (1989–2008) have shown an initial steep increase, followed by a leveling-off during the last few years of observation. The purpose of the present study was to follow up on hip fracture incidences for another 10 years (2009–2018) and to analyze trends over the entire period of 30 years.MethodsICD-10 code classes S72.0, S72.1, and S72.2 were applied. All data were retrieved from the Statistics Austria database and its hospital discharge register. Annual absolute numbers, crude and age-standardized incidences, and incidence rate ratios (IRR) were stratified by sex and 5-year age intervals, and calculated by using a correction factor for multiple registrations.ResultsTotal number of hip fracture cases increased from 13,984 (2009) to 14,640 (2015), and decreased thereafter to 14,457 (2018), despite a persistent increase in men. Age-standardized incidences peaked at 476/100,000 (2010), followed by a decrease to 408/100,000 (2018). The observed overall decrease was mainly driven by the female population. Incidence rate ratios (IRRs) yielded a statistically significant average annual decrease of age-standardized incidences in both women and men (∆IRR 0.984; 0.981–0.987).ConclusionWhile absolute numbers of hip fracture in women showed a slight decrease during the last 10 years of observation, numbers in men continued to increase. Age-standardized incidences nevertheless decreased in both men and women, which may be interpreted as a trend in the right direction. However, due to the rapid aging of the population, it cannot be precluded that this trend will be compromised during the next few decades.