Treatment Of Type Research Articles

Effects of acupuncture on shoulder impingement syndrome: A systematic review and meta-analysis.

Shoulder impingement syndrome (SIS) is a common condition that causes chronic shoulder pain. The effectiveness of acupuncture in treating chronic shoulder pain has been documented in previous studies; however, existing systematic reviews and meta-analyses have often excluded Chinese databases and combined different types of acupuncture interventions, such as electroacupuncture, warm acupuncture, pharmacopuncture, and acupotomy. Thus, this study specifically examines the exclusive impact of manual acupuncture on SIS. Several databases, including PubMed, Cochrane Central, Embase, 1 Chinese database (China National Knowledge Infrastructure), and 5 Korean databases (ScienceON, Oriental Medicine Advanced Searching Integrated System, KoreaMed, Korean Studies Information Service System, and KMBASE), were systematically searched for relevant studies. The quality of the included studies was evaluated using the Cochrane Assessment Tool for Risk of Bias Version 2. Data collected from the selected studies were synthesized for meta-analysis. The primary outcome was a pain scale score, and the secondary outcomes were shoulder function and disability. This study included 5 randomized controlled trials. The primary outcome assessment revealed significantly reduced pain (standardized mean difference [SMD] = -0.50, 95% confidence interval [CI] = -0.74 to -0.27) and improvements in shoulder function and disability (SMD = -0.57, 95% CI = -0.96 to -0.19). A subgroup analysis based on treatment duration indicated that short-term acupuncture treatment (≤4 weeks) exhibited a high level of confidence with low heterogeneity (SMD = -0.37, 95% CI = -0.73 to -0.02). Manual acupuncture is effective for relieving pain and improving shoulder function and disability in patients with SIS. However, further research is necessary to validate these findings owing to the limited number of patients and heterogeneity among the studies reviewed.

373 Effect of Cu and Zn contents in growing finishing pig diets on animal performance and Cu and Zn content in manure, according to three manure management chains

Abstract Copper (Cu) and zinc (Zn) are essential nutrients for swine. However, as pigs have a low retention rate for these elements, more than 90% of ingested Cu and Zn are excreted, mainly in feces. After spreading manure, these trace elements could accumulate in the soil and potentially have negative environmental effects. Moreover, Cu and Zn are also limited natural resources that should be preserved. A better understanding of the behavior of these elements throughout the feed-animal-effluent-treatment continuum according to feed composition and manure management chain is thus required to propose alternative ways to reduce these environmental impacts. Three feeding strategies differing in their Cu and Zn contents were compared in 72 growing-finishing pigs raised in individual pens [from 24.3 ± 3.3 up to 110 ± 9.0 kg body weight (BW), one-half males; and one-half females] a first diet with Cu and Zn at maximum EU regulation levels (20 and 100 ppm of Cu and Zn, respectively; REG), a second diet without any Cu and Zn supplementation (5 ppm Cu, 30 ppm Zn; WS) and a third diet with Cu and Zn at an intermediary level (10 and 50 ppm of Cu and Zn; INT). Cu and Zn were supplemented as Cu2O (CoRouge, Animine) and ZnO (HiZox, Animine), respectively. Eighteen additional finishing pigs (6 per diet) were raised in digestibility cages for excreta collection over 10 d, and their feces were submitted to two types of manure treatment: anaerobic digestion (AD) and composting with straw. Over the entire experimental period, the dietary Cu and Zn content did not influence growth performance of pigs. The Cu and Zn concentrations of the feces decreased linearly (P < 0.001) with dietary content from 191 and 834 (REG) up to 63 and 359 (INT) and 40 and 213 (WS) mg Cu and Zn/kg dry matter (DM) respectively. After both manure treatments, the degradation of the organic matter resulted in a significant increase (twice as much) in Cu and Zn concentration per kg of DM. Feeding strategy appears to be the main lever to reduce the Cu and Zn content of effluents. However, in the context of the diversification of manure management strategies, it is also important to take into account the effect of the effluent collection and treatment chain (e.g., spreading of raw slurry, phase separation, anaerobic digestion, composting), which has also an impact on the behavior of Cu and Zn and consequently on the risk for the environment.

Optimization of the interfacial properties between mechanically and electrochemically treated aluminium and nano-modified coatings for printed outdoor applications

The aim of this research was to analyze the interfacial properties between the surfaces of mechanically and electrochemically treated aluminium substrates and the printed coatings modified by the addition of silicon dioxide (SiO2) and titanium dioxide (TiO2) nanoparticles. The nanoparticles were added to the printing inks in various concentrations with the scope to optimize the interface properties of the prints for outdoor applications. The surface, as well as the structural and mechanical properties of the printed coatings were evaluated. Various methods were employed to measure and analyze the surface and interfacial properties of aluminium and coatings. Surface microphotographs and the roughness of the treated aluminium substrates were examined, the surface free energy of the aluminium and the coatings as well as the adhesion properties were calculated, and the thickness and optical density of the coatings were measured. Considering that the treated aluminium samples prepared for this research had quite textured and different surfaces, the contact angles used for the calculation of surface free energy were calculated with and without Wenzel model to obtain detailed information about the interactions between the surface of aluminium samples and the printed modified coatings. The results showed that the type of treatment of aluminium substrates as well as the modification of the printing inks have a significant influence on the adhesion and surface properties of the coatings considered. Furthermore, the results demonstrated that the produced nano-modified coatings can be used as printed coatings or as customized primers for applying various types of inks and coatings.

B - 92 Memory Rehabilitation Following Stroke and Traumatic Brain Injury

Abstract Objective Several Meta analyses suggest mixed but objective support for internal strategies. Typically, successful rehabilitation involves at least 8 hour of memory training and often results in 0.25 to 0.50 standard deviation (SD) improvements depending on how long post injury. Intervention dose, strategies, level of impairment, and patient self-awareness and motivation all appear relevant. Methods Data is taken from 21 continuous referrals. Three individuals did not want to work on memory strategies, so their data was separated from the rest. Participants: 18 individuals with acquired brain injuries, with an average age of 51.6 and about 15 years of education, who were 76.6 days post brain injury. Intervention: Each individual was involved in 8 weeks of transdisciplinary rehabilitation. Many goals were addressed and memory rehabilitation was treated via 1 or 2 weekly sessions with a neuropsychologist. Internal and external strategy use was taught. Individuals received 8 to 10 hours of memory rehabilitation involving repetitive practice of clustering, semantic clustering, organizing information into sentences or stories, rhyming, and acronyms. Results Delayed List Recall significantly improved from standard scores of 73.5 to 89.7 and the delayed Story Recall improved from 75 to 90. The mean improvement was nearly 1 standard deviation across measures. Conclusions Individuals showed significant improvement in immediate and delayed recall memory scores. These individuals showed more than 0.5 SD short-term memory (STM) gain and also self-reported improved STM. Durability of gains was not measured in follow-ups. These interventions improve memory skills, but not all patients choose to participate in this type of treatment.

A Scoping Review of Technology-Based Approaches for Upper Limb Motor Rehabilitation after Stroke: Are We Really Targeting Severe Impairment?

Technology-based approaches for upper limb (UL) motor rehabilitation after stroke are mostly designed for severely affected patients to increase their recovery chances. However, the available randomized controlled trials (RCTs) focused on the efficacy of technology-based interventions often include patients with a wide range of motor impairment. This scoping review aims at overviewing the actual severity of stroke patients enrolled in RCTs that claim to specifically address UL severe motor impairment. The literature search was conducted on the Scopus and PubMed databases and included articles from 2008 to May 2024, specifically RCTs investigating the impact of technology-based interventions on UL motor functional recovery after stroke. Forty-eight studies were selected. They showed that, upon patients' enrollment, the values of the UL Fugl-Meyer Assessment and Action Research Arm Test covered the whole range of both scales, thus revealing the non-selective inclusion of severely impaired patients. Heterogeneity in terms of numerosity, characteristics of enrolled patients, trial design, implementation, and reporting was present across the studies. No clear difference in the severity of the included patients according to the intervention type was found. Patient stratification upon enrollment is crucial to best direct resources to those patients who will benefit the most from a given technology-assisted approach (personalized rehabilitation).

UJI BERBAGAI JENIS BAHAN MATRICONDITIONING TERHADAP VIABILITAS DAN VIGOR BENIH PADI (ORYZA SATIVA L.) VARIETAS INPARI 32

The aim of this research was to determine the type of matriconditioning material on the viability and vigor of rice seeds of the Inpari 32 variety. The research was carried out in April – June 2024 at the Agroecotechnology Integrated Laboratory, Faculty of Agriculture, ULM. The research used a single factor Completely Randomized Design (CRD), namely treatment type matriconditioning consisting of: m0: control (water); m1: Husk charcoal; m2: Rubbing ash; m3: Sawdust; m4: Charcoal husk & Ash (1:1); m5: Husk charcoal & sawdust (1:1); m6: Crushed ash & Sawdust (1 : 1) and m7: Husk charcoal & Crushed ash & Sawdust (1:1:1). The results of the research showed that the treatment had no real effect on the maximum growth potential of the seeds, but had a significant effect on the germination capacity, simultaneous growth and growth speed of the rice seeds of the Inpari 32 variety. The best treatment was sawdust matriconditioning material which was able to increase the viability and vigor of the rice seeds. Inpari 32

A - 141 The Relationship of Tumor Location and Treatment on Cognition in Long-Term IDH-Mutant Glioma Survivors

Abstract Objective Isocitrate dehydrogenase 1 mutation (IDH-M) denotes a distinct subtype of glioma which has a relatively favorable prognosis but nevertheless requires treatment including surgery, radiation and/or chemotherapy and the tumors inevitably recur. Factors influencing cognition in long-term survivors (LTS) of IDH-M have not been well characterized. We investigated factors affecting cognition in a cohort of well characterized of IDH-M LTS. Method Patients (N = 65; 98.5% Caucasian; 47.7% female; Mage = 47.51; Medu = 16.06) who were at least 3 years post-IDH-M diagnosis who completed neuropsychological assessment in the Neuro-oncology division at Massachusetts General Hospital were included. Tests of processing speed, working memory, episodic memory, and executive function were analyzed along with tumor, treatment, and individual difference factors relevant to cognition. Exploratory analyses were conducted to generate hypotheses regarding factors of interest. Results Tumor hemisphere affected delayed recall of word list learning Z-score (F = 4.00; p = 0.024; left = −1.41; right = −0.59). Tumor lobe affected visual learning (F = 3.11; p = 0.054; frontal = −0.594; temporal = −0.807; parietal = −1.983). There were no effects of treatment type (photon vs proton radiation; single vs multi-agent chemotherapy), presence of seizures, psychiatric diagnosis, tumor subtype (oligodendroglioma/astrocytoma), grade (2,3,4) or disease duration (Mean = 9.5y; min = 3y; max = 28.8y) on cognition. Conclusions In this heavily treated group of IDH-M glioma LTS referred for neuropsychological evaluation, typical lateralizing/localizing cognitive deficits were revealed. However, simple dichotomies may fail to capture relevant contributors to cognitive impairment. Integration with individual factors including premorbid cognition, radiation dosimetry and brain network connectivity may be necessary to predict cognitive trajectories and outcomes.

Harnessing machine learning algorithms to unveil energy efficiency investment archetypes

Increasing transparency about the performance of different projects is crucial to reducing the heterogeneity in the energy efficiency services market, thereby upscaling investments. In this context, machine learning algorithms could assist in identifying and analyzing energy efficiency project archetypes, although this field has so far been explored with a limited view in the literature. This paper aims to address this gap by identifying energy efficiency investment families and the determinant factors of the classification scheme, using machine learning. In this effort, it hinges on a wide range of indicators from implemented projects around Europe and the USA, including investment profitability, initial investment, risk of failure, intervention type, life measure, region of implementation and building type. The analysis employs two clustering approaches, namely Partitioning Around Medoids (PAM) and K-means, determining the number of clusters based on the Silhouette index and total within–cluster sum of squares. The results indicate that energy efficiency investments can be classified into three categories: (i) “junk investments”, characterized by low–profitability (IRR∼10%), moderate risk, and extended horizons; (ii) “safe profitability”, distinguished by high profitability (IRR∼30%) and minimal risk; and (iii) “high stakes”, described by exceptionally high profitability (IRR∼40%), coupled with a substantial risk. Next to profitability and risk of failure, also energy efficiency intervention and building type (sector) emerge among the most influential factors in the classification scheme. Feature importance shows a significant sensitivity to the chosen classification model.

Evaluating the direct effect of vaccination and non-pharmaceutical interventions during the COVID-19 pandemic in Europe

BackgroundAcross Europe, countries have responded to the COVID-19 pandemic with a combination of non-pharmaceutical interventions and vaccination. Evaluating the effectiveness of such interventions is of particular relevance to policy-makers.MethodsWe leverage almost three years of available data across 38 European countries to evaluate the effectiveness of governmental responses in controlling the pandemic. We developed a Bayesian hierarchical model that flexibly relates daily COVID-19 incidence to past levels of vaccination and non-pharmaceutical interventions as summarised in the Stringency Index. Specifically, we use a distributed lag approach to temporally weight past intervention values, a tensor-product smooth to capture non-linearities and interactions between both types of interventions, and a hierarchical approach to parsimoniously address heterogeneity across countries.ResultsWe identify a pronounced negative association between daily incidence and the strength of non-pharmaceutical interventions, along with substantial heterogeneity in effectiveness among European countries. Similarly, we observe a strong but more consistent negative association with vaccination levels. Our results show that non-linear interactions shape the effectiveness of interventions, with non-pharmaceutical interventions becoming less effective under high vaccination levels. Finally, our results indicate that the effects of interventions on daily incidence are most pronounced at a lag of 14 days after being in place.ConclusionsOur Bayesian hierarchical modelling approach reveals clear negative and lagged effects of non-pharmaceutical interventions and vaccination on confirmed COVID-19 cases across European countries.

Overactive bladder: results from patients treated by hyaluronic acid-chondroitin sulphate therapy.

Overactive bladder (OAB) is a chronic condition. This study was prompted by the need to fill the gap between medical treatment and advanced therapies allowing improvement in Quality of Life. The aim of the current study was to evaluate the association between treatment type (Ialuril®; IBSA Farmaceutici, Lodi, Italy; in combination with antimuscarinic or alone after drop-out of antimuscarinic, relative to antimuscarinic alone treatment) and functional outcomes (number of micturitions, pelvic pain, urinary incontinence, nocturia, urgency). Of all patients newly diagnosed (January 2016 - January 2022) with OAB syndrome, we retrospectively identified 150 patients. They harbored three groups of 50 patients each: group 1 (antimuscarinic drug), group 2 (antimuscarinic drug + hyaluronic acid-chondroitin sulphate [HA-CS]), group 3 (antimuscarinic dropout patients). Univariable linear and logistic regression models were fitted for number and rates of incontinence, urgency, pelvic pain, nocturia, respectively. A significant mean reduction of 1.5 micturition (P=0.02) was recorded in group 2 compared to group 1. Conversely, no statistically significant mean difference was recorded in group 3 compared to group 1. Regarding pelvic pain, both group 2 and group 3 were associated with lower rate of pelvic pain (P<0.001). Regarding urgency, a statistically significant protective OR was recorded for group 2 (OR=0.39; P=0.04), compared to group 1. The combination therapy was associated with symptom improvement in antimuscarinic naïve OAB patients. Conversely in antimuscarinic dropped-out patients only pelvic pain improved with the HS-CA. No statistically significant differences were recorded for other functional outcomes, such as incontinence and nocturia.

Nurse-Led Interventions in Managing Cancer-Related Fatigue: A Systematic Review.

Cancer-related fatigue (CRF) is common among patients with cancer. Various interventions have been reported to reduce fatigue, and some evidence suggests that nurse-led interventions may be effective in the management of CRF. A systematic review was conducted to assess the effectiveness of nurse-led interventions for CRF in patients with cancer and survivors. The aim of this study was to review and appraise the evidence for the effectiveness of different types of nurse-led interventions on fatigue in patients with cancer and survivors. Electronic databases such as PubMed, Scopus, Cochrane Library, Web of Science, and ScienceDirect were searched to identify studies published from January 2013 to October 2023. The studies that described nurse-led interventions in patients with cancer or survivors regardless of treatment duration, modes of intervention delivery, and any based intervention were included. The studies were excluded if no fatigue was an outcome measure. Twelve studies from 2013 to 2023 were included and eligible for the review. Nine studies obtained a Jadad score of 3 or more, indicating high quality for the quality assessment. Eleven of the included studies reported a significant effect of the nurse-led interventions in reducing fatigue in patients with cancer or survivors. Nurse-led interventions that focus on multidisciplinary, exercise, psychological, and behavioral approaches appear promising in the management of CRF. More research is needed in order to determine the most acceptable forms of intervention. The development of evidence-based interventions for managing CRF is significant to nursing practice.

ORAL HEALTH AND THE NEED FOR DENTAL CARE IN A GROUP OF PATIENTS FROM OLTENIA

(1) Background: Oral diseases are a major health burden in many countries and affect people throughout life, causing pain, discomfort, changes in facial physiognomy, and even death. The aim of the study was to determine dental treatment needs in a group of patients from Oltenia; (2) Methods: The retrospective study included 813 people, 341 men and 472 women, aged 6-93 years, presented for diagnosis and dental treatment between 2008-2018. The dental records of patients were used to evaluate the state of oral health, and the treatment needs of the patients. Data were collected and stratified into a database in Excel Windows (3) Results: Dental treatment needs included: oral health education sessions (33%), periodontal treatment (30.62%), fillings or other types of direct or indirect dental restorations (20.04%), including endodontic treatments, non-carious lesions treatment, extractions (27.42%), prosthetic restorations (71.83%), of which 10.08% complete dentures or overdentures with tooth or implant support and 43.9% partial dentures or bridges with tooth or implant support. (4) Conclusions: Social factors (socio-economic status and education of the population) and behavioral factors (diet and dental hygiene) have a great influence on dental health status.

An online compassion-focused intervention for middle school students: the Inspiring Comfort program

ABSTRACT Interventions that build compassion for others may help increase social connectivity, combat loneliness, and promote positive adjustment in youth. However, limited research has examined the effects of this type of intervention on youth well-being. The goal of this small open pilot study was to examine the feasibility, acceptability, and outcomes of Inspiring Comfort, a 12-session group program in which youth learn and practice compassion, empathy, and helping others in distress. The program was implemented virtually during the COVID-19 pandemic with a sample of 10 students (ages 11 to 14) attending a non-profit special education school. Following the program, reductions in child-reported loneliness, depressive symptoms, and social anxiety were observed, along with increases in compassion for others and self-compassion. Students reported high satisfaction with the program, though challenges with the virtual format were noted. Findings suggest that a compassion-focused intervention may hold promise for addressing loneliness and internalising symptoms in youth, though randomised controlled trials with larger samples are needed.

Impact of Initial Surgical Interventions on Empyema Outcomes: Insights From a Cohort Study in Yemen.

Purpose The study aimed to evaluate the effectiveness of different initial interventions, including thoracostomy drain tubes, open thoracotomy with decortication, and video-assisted thoracoscopic surgery (VATS) thoracoscopy in the management of empyema. Methods This prospective cohort study was conducted at two teaching hospitals in Sana'a, Yemen, over a two-year period from 2022 to 2024. The study included 40 patients diagnosed with empyema, categorized according to the type of initial intervention received. Demographic data, clinical presentation, imaging findings, intervention details, and outcomes were systematically collected and analyzed. Statistical analyses were performed to identify associations between demographic characteristics, empyema stage, intervention type, and treatment success. Results The study included 40 patients with a higher proportion of males (67.5%) than females (32.5%). The mean age was 47.1 years (standard deviation (SD): 12.85). The overall success rate of the initial interventions was 55%, with significant variation based on empyema stage, comorbidities, and intervention type. Stage I empyema had the highest success rate (80%), followed by Stage II (50%) and Stage III (27.3%), with a statistically significant difference (p = 0.034). Smoking history was identified as a significant negative predictor of success (p = 0.001). Higher pleural fluid pH was associated with better outcomes (p = 0.015). The most common complications were chest infections (20%) and bronchopleural fistulas (10%), with a mortality rate of 7.5%. Conclusion The empyema stage significantly affects the success rate, with early stages showing better outcomes. Early and appropriate intervention, particularly in later stages, is crucial for better outcomes. Effective management of postoperative complications is vital. This study highlights the need for early diagnosis and tailored interventions based on the empyema stage to improve patient outcomes. Future research should focus on larger multicenter studies to validate these findings and develop standardized treatment protocols.

Complementary and Alternative Therapies for Genitourinary Syndrome of Menopause : An Evidence Map.

Women seeking nonhormonal interventions for vulvovaginal, urinary, and sexual symptoms associated with genitourinary syndrome of menopause (GSM) may seek out complementary and alternative medicine or therapies (CAMs). To summarize published evidence of CAMs for GSM. Ovid MEDLINE, EMBASE, and CINAHL from inception through 11 December 2023. Randomized controlled trials (RCTs) 8 weeks or more in duration that evaluated the effectiveness or harms of CAMs for postmenopausal women with GSM and reported 1 or more outcomes of interest, with sample sizes of 20 or more participants randomly assigned per group. Data were abstracted by 1 reviewer and verified by a second. An evidence map approach was used to organize and describe trials. Studies were organized by type of intervention, with narrative summaries for population, study characteristics, interventions, and outcomes. Fifty-seven trials were identified that investigated 39 unique interventions. Studies were typically small (n < 200), and most were done in Iran (k = 24) or other parts of Asia (k = 9). Few trials evaluated similar combinations of populations, interventions, comparators, or outcomes. Most studies (k = 44) examined natural products (that is, herbal or botanical supplements and vitamins), whereas fewer reported on mind and body practices (k = 6) or educational programs (k = 7). Most studies reported 1 or 2 GSM symptoms, mainly sexual (k = 44) or vulvovaginal (k = 30). Tools used to measure outcomes varied widely. Most trials reported on adverse events (k = 33). Only English-language studies were used. Effect estimates, risk of bias, and certainty of evidence were not assessed. There is a large and heterogeneous literature of CAM interventions for GSM. Trials were small, and few were done in North America. Standardized population, intervention, comparator, and outcomes reporting in future RCTs are needed. Agency for Healthcare Research and Quality and Patient-Centered Outcomes Research Institute. (PROSPERO: CRD42023400684).

Clinically important interactions of macrolides and tetracyclines with dietary interventions-a systematic review with meta-analyses.

Effective management of drug-food interactions is crucial for enhancing antibiotics' efficacy/safety. Adhering to PRISMA guidelines, we conducted a systematic review to assess the impact of dietary interventions on the bioavailability of 15 macrolides and 10 tetracyclines. We included studies examining the influence of food, beverages, antacids, and mineral supplements on the pharmacokinetic parameters of orally administered macrolides and tetracyclines. We searched Medline (via PubMed), Embase and Cochrane Library databases up to December 2022. Risk of bias was assessed using Cochrane and NIH tools. Quantitative analyses were conducted if two or more comparable food-effect studies were available; otherwise, a qualitative summary was provided. We included 120 studies from 97 reports. Meta-analyses were conducted for 8 macrolides and 4 tetracyclines, with qualitative synthesis for 10 and 9, respectively. About 64% of the studies were open-label, crossover designs. Our assessment found that 37% of the studies had a high risk of bias, while only 6% had low risk. Food significantly affected 10 of 13 macrolides (77%) and 6 of 7 tetracyclines (86%). High positive effects on bioavailability were seen with extended-release azithromycin and clarithromycin, and erythromycin estolate. High negative impacts were observed with erythromycin propionate and stearate, azithromycin capsules, demeclocycline and omadacycline. Antacids and mineral supplements significantly decreased tetracyclines absorption. Milk and grapefruit juice showed variable impacts on absorption. Interactions depend on antibiotics' physicochemical characteristics, intervention type, drug formulation and potential patient factors. The quality of evidence was rated low due to outdated studies, methodological diversity and unequal data availability.

A systematic review of chatbot-assisted interventions for substance use.

This study systematically reviewed research on the utilization of chatbot-related technologies for the prevention, assessment, and treatment of various substance uses, including alcohol, nicotine, and other drugs. Following PRISMA guidelines, 28 articles were selected for final analysis from an initial screening of 998 references. Data were coded for multiple components, including study characteristics, intervention types, intervention contents, sample characteristics, substance use details, measurement tools, and main findings, particularly emphasizing the effectiveness of chatbot-assisted interventions on substance use and the facilitators and barriers affecting program effectiveness. Half of the studies specifically targeted smoking. Furthermore, over 85% of interventions were designed to treat substance use, with 7.14% focusing on prevention and 3.57% on assessment. Perceptions of effectiveness in quitting substance use varied, ranging from 25% to 50%, while for reduced substance use, percentages ranged from 66.67% to 83.33%. Among the studies assessing statistical effectiveness (46.43%), all experimental studies, including quasi-experiments, demonstrated significant and valid effects. Notably, 30% of studies emphasized personalization and providing relevant tips or information as key facilitators. This study offers valuable insights into the development and validation of chatbot-assisted interventions, thereby establishing a robust foundation for their efficacy.

Maternal Dietary Strategies for Improving Offspring Cardiovascular-Kidney-Metabolic Health: A Scoping Review.

Dietary regulation has been recognized for its profound impact on human health. The convergence of cardiovascular, kidney, and metabolic disorders at the pathophysiological level has given rise to cardiovascular-kidney-metabolic (CKM) syndrome, which constitutes a significant global health burden. Maternal dietary nutrients play a crucial role in fetal development, influencing various programmed processes. This review emphasizes the effects of different types of dietary interventions on each component of CKM syndrome in both preclinical and clinical settings. We also provide an overview of potential maternal dietary strategies, including amino acid supplementation, lipid-associated diets, micronutrients, gut microbiota-targeted diets, and plant polyphenols, aimed at preventing CKM syndrome in offspring. Additionally, we discuss the mechanisms mediated by nutrient-sensing signals that contribute to CKM programming. Altogether, we underscore the interaction between maternal dietary interventions and the risk of CKM syndrome in offspring, emphasizing the need for continued research to facilitate their clinical translation.

Induced abortion incidence and associated factors in a cohort of women living with HIV in Rio De Janeiro, Brazil, 1996–2016

Background Abortion is a public health problem in Latin America and is more common among women living with HIV. Objective to verify the incidence and factors associated with induced abortion in a cohort of women living with HIV assisted in a reference service for care for individuals with HIV/AIDS in Rio de Janeiro/Brazil. Methods Prospective cohort during the period 1996–2016. We estimated the incidence of induced abortions during follow-up in the cohort by calculating person-time incidence rates [per 100 persons-years (PY)] and investigated the factors associated with the outcome “induced abortion” using a generalized linear mixed model. Results 753 women and 210 pregnancies were included in the present analysis. We estimated an induced abortion incidence rate of 0.68/100 persons-years (95% confidence interval [CI]: 0.47; 0.94) in the study period, with a significant reduction after 2006. The main factors associated with an induced abortion were currently living with a partner (adjusted OR [AdjOR] 0.32 95% CI: 0.10–0.98), number of children (2 children AdjOR 0.12, 95% CI: 0.02–0.95) and the type of antiretroviral treatment used (regimen without Efavirenz: AdjOR: 0.11, 95% CI 0.02–0.70). Conclusions We showed a significant reduction in the incidence of induced abortions in a cohort of women living with HIV in Rio de Janeiro, Brazil, probably due to a decrease in the incidence of pregnancies observed in the same period. The factors associated with a lower occurrence of induced abortion suggest a good integration between the clinical and reproductive assistance offered to those women.

Do Preventive Programs Reduce the Need for New Sedations for the Treatment of Oral Pathologies in Healthy and Special Health Care Needs Children?

Background: The goal is to analyze the need for reinterventions under deep sedation to treat oral pathologies in a population of children with special health care needs (SHCNs) and healthy children who followed a prevention program and to study the influence of parental motivation and child collaboration on the need for reinterventions under deep sedation. Methods: A retrospective study was carried out in a private clinic in Cartagena (Murcia, Spain), with patients treated under deep sedation from 2006 to 2018, both years included, following the Strobe statement. Results: In this study with 230 children who were treated under deep sedation, 23.92% underwent two or more sedations. The mean time elapsed between the first and the second sedations was 21.64 ± 15.87 months, and the main cause for reinterventions was the occurrence of new pathologies. Significantly more pulp treatments were performed in the first sedation than in the second (p = 0.013) and in the third (p = 0.007). Healthy children required fewer reinterventions under deep sedation than children with special needs (6.42% vs. 39.67%). Similarly, patients who followed the preventive program and required some type of dental treatment were reoperated fewer times than those who did not follow the preventive program (35.8 vs. 50%); than "cooperative" children as opposed to "non-cooperative" (12.12% vs. 60.93%) and than patients with "motivated" parents as opposed to those with "non-motivated" parents (20.83% vs. 46.34%). A total of 50% of the children who participated in the preventive program became "cooperative", and 100% were able to receive some treatment in the dental chair. Conclusions: Prevention programs, including motivational interviewing, are essential to improve children's behavior in the dental chair and reduce the need for reinterventions under general anesthesia or deep sedation. Although patients with special needs do require more sedation during their lifetime due to their inability to cooperate, these programs are necessary for the maintenance of oral health status and for the early diagnosis of caries lesions. Pediatric dentists should implement a quarterly preventive program because it improves patient collaboration. It is essential to achieve the motivation of parents in the oral care of their children.