Timing Of Intervention Research Articles

Weed management in direct wet-seeded rice - A comprehensive review to higher productivity

This review examines various weed control strategies for Direct Seeded Rice systems. The diverse weed flora in DSR includes grasses (Echinochloa colona), sedges (Cyperus iria) and broadleaf weeds (Ludwigia parviflora) being prevalent. Integrated weed management combining cultural, mechanical, biological and chemical methods is recommended for sustainable control. Cultural practices such as stale seedbed techniques, crop rotations and flooding help suppress the growth of weeds. Mechanical methods, including hand weeding and the use of weeders, are effective but labour-intensive. Chemical control via pre-emergence (pretilachlor) and post-emergence (bispyribac-sodium) herbicides has shown promising results optimally. This review highlights that an integrated approach utilizing multiple complementary weed management tactics is essential for effective and sustainable weed control in direct-seeded rice. The proper timing of interventions, combinations of methods, and consideration of local conditions are essential factors. Although chemical herbicides are still valuable tools, there is a growing emphasis on reducing their use by integrating alternative methods. Overall, continued review of innovative biological and ecological approaches can further enhance the existing options for weed management in DSR systems.

The Role of GLP-1 Agonists in Esthetic Medicine: Exploring the Impact of Semaglutide on Body Contouring and Skin Health.

Glucagon-like peptide-1 (GLP-1) receptor agonists, such as semaglutide, have revolutionized the treatment of diabetes and obesity by promoting significant weight loss through incretin effects. However, rapid weight reduction induced by these medications often leads to esthetic challenges, including facial volume loss, skin laxity, and body contour irregularities. This commentary reviews the esthetic consequences of GLP-1-induced weight loss and explores solutions for managing these concerns in clinical practice. This review synthesizes available literature and clinical observations to identify key esthetic concerns associated with GLP-1-induced weight loss. It examines various treatment modalities, including dermal fillers, biostimulatory agents, energy-based devices, and surgical procedures. The discussion highlights gaps in empirical data, optimal timing for interventions, and the need for personalized, multimodal treatment strategies. Imaging tools and psychological support are also considered as complementary approaches. As GLP-1 agonists become a cornerstone in obesity management, their esthetic implications necessitate a proactive response from esthetic practitioners. Effective management of facial volume loss, skin laxity, and body contour challenges requires a combination of injectable treatments, energy-based devices, and, in some cases, surgical interventions. Future research should focus on understanding the molecular mechanisms of skin and fat changes and developing standardized guidelines for treating this unique patient population. Additionally, a holistic approach that addresses both physical and psychological outcomes is critical to ensuring patient satisfaction and long-term well-being.

FBG‐driven simulation for virtual augmentation of fluoroscopic images during endovascular interventions

AbstractEndovascular interventions are procedures designed to diagnose and treat vascular diseases, using catheters to navigate inside arteries and veins. Thanks to their minimal invasiveness, they offer many benefits, such as reduced pain and hospital stays, but also present many challenges for clinicians, as they require specialized training and heavy use of X‐rays. This is particularly relevant when accessing (i.e. cannulating) small arteries with steep angles, such as most aortic branches. To address this difficulty, a novel solution that enhances fluoroscopic 2D images in real‐time by displaying virtual configurations of the catheter and guidewire is proposed. In contrast to existing works, proposing either simulators or simple augmented reality frameworks, this approach involves a predictive simulation showing the resulting shape of the catheter after guidewire withdrawal without requiring the clinician to perform this task. This system demonstrated accurate prediction with a mean 3D error of 2.4 1.3 mm and a mean error of 1.1 0.7 mm on the fluoroscopic image plane between the real catheter shape after guidewire withdrawal and the predicted shape. A user study reported an average intervention time reduction of 56 when adopting this system, resulting in a lower X‐ray exposure.

Creating a food environment scoring index for online food delivery outlets: Delphi study with Australian nutrition and public health professionals.

This study aimed to develop a scoring index for the healthfulness of food outlet menu offerings available through Australian delivery platforms. The Delphi method was employed to achieve consensus among a panel of Australian nutrition and public health experts regarding the food environment scores assigned to online food outlets, classified by type. From previous studies and scoping of delivery platforms, 36 food outlet types were identified. Australian nutrition and public health experts were recruited to complete an online Delphi survey to score the healthfulness of these outlets using a scale from -10 (least healthful) to +10 (most healthful), based on typical menu offerings. The first round of the survey was opened for approximately 5 weeks in July to August 2023, and the second round was opened for 2 weeks in September 2023. The mean food environment score, minimum and maximum awarded food environment score, and SD for each outlet type, and coefficient of variation was calculated after each survey round to provide a measure of the spread of the data around the mean and the degree of consistency in the distribution of responses. Following the second survey round, results were assessed for consensus among the participants. Fifty-four participants completed the round one survey, and n=14 completed round two. The majority of online food delivery outlet types received a food environment score of less than +5, and were considered 'less healthful.' Participants scored greengrocers as the most healthful outlet type (mean food environment score of 8.83 ± 0.37) and liquor selling stores as the least healthful (score of -8.10 ± 1.14). The group reached consensus after two survey rounds due to decreases in the standard deviations of mean food environment scores. This study provides an expert-informed tool, the DIGIASSESS tool, that can be easily applied by researchers, policy makers, health workers and public health professionals to understand the rapidly evolving online food delivery environment, including changes over time and areas for potential intervention.

Risk of Reading Difficulties in School-age Children Treated for Non-syndromic Craniosynostosis.

We assessed the prevalence of guardian-reported reading difficulties in children treated for non-syndromic craniosynostosis (NSC) and in relation to the location of the closed suture. Additionally, we determined correlations with guardian-reported neurodevelopmental disorders (NDDs) and associations between reported reading ability, sex, timing of surgical intervention, parental education, and heredity of reading difficulties in guardians. Cross-sectional, prospective, population-based study. Tertiary hospital. The cohort included 127 participants (aged 9-10 years) treated for NSC (76 sagittal, 38 metopic, 9 unicoronal, and 1 each of bicoronal, lambdoid, frontosphenoidal, and multisuture NSC). The prevalence of guardian-reported reading difficulties was defined as a score ≥8 out of 14 points on the Short Dyslexia Scale. We determined associations between reported reading ability and reported NDDs through binomial regression analysis. The cohort demonstrated a 14.2% risk of of guardian-reported reading difficulties, with sagittal, metopic, and unicoronal NSCs exhibiting respective prevalences of 10.5%, 18.4%, and 23.1%. NDDs were reported in 22% of participants and significantly associated with reading difficulties. The results indicated that participants with sagittal NSC showed the lowest risk of reading difficulties. Additionally, we found that NDDs represent significant risk factors for guardian-reported reading difficulties across the patient cohort. These findings underscore the need for targeted screening and support, especially for patients with metopic and unicoronal NSC, to guide clinical and educational decisions.

Assessing the direct and spillover protective effectiveness of Wolbachia-mediated introgression to combat dengue

Dengue remains a global health challenge with limited treatment options, highlighting the need for effective vector control strategies. The introduction of Wolbachia pipientis into Aedes aegypti populations has shown success in reducing dengue transmission across global field trials. However, the spillover effectiveness of the technology on untreated areas is not well-known. This study estimates the spillover protective effectiveness (PE) of Wolbachia-mediated introgression on dengue. We used the synthetic control method (SCM) under assumption of partial interference to evaluate the direct and spillover PEs of Wolbachia-mediated introgression in a long-running operational trial of the intervention in Malaysia. Synthetic controls (SCs), which comprise of a weighted sum of non-spillover controls, were constructed for each directly-treated and spillover site in the pre-intervention period to account for historical imbalances in dengue risk and risk trajectories. SCs were compared to directly/spillover-treated sites to estimate the impact of Wolbachia-introgression on dengue incidence across each site, calendar year and intervention time. Robustness checks, including visual inspections, root-mean-square error (RMSE) calculations, in-space and in-time placebo checks, and permutation tests, were used to inspect the model's ability in attributing dengue incidence reductions to the Wolbachia interventions. The direct and spillover PEs of Wolbachia on dengue incidence were expressed as a percentage reduction of dengue incidence, or the absolute case reductions, by comparing SCs to actual intervention/spillover sites. Findings indicate a direct reduction in dengue incidence by 64.35% (95% CI: 63.50-66.71, p<0.05 using permutation tests) in directly treated areas, corresponding to 1802 (95% CI: 1768-1932) cases averted. Meanwhile, spillover effects contributed to a 37.69% (95% CI: 36.45-38.49, p<0.05) reduction in adjacent non-intervention areas, accounting for 115 (95% CI: 104-132) absolute cases averted. Tracking PEs by intervention time revealed a dose-response relationship, where PEs increased concomitantly with Wolbachia frequency. Model checks confirmed the robustness of these results, and ascertained that these PEs were not an artefact of poor control selection, pre-trends in dengue incidence or poor predictive ability of the fitted SCs. Wolbachia-introgression effectively diminished dengue incidence in directly-treated and surrounding spillover regions. This dual effectiveness highlights the potential of Wolbachia-infected mosquitoes as a sustainable, cost-effective strategy against dengue. This research is hosted by CNRS@CREATE and supported by the National Research Foundation, Prime Minister's Office, Singapore, under its Campus for Research Excellence and Technological Enterprise (CREATE) program, and is funded by the Lee Kong Chian School of Medicine-Ministry of Education Start-Up Grant. The original Hoffmann etal. (2024) study was funded by the Wellcome Trust Awards 226166, 108508, 202888 and the Ministry of Health Malaysia NMRR-16-297-28898.

Structural Antibiotic-Coated Hindfoot Nail Preparation: A Technique Guide

The current guide describes a technique that has been in place at the University of Louisville for several years and has been utilized to create structural antibiotic hindfoot nails. This has the intention of creating a stable construct that can be utilized in the setting of previous osteomyelitis, or that is at high risk of developing infections in the postoperative state. This technique guide provides a reproducible way to apply an antibiotic delivery system to a tibiotalocalcaneal nail at the time of definitive surgical intervention. It described our method at rural state level one trauma hospital of utilizing antibiotic-impregnated polymethylmethacrylate around a nail for both antibiotic properties as well as structural properties. Antibiotic delivery systems are a well-researched surgical tool, combining this with a hindfoot nail offers definitive surgical management of otherwise complicated surgical cases. Although this technique has been in use at the University of Louisville for many years, additional research should be done to determine long-term outcomes. Level of Evidence: Diagnostic Level VII. See Instructions for Authors for a complete description of levels of evidence.

Association of early life cardiovascular risk factors with grey matter structure in young adults in the United Kingdom: the ALSPAC study

Cumulative exposures to obesity, hypertension, and physical inactivity from midlife (40-65 years) onwards are three known cardiovascular risk factors for dementia and associated cerebral structural damage. Exactly how early in the lifespan sensitive periods for exposure to these risk factors begin is yet to be established, specifically with respect to onset of cerebral structural changes. We aimed to investigate whether cardiovascular risk across childhood and adolescence is already associated with cerebral structure in regions previously linked with dementia, during young adulthood. Participants were selected from the Avon Longitudinal Study of Parents and Children (ALSPAC), a UK-based prospective cohort of young people, if they had participated in a neuroimaging sub-study (N=862). We entered data from repeated clinical assessments into mixed-effects models to estimate baseline and rate of change in body mass index (BMI) and mean arterial pressure (MAP) between ages 7-17 years, and physical activity (PA) between 11-15 years. Linear models assessed whether cardiovascular risk factors were associated with grey matter macrostructural indices (cortical thickness, surface area, volume) in young adulthood (∼20 years). BMI was found to be associated with grey matter macrostructure in nodes of Default Mode Network previously found to show atrophy in dementia. Baseline BMI was associated with thickness of precuneus cortex and entorhinal surface area, whilst rate of change in BMI across childhood and adolescence was associated with thickness of parahippocampal and middle temporal gyri and inferior parietal cortex in addition to entorhinal and parahippocampal surface area. Further, we identified associations between baseline MAP and PA and entorhinal surface area. Exploratory whole-brain analyses revealed associations between baseline and rate of change in these cardiovascular risk factors and the cortical thickness, surface area, and volume of broader groups of cortical and subcortical regions. Findings provide preliminary evidence that cerebral structural differences in regions linked to dementia in old age may be legacy of developmental differences associated with cardiovascular risk exposure during early life. This has relevance for lifespan models of dementia risk and timing of preventative interventions. Further work is required to generalise findings beyond this predominantly white, male, and middle-class sample to more diverse cohorts. NIHR Oxford Health BRC (NIHR203316), Wellcome Trust (203139/Z/16/Z).

Enhanced Mastitis Severity Classification in Dairy Cows Using DNN and RF: A Study on PCA and Correlation-Based Feature Selection

Mastitis presents a critical challenge in dairy farming, significantly impacting both animal health and economic stability. This study advances mastitis severity classification in Holstein-Friesian cows through an interdisciplinary approach that integrates advanced machine learning methods within a veterinary context, shifting focus from traditional disease detection or diagnosis to refined severity classification, which is critical for aligning treatment strategies with disease progression and optimizing intervention timing. Clinical measurements from 1,886 Holstein-Friesian dairy cows, aged 3-4 years, across 21 parameters were analyzed. Both Deep Neural Networks (DNN) and Random Forests (RF) were utilized, with dimensionality reduction applied through Principal Component Analysis (PCA) and correlation-based feature selection to retain essential features and enhance computational efficiency. Key parameters in the RF and DNN models were carefully selected to ensure robust performance across diverse datasets. By categorizing mastitis into acute, acute with bloody milk, and peracute stages, this study addresses unique diagnostic challenges within veterinary medicine. The RF and DNN models achieved superior accuracy, ranging from 97% to over 98%, surpassing traditional diagnostic methods in precision, recall, and F1 metrics. These findings highlight the broader applicability of machine learning advancements beyond veterinary sciences, demonstrating the potential for interdisciplinary research across veterinary medicine, computer science, and engineering to drive innovation in automated diagnostics and resource management in dairy farming. The research was conducted using the MATLAB® Deep Learning App.

Counselling in Fetal Medicine: Complications of Monochorionic Diamniotic Twin Pregnancies

Twin pregnancies are at increased risk of morbidity and mortality compared to singletons. Among all twins, monochorionic pregnancies are at higher risk of specific and non-specific complications compared to dichorionic pregnancies. Therefore, it is of great importance to properly counsel future parents with monochorionic pregnancies regarding the risks of adverse outcomes and the modalities of monitoring and intervention of the potential complications. Conditions related to the monochorionicity include twin-to-twin transfusion syndrome (TTTS), twin reversed arterial perfusion sequence (TRAP), and twin anemia polycythemia syndrome (TAPS); other complications include selective fetal growth restriction (sFGR) and congenital anomalies. This review aims to summarize the information available in the current literature regarding the complications in monochorionic diamniotic twin pregnancies, including outcomes and guideline recommendations about the clinical surveillance, management, and timing of interventions of these conditions that should be included in counselling in routine clinical practice.

The importance of timing: evaluating the optimal age for surgical intervention in asymptomatic dermal sinus tracts.

Dermal sinus tracts (DSTs) are rare congenital lesions resulting from errors of spinal cord disjunction, leading to a persistent connection between the cutaneous ectoderm and underlying neural elements. As patients are at increased risk of infection and irreversible neurological compromise due to tethering, resection and detethering are recommended as a prophylactic measure. The ideal timing of surgical intervention in an asymptomatic cohort, however, remains unclear. A retrospective chart review was performed at a single institution from 1998 to 2022 of all patients surgically treated for lumbar DST by 10 different surgeons. Demographic, presentation, operative, and postoperative details were obtained. Five patients who presented with infectious or neurological symptoms were excluded from primary analysis. The age at the time of surgery was then analyzed as a continuous variable against the operative details and postoperative outcomes utilizing Spearman's correlation coefficient and the Mann-Whitney U-test. Fifty-two patients underwent prophylactic surgical excision of their DST as well as detethering. Overall, 65% of patients were female and the median age at diagnosis was 3 months, while the median age at the time of surgery was 7 months. An additional cutaneous finding was identified in 71% of patients, with hemangioma being most frequent (40%). Additional spinal lesions were radiographically identified in 29% of patients, including lipoma (19%), dermoid and epidermoid inclusion cysts (8%), and an arachnoid cyst (2%). Postoperative complications occurred in 8% (n = 4) of patients, primarily related to wound healing (3/4), with significant risk attributed to younger age at time of surgery (mean 3 months, range 1-5 months) (p = 0.01). During 56 months of follow-up, long-term rates of retethering (6%, p = 0.02) and abnormal neurological examinations (8%, p = 0.001) were associated with concurrent lipomas, but not with age at operation. In a series of 52 pediatric patients undergoing prophylactic resection of a DST with detethering, the complication rate was 8% and was significantly associated with age < 6 months at the time of operation. Associated spinal lipomas significantly influenced long-term outcomes. When evaluating asymptomatic infants with DST, patient age is a significant factor in assessing the risks and benefits of surgical timing.

Impact of the COVID-19 pandemic on direct medical costs of acute coronary syndrome admissions in Yogyakarta, Indonesia

The number of admissions, therapeutic management, and clinical results of acute coronary syndrome (ACS) have been extensively reported. However, the economic impact of ACS therapy has been ignored. This study examined the effect of the COVID-19 pandemic on direct medical costs for ACS hospitalizations in Yogyakarta, Indonesia. A retrospective study of patients with ACS admitted to one of three hospitals during March to August in 2019, 2020, and 2021 was conducted. Direct medical costs from a provider’s perspective were estimated using the charges. All costs were reported in Indonesian Rupiah (IDR) at a 2021 value. Multiple linear regression analysis was used to evaluate the impact of the pandemic on total direct medical costs. The total direct medical costs associated with ACS admission per patient during the pandemic period was approximately 40% higher than that during the pre-COVID period (28.41 vs. 20.33 million IDR or 1976.90 vs. 1414.65 USD). A substantial impact of the COVID-19 pandemic on total direct medical costs still remained after adjusting the ACS types, hospital types, length of stay, percutaneous coronary intervention, in-hospital mortality, and delay time of onset to first medical contact. Given the limited health budget, reallocation of health care resources must be prioritized to maintain the provision of essential health care for those who timely treatment is crucial.

Climate Adaptation of Roads to Flooding Hazards—A Review

Flooding hazards due to climate change are increasingly becoming a frequent global occurrence. The aim of this study is to provide a comprehensive review of the various structural mitigation and adaptation strategies available to engineers and designers at various stages of road construction and rehabilitation to increase the resilience of roads to flooding damage. The criteria for categorising the various strategies available were the time of intervention with respect to the occurrence of the hazard. Thus, all studied strategies were separated into pre-construction design changes, post-construction mitigation and adaptation options like Sustainable Urban Drainage Systems (SuDS). The main findings were that changing the specifications of commonly used materials can provide increased flood resilience, and a preliminary design for flooding can reduce post-flooding rehabilitation. The study can be used as a guide for the different options available to deliver a design that takes flooding into consideration.

Xenon as an anesthetic of choice for full mouth debridement in a child with drug-resistant epilepsy: A clinical case

Background: Outpatient dental care in children with epilepsy (particularly drug-resistant epilepsy) is challenging for anesthesiologists in terms of selecting appropriate anesthesia methods and agents, as well as for dentists in terms of improving treatment efficacy and quality while minimizing intervention time. General anesthetics may trigger seizures in patients with epilepsy, including those with drug-resistant epilepsy. As a result, selecting the appropriate anesthetic is critical during preparation stages and anesthetic management in these patients. Case description: A clinical case of full mouth debridement in a 3-year-old child with drug-resistant epilepsy is presented to demonstrate the efficacy of xenon as an inhalational anesthetic in patients with drug-resistant epilepsy. Combination inhalation anesthesia with xenon was used. There were no signs of seizures during surgery and within two days after anesthesia. Conclusion: Xenon may be a viable inhalational anesthetic for patients with drug-resistant epilepsy.

Polyneuropathy in Cerebrotendinous Xanthomatosis: Diagnostic Challenges and Potential for Therapeutic Intervention.

Cerebrotendinous xanthomatosis (CTX) is a rare metabolic disorder caused by mutations in the CYP27A1 gene, leading to cholestanol accumulation in various tissues, including peripheral nerves. Polyneuropathy is an underrecognized feature with considerable variability in clinical presentation and neurophysiological findings in CTX. This review assesses the prevalence, clinical manifestations, and diagnostic methodologies of polyneuropathy in CTX, exploring its underlying mechanisms and potential treatment outcomes. A literature review was conducted using PubMed, Embase, and the Virtual Health Library databases with search terms related to CTX and polyneuropathy. A total of 892 articles were initially identified, with 59 selected for in-depth analysis. The review focused on studies examining peripheral nerve involvement in CTX, including nerve conduction studies, electromyography, and nerve ultrasound. Polyneuropathy in CTX was observed in 50% to 77.7% of patients across multiple case series. Neurophysiological findings varied, with reports of axonal, demyelinating, and mixed polyneuropathies. Clinical presentation included lower limb atrophy, pes cavus, and distal weakness, with sensory symptoms less frequently reported. Treatment with chenodeoxycholic acid (CDCA) showed potential in improving nerve conduction parameters, although the response was variable and dependent on the timing of intervention. Polyneuropathy in CTX presents significant diagnostic challenges due to its heterogeneous presentation and varying neurophysiological findings. Early recognition and intervention are crucial for improving patient outcomes. Peripheral nerve ultrasound is a promising diagnostic tool, complementing traditional neurophysiological assessments. Further research is needed to standardize protocols and explore the full therapeutic potential of CDCA in managing CTX-related polyneuropathy.

Transcatheter intervention of modified Blalock-Taussig shunts in patients with hypoplastic left heart syndrome undergoing stage 1 palliation.

While several studies have explored the outcomes of transcatheter interventions for modified Blalock-Taussig shunts (MBTSs) in a broad range of congenital heart diseases, none have specifically examined the interventions in patients with hypoplastic left heart syndrome (HLHS) who underwent Norwood palliation (NP). This retrospective study was conducted between 2020 and 2024, when 24 urgent interventions were performed on 17 patients at our center. We recorded several key outcomes, including early and late intervention-related complications, the need for reintervention, the interval between the NP and the first intervention, shunt patency following the intervention, associated morbidities, and thrombosis-related sudden events. Additionally, during follow-up, we documented the outcomes for patients who underwent the Glenn procedure and those who were palliated, including late death. The median age and weight at the time of intervention were 88 days (range: 15-300 days) and 5 kg (range: 2.6-7.6 kg), respectively. The median interval between the Norwood procedure and the transcatheter intervention was 61 days (7-160 days), with median shunt patency lasting 62 days (1-150 days). Notably, there were no intervention-related complications or deaths. In-stent thrombosis, a late complication, occurred in four patients; two of these had impaired anticoagulation, including extracorporeal membrane oxygenation (ECMO)-related causes, while the other two, who were on aspirin, had multiple stents within the shunt, one of whom experienced sudden death. Six patients required seven reinterventions: four due to shunt obstruction or restenosis and two to delay surgery or provide palliation for patients unfit for surgery, aiding in pulmonary development. The transcatheter intervention of the MBTSs in patients with HLHS undergoing NP is considered both safe and potentially life-saving in emergent situations. This approach may facilitate improved pulmonary development, postpone the need for subsequent surgeries, and provide medium-term palliative care for critically ill patients. However, managing late complications such as stent thrombosis remains a significant challenge. Our findings indicate that risk factors for shunt thrombosis include using ECMO therapy, underlying coagulation disorders, impaired lymphatic drainage, requiring multiple stents within the shunt, and a prior history of thrombosis before intervention. Dual antiplatelet therapy is recommended to alleviate the risk of thrombotic events in this population.

Improvement effect of insulin resistance in one-day outpatient service by reducing stress adaptation disorders in patients with gestational diabetes mellitus.

Conducted a one-day outpatient service for GDM patients, analyzed the relationship between stress adaptation disorder and insulin resistance in GDM patients after intervention, and tried to provide some new clues for the prevention and treatment of GDM, provide some theoretical basis for the multidisciplinary diagnosis and treatment model of GDM patients. 240 GDM women were included in this study, 120 women were included in one-day diabetes clinic management for GDM women as GDM Intervention Group, and 120 GDM women receiving regular dietary education as GDM Control Group. One-day diabetes clinic management including disease knowledge and dietary education, sports education and blood sugar monitoring and personalized issues and follow-up visits, and intervention time lasting for 1 month. After intervention, the concentration of 2-h postprandial blood glucose, and HOMA-IR were decreased in GDM Intervention Group, while weekly weight gain rate and insulin application rate were significantly lower than GDM Control Group (all p < 0.05). Cortisol and MDA in GDM Intervention Group were significantly lower than GDM Control Group (both p < 0.01). HOMA-IR was positively correlated with weight gain, E, NE and cortisol (r = 0.249, 0.242, 0.663, 0.313, all p < 0.01), E and HOMA-IR were negatively correlated with SOD in GDM Intervention Group (r = -0.306, -0.213, both p < 0.01). The intervention model in our study was based on the one-day outpatient comprehensive management model of diabetes, which improved the insulin resistance of GDM patients. The possible mechanism was related to the implementation of one-day outpatient intervention measures, which reduced the stress adaptation disorder and oxidative stress injury of GDM patients. At the same time, the implementation of intervention measures reduced the rate of weight gain, which can also alleviate insulin resistance to a certain extent. One-day outpatient treatment has a positive effect on improving insulin resistance in GDM women, which can reduce the risk of maternal and fetal complications.

Community-based smart healthcare initiative reduces carotid intima-media thickness and thrombotic markers in patients with hypertension: A prospective study

ObjectiveUnhealthy lifestyles negatively impact the prognosis and outcomes of cardiovascular disease. The objective of this study is to examine the effects of smart healthcare technology in assisting physicians with monitoring and improving patient lifestyles, as well as adjusting treatment plans on carotid intima-media thickness (IMT) and thrombotic markers during the therapeutic management of hypertension. Furthermore, we compared the efficacy of smart healthcare interventions with conventional hospital-based follow-up in ameliorating cardiovascular complications in patients with established hypertension. The goal is to elucidate the optimal timing for clinical interventions and to develop personalized treatment plans to enhance the long-term prognosis of patients with cardiovascular disease. MethodsA stratified sample of 174 patients with established hypertension from two villages in southeastern China was selected. The study cohort comprised 85 participants in the smart healthcare intervention group and 89 participants in the regular follow-up control group. Changes in median levels of IMT, von Willebrand factor (vWF), P-selectin (P-S), body mass index (BMI), blood pressure, and cholesterol were assessed before and after the study period. Comparative analysis of changes in IMT, vWF, P-S, blood pressure, and cholesterol between the two groups was conducted over the study period. ResultsThe intervention group demonstrated significantly greater improvements in IMT, vWF, and P-S levels compared to the control group (P < 0.05). At the 12-month follow-up (T12), blood pressure, BMI, total cholesterol, IMT, P-S, and vWF levels were significantly lower in the intervention group than in the control group (P < 0.05). The reduction in IMT was particularly notable, with the intervention group revealing a statistically significant improvement compared to the control group (P < 0.001). ConclusionThe smart healthcare intervention model resulted in more significant improvements in IMT and thrombotic markers compared to the traditional hospital follow-up model. Patients using the smart blood pressure monitors exhibited significantly lower levels of IMT, vWF, and P-S compared to their pre-intervention levels.

ICoaching the coach: building capacity with embedded evidence-based practice implementation support

PurposeThe purpose of this study was to investigate the effectiveness of iCoaching during reading intervention. An interventionist received mentoring support to implement iCoaching. The goal of the study was to increase teacher-delivered, behavior-specific praise (BSP).Design/methodology/approachUsing a single-case multiple-probe design across participants (Gast, 2010; Horner and Baer, 1978), iCoaching was implemented in a two-part package of (1) professional development (PD) and (2) live iCoaching sessions where three teachers received preemptive coaching comments to increase BSP delivery during reading intervention. Visual analysis identified changes in teacher behavior.FindingsFindings demonstrated the iCoaching intervention package increased teacher knowledge and implementation of evidence-based practices (EBPs; i.e. BSP) during tiered reading intervention groups. Most student participants made gains in reading skills (accuracy, words per minute and composite score) across the areas measured.Research limitations/implicationsTeacher absences, observation scheduling, an ongoing global pandemic, IEP meetings during intervention time, and other changes in the schedule were limitations of this study. The first set of earbuds lost the audio signal several times, and researchers lost the ability to hear the instruction occurring in the classroom; the earbuds were replaced by the first intervention phase.Practical implicationsPrevious iCoaching literature demonstrates iCoaching provides implementation support for EBPs learned in PD. Peer coaching can have a positive impact on EBP implementation when iCoaching is non-evaluative, which supports teachers with EBP implementation with minimal disruption to teaching.Originality/valueThis manuscript extends iCoaching research (Randolph et al., 2020, 2021) from small group special education settings to general education intervention groups. Additionally, research shows iCoaching can be extended with mentoring.

Micro‐Doses of DNP Preserve Motor and Muscle Function with a Period of Functional Recovery in Amyotrophic Lateral Sclerosis Mice

ObjectiveMitochondrial dysfunction is one of the earliest pathological events observed in amyotrophic lateral sclerosis (ALS). The aim of this study is to evaluate the therapeutic efficacy of 2,4‐dinitrophenol (DNP), a mild mitochondrial uncoupler, in an ALS mouse model to provide preclinical proof‐of‐concept evidence of using DNP as a potential therapeutic drug for ALS.MethodshSOD1G93A mice were treated with 0.5–1.0 mg/kg DNP through daily oral gavage from presymptomatic stage or disease onset until 18 weeks old. Longitudinal behavioral studies were performed weekly or biweekly from 6 to 18 weeks old. In situ muscle contraction measurements in extensor digitorum longus muscles were conducted to evaluate the preservation of contractile force and motor unit numbers in hSOD1G93A mice following DNP treatment. Muscle innervation and inflammatory markers were assessed using immunostaining. Extent of protein oxidation and activation of Akt pathway were also examined.ResultsDNP delayed disease onset; improved motor coordination and muscle performance in vivo; preserved muscle contractile function, neuromuscular junction morphology, and muscle innervation; and reduced inflammation and protein oxidation at 18 weeks old in hSOD1G93A mice. Strikingly, symptomatic hSOD1G93A mice exhibited a period of recovery in running ability at 20 cm/s several weeks after 2,4‐dinitrophenol treatment started at disease onset, offering the first observation in disease phenotype reversal using a small molecule.InterpretationOur results strongly support that micro‐dose DNP may be used as a potential novel treatment for ALS patients, with a possibility for recovery, when used at optimal doses and time of intervention. ANN NEUROL 2024