Controlled Study Research Articles

Psychological autopsies: religious and spiritual factors for suicide in cases and controls

IntroductionIn recent years, there has been a growing body of evidence supporting the notion that spirituality and religion can improve one’s physical and mental health. Studies show that religion and spirituality play a significant role in the suicidal path. Considering the dearth of data on the patterns of suicidal thoughts, acts and related factors in Pakistan, a country with a large Muslim population and stigma with sociocultural perceptions of religious notions, the current study investigated the role of religious and spiritual factors of suicide using psychological autopsies.MethodPurposive sampling was used to gather retrospective data records from police stations and hospital forensic departments in Rawalpindi and Islamabad, Pakistan, between January 2021 and July 2022. In total, 60 samples (30 cases and 30 controls) were used in this autopsies investigation. As with the majority of case control studies, the study sample cases were matched with the controls. At least two close bereaved family members served as the primary information sources, and data was gathered using the Semi Structured Interview Protocol for Psychological Autopsies.ResultsAccording to statistical analysis, both the suicide cases and the controls were comprised mostly of Muslim individuals. They follow Islam and hold the view that suicide is prohibited, forbidden, and haram in Islam. Regarding spirituality and religion, the majority of cases, according to the respondents interviewed, were not spiritual at all, while the controls are slightly spiritual. While the majority of both cases and controls had reduced interest in or practice of religious activities over the past year, a higher number of cases rarely performed and attended the religious services/activities as compared to controls.DiscussionIt was thus evident that the cases lacked significant engagement in spiritual and religious activities, and their attendance at such gatherings had notably decreased in the year preceding the suicide attempt. This decline in involvement in spiritual and religious practices might be linked to decreased levels of satisfaction, sense of belongingness, which could raise the risk of suicide. Therefore, in nations where Muslims predominate, culturally relevant suicide prevention initiatives including spiritual and religious treatments aimed at reducing the risk of suicide should be considered.

Impact of text message reminders on immunosuppressive medication adherence among kidney transplant recipients: A randomized controlled study.

One of the most common problems encountered in transplant patients is nonadherence with immunosuppressive drugs, one of the most important reasons for graft rejection. The study aimed to assess the impact of text message reminders on medication adherence among kidney transplant recipients. A randomized controlled trial. The study was conducted from January to October 2021. This study included a total of 100 patients receiving a kidney transplant, 50 in the intervention group and 50 in the control group. Patients in the intervention group were sent text message reminders four times a day during the 6th-9th months after transplantation. Control patients received no such intervention. Tacrolimus concentrations in the bloodstream were monitored for all participants through measurements taken at Months 7, 8 and 9. Data collection tools included Sociodemographic Form and Immunosuppressive Medication Adherence Scale. Patients were homogeneously distributed among the groups. Sending daily text message reminders to transplant recipients caused an independent positive effect on medication adherence scale scores at the end of the study. Mean pretest medication adherence score of all patients was 45.18 ± 4.22 and posttest score was 47.4 ± 3.6. The intervention group exhibited a significantly higher mean posttest adherence score compared to controls, with values of 48.68 ± 2.58 and 45.62 ± 4.42, respectively (p < 0.001). Findings demonstrated a substantial improvement in the final medication adherence scores of transplant patients when they received daily Short Message Service reminders, acting as an independent factor (β = 0.356, p < 0.001). Sending text message reminders to kidney transplant recipients is a statistically and clinically effective intervention to improve immunosuppressive medication adherence.

Green Approach for the Synthesis of 2-Phenyl-2H-indazoles and Quinazoline Derivatives Using Sustainable Heterogeneous Copper Oxide Nanoparticles Supported on Activated Carbon and OER Study.

This research work reports the synthesis of copper oxide (CuO) nanoparticles supported on activated carbon by a simple impregnation method using 2-propanol as a green solvent, followed by calcination. The synthesized CuO@C is used as an efficient heterogeneous nanocatalyst for the synthesis of 2H-indazoles and quinazolines utilizing commercially available 2-bromobenzaldehydes, primary amines, and sodium azide under ligand-free and base-free conditions. The present methodology demonstrates the formation of new N-N, C-N, and C═N bonds under one-pot reaction conditions using PEG-400 as a green solvent. The reaction pathways are supported by control experiments and mechanistic elucidation. Further, the synthesized catalyst was characterized by a range of microscopic and spectroscopic techniques such as powdered X-ray diffraction, fourier transform infrared spectroscopy, field emission scanning electron microscopy, energy-dispersive X-ray, UV-vis, X-ray photoelectron spectroscopy, high-resolution transmission electron microscopy, and BET-BJH analysis. Importantly, the study focused on the recyclability of the catalyst and successfully showed gram-scale production. Significantly, our active catalyst exhibited an outstanding performance in the oxygen evolution reaction, with an overpotential of 290 mV and a swallow Tafel slope of 91 mV dec-1.

Effects of collaborative learning-based food literacy program on healthy eating behavior and hemoglobin A1c among older adults with uncontrolled type 2 diabetes: A randomized controlled trial study in Thailand.

Uncontrolled type 2 diabetes mellitus (T2DM) is a prevalent issue among older adults. Healthy eating behavior (HEB) is a significant factor contributing to blood sugar control. It is a complex behavior that requires knowledge, attitudes, and skills in food literacy, which can be achieved through collaborative learning by nurses. Although collaborative learning has successfully improved food literacy and HEB among adults and older adults in general, its effectiveness has not been investigated among older adults with uncontrolled T2DM. This randomized controlled trial aimed to examine the effects of the Collaborative Learning-Based Food Literacy Enhancement Program (CLFLEP) on HEB and hemoglobin A1c (HbA1c) levels among older adults with uncontrolled T2DM. Participants were 80 older adults with uncontrolled T2DM attending primary care units (PCUs) or sub-district health promotion hospitals in northern Thailand. They were randomly assigned to either the experimental group (n = 40) or the control group (n = 40). The experimental group received the CLFLEP to enhance four domains of food literacy through five major elements of collaborative learning, while the control group received standard care. Data were collected between January and June 2023 using the Demographic Data Form, the Eating Behavior Questionnaire, the HbA1c test, and the Short Food Literacy Questionnaire. Data analysis involved descriptive statistics for demographic characteristics and independent t-test and paired sample t-test for HEB and HbA1c based on intention-to-treat (ITT) and per-protocol (PP) analyses. The experimental group had a higher HEB score than the control group (p <0.001 for ITT and PP) and higher than their scores before program participation (p <0.001 for ITT and PP). The effect size (Cohen's d) was 1.46. The experimental group also had a lower HbA1c level than the control group (p = 0.002 for ITT and PP) and lower than their levels before program participation (p = 0.005 for ITT and 0.001 for PP). The effect size (Cohen's d) was 0.70. The CLFLEP was effective in promoting food literacy, HEB, and blood sugar control. Nurses can be trained to use this program to provide collaborative health education for older adults with uncontrolled T2DM. Nursing administrators can use these findings to develop organizational policies that enhance nurses' competencies as educators skilled in collaborative learning. TCTR20221222005 [Thai Clinical Trials Registry].

Comparison of outcomes of dual-mobility cemented total hip arthroplasty versus bipolar cemented hemiarthroplasty in patients with femoral neck fractures

Background: Elderly people with femoral neck fractures are more likely to experience complications after hip replacement. Compared with total tripolar hip arthroplasty (THA), bipolar hemiarthroplasty (HA), more effective alternative treatments that improve overall safety. We aimed to review the benefits of dual mobility tripolar arthroplasty and compare it to bipolar hemiarthroplasty in treatment of the femoral neck in the elderly. Methods: This study was conducted as a comparative randomized controlled prospective study. Patients were divided randomly to two equal groups 19 patients each one group underwent cemented bipolar hip hemi arthroplasty and the other group underwent cemented tripolar total hip arthroplasty, surgical approach for the two study groups was modified lateral Hardinge approach. The patients were followed up after one month, three months 6 months and one year. The follow up period was one year, and modified Harris hip score was reported, and radiograph scan of fracture site was done before and after surgery. Complications were reported whether intraoperative or in the follow up period. Results: The result of the study showed that the operative time was much longer in tripolar group as compared to bipolar group, there was more blood loss in tripolar group more than bipolar group. The functional outcome assessed using Harris hip score showed better outcome in tripolar group as compared to bipolar group. As regard complication, there was one case of periprosthetic fracture intraoperative in bipolar group and one case of cement extrusion in tripolar group. There was no dislocation in both groups. Conclusions: Tripolar total hip arthroplasty had better functional outcome than bipolar hip hemiarthroplasty and we recommend more studies for a longer period of follow up to assess rate of complications and functional outcome on the long run.

Soft tissue response to titanium healing abutments treated by Er: YAG laser or plasma spray: A randomized controlled feasibility clinical study with SEM and histological analysis.

Soft tissue seal around implants ensures stable osseointegration and a long-term survival of dental implants. Different surface modification and decontamination for implant abutments were endorsed in order to improve peri-implant soft tissue healing, such as laser, plasma spray, acid etching, and steaming. The aim of this study was to evaluate the response of peri-implant soft tissue to titanium abutments treated with Erbium-doped: Yttrium-Aluminum-Garnet (Er:YAG) laser versus plasma spray. Twenty-four patients who required implant placement in the maxillary arch participated in this study. Patients were divided into three groups, abutments treated with Er:YAG laser versus cold plasma spray and untreated abutments. Fourteen days following the implant abutment insertion, soft tissue peri-implant biopsies were taken for histological, histochemical, and immunohistochemical evaluation. Scanning electron microscopy was done for the abutments; plaque index (PI) and gingival index (GI) were assessed 14 days and 3 months following final restoration. Regarding the histological results, the least mean inflammatory cell count was in the plasma group (174.09 ± 40.67), followed by the laser group (654.27 ± 85.95) and the control group (852.00 ± 117.98), with statistically significant differences between them. The mean area fraction of collagen fibers showed the highest value in the plasma group (9.73 ± 1.91), followed by the laser group (3.25 ± 0.49), while the lowest value was found in the control group (1.17 ± 0.51). The immunohistochemical expression of E-cadherin was significantly higher and uniformly distributed in the plasma group (42.4 ± 11.2%) followed by the laser group (15.4 ± 4.07%) and the control group (6.8 ± 1.7%). SEM analysis of healing abutments showed fibroblast-like cells, which were more developed with dense fibers in the plasma group; laser group fibers showed fewer and more delicate fibers than the plasma group, while no fibers were detected in the control group. Within the limitations of this feasibility study, the present data concluded that plasma spray and Erbium: YAG laser can be used for abutment surface treatment to achieve better peri-implant soft tissue healing. Clinically and histologically, plasma spray showed a better effect on the peri-implant soft tissues by reducing the inflammatory reaction, promoting collagen fiber formation, higher fibroblast-like cell attachment, and upregulating E-cadherin expression than Erbium: YAG laser and control groups.

Efficacy of combined surgical approaches in the management of sinonasal and orbital pathologies: innovations in minimally invasive techniques and their impact on postoperative outcomes

Sinonasal and orbital pathologies present unique challenges due to their anatomical complexity requiring advanced surgical approaches for optimal management. This systematic study demonstrates the effectiveness of combined surgical interventions based on advancements in minimally invasive approaches. An electronic literature search was performed on articles reporting patient outcomes after combined surgical management in sinonasal and orbital pathologies through the PubMed, Scopus, and Cochrane databases. Under the inclusion criteria, randomized controlled trials, literature reviews, cohort studies, and case reports published in the last decade on reputable journals were taken under consideration. Complications and functional outcomes were improved as compared to the conventional surgery techniques when looked into the previous evidences. Heterogeneities of the study designs and duration of follow-up did not permit a meta-analysis. The endoscopic orbital decompression, and other such sinonasal surgeries were now performed with less intraoperative blood loss, shorter hospital stays, and quicker recovery times. After all research, it can be concluded that combined surgical techniques do improve outcomes, but more high-quality, standardized work needs to be done to establish long-term efficacy. Our research findings support this trend of minimalization of invasive techniques to treat pathologies within the sinonasal and orbital spaces and stress their overall capacity to enhance postoperative results. Future research should focus on standardizing protocols and longer follow up periods to evaluate recurrence and long-term complications better.

Intestinal Region-Dependent Impact of NFκB-Nrf Crosstalk in Myenteric Neurons and Adjacent Muscle Cells in Type 1 Diabetic Rats.

Type 1 diabetes affects cytokines as potential inducers of NFκB signalling involved in inflammation and neuronal survival. Our goal was to assess the expression of NFκB p65 and its negative regulator, Nrf2, in myenteric neurons and adjacent smooth muscle of different gut segments after chronic hyperglycaemia and immediate insulin treatment. After ten weeks of hyperglycaemia, intestinal samples of control, streptozotocin-induced diabetic and insulin-treated diabetic rats were prepared for fluorescent immunohistochemistry, immunogold electron microscopy, ELISA and qPCR. In the diabetic rats, the proportion of NFκB p65-immunoreactive myenteric neurons decreased significantly in the duodenum and increased in the ileum. The density of NFκB p65-labelling gold particles increased in the ileal but remained unchanged in the duodenal ganglia. Meanwhile, both total and nuclear Nrf2 density increased in the myenteric neurons of the diabetic duodenum. In smooth muscle, NFκB p65 and Nrf2 density increased in the small intestine of diabetic rats. While on the mRNA level, NFκB p65 and Nrf2 were induced, on the protein level, NFκB p65 increased and Nrf2 decreased in muscle/myenteric plexus homogenates. Insulin treatment had protective effects. Our findings reveal a segment-specific NFκB and Nrf expression in myenteric neurons and ganglionic muscular environments, which may contribute to regional neuronal survival and motility disturbances in diabetes.

Performance control during longitudinal activation fMRI studies

The documentation of performance during functional imaging represents a standard procedure employed to control for compliance, sensorimotor, and cognitive demands. In the case of motor tasks, preciseness, force, and frequency have a significant impact on the magnitude of functional activation. Questionnaires are used in psychological investigations to control for cognitive demand, while psychophysiological documentation is employed to record bodily responses. For longitudinal intervention studies, it is of utmost importance to implement meticulous pre- and post-performance controls and balance to accurately assess changes over time. Any changes in compliance may introduce additional uncontrolled variables, which can hinder the interpretation of functional magnetic resonance imaging (fMRI)-related changes. This narrative review presents strategies for controlling and balancing performance in functional imaging approaches to document neuroplasticity in rehabilitative studies. These strategies include not only motor-related aspects, such as precision, velocity, and force, but also timing aspects, such as the start and stop of movement periods. In addition, it discusses strategies for the modulation and control of movement aspects with visual feedback, as well as for the control of physiological changes during experimental modulation. Although these measures require additional care, which is often more demanding than the neuroimaging part of the study, they are crucial for a relevant interpretation and publication of fMRI studies.

Comparison of Friction Resistance Between Different Bracket Systems: An In Vitro Study

Introduction The efficiency of tooth movement associated with orthodontic sliding mechanics can be compromised by friction between archwire and tube or bracket slot. Orthodontic brackets and archwires are important constituents of an orthodontic appliance system. Friction is an uncontrolled variable of particular interest when continuous arch techniques are used to align and move teeth by way of sliding a tube or bracket along an arch. Aim and Objectives Comparison of frictional resistance between different bracket systems of 3M and MO brands in combination with different wires of 3M, MO, and G&amp;H brands. Evaluation of frictional resistance between two different types of bracket systems and different types of wire combinations. Materials and Methods Two types of bracket systems were used: metal bracket system and ceramic bracket system (3M and MO brands). Four different orthodontic wire alloys were used: stainless steel (SS), TMA, NiTi, and CuNiTi (3M, MO, and G&amp;H brands). A rectangular block made up of self-cure acrylic resin was designed to hold the bracket during the mechanical test. Each bracket base was glued to an acrylic block with cyanoacrylate glue. The wire segment was inserted into the bracket and was ligated passively with SS ligature wire. The bracket–wire combination was submitted to mechanical tests with a universal testing machine. One end of the acrylic block was mounted to the lower grip of the universal testing machine. The free end of the archwire was fixed to the upper grip of the universal testing machine. The friction which was generated between the wire and bracket was measured under dry conditions and at room temperature. The test wire was pulled through the bracket at a speed of 0.5 cm/min. The load cell registered a maximum force level. This data was stored in the computer and was submitted to statistical analysis, and parameter tests were applied. Results The highest mean friction resistance of 5.998 N was generated by group B2-E2 (ceramic bracket – MO + TMA archwire – MO). The lowest mean friction resistance of 2.552 N was generated by group A1-C1 (metal bracket – 3M + SS wire – 3M). There was a statistically significant difference between the friction generated by the metal bracket on SS archwire and the ceramic bracket on TMA archwire regardless of 3M or MO brand material ( p value &lt; .0001) and metal bracket ( p = .0004).

Autonomous nervous system responses to environmental-level exposure to 5G's first deployed band (3.5GHz) in healthy human volunteers.

Following the global progressive deployment of 5G networks, considerable attention has focused on assessing their potential impact on human health. This study aims to investigate autonomous nervous system changes by exploring skin temperature and electrodermal activity (EDA) among 44 healthy young individuals of both sexes during and after exposure to 3.5GHz antenna-emitted signals, with an electrical field intensity ranging from 1 to 2V/m. The study employed a randomized, cross-over design with triple-blinding, encompassing both 'real' and 'sham' exposure sessions, separated by a maximum interval of 1week. Each session comprised baseline, exposure and postexposure phases, resulting in the acquisition of seven runs. Each run initiated with a 150s segment of EDA recordings stimulated by 10 repeated beeps. Subsequently, the collected data underwent continuous decomposition analysis, generating specific indicators assessed alongside standard metrics such as trough-to-peak measurements, global skin conductance and maximum positive peak deflection. Additionally, non-invasive, real-time skin temperature measurements were conducted to evaluate specific anatomical points (hand, head and neck). The study suggests that exposure to 3.5GHz signals may potentially affect head and neck temperature, indicating a slight increase in this parameter. Furthermore, there was a minimal modulation of certain electrodermal metrics after the exposure, suggesting a potentially faster physiological response to auditory stimulation. However, while the results are significant, they remain within the normal physiological range and could be a consequence of an uncontrolled variable. Given the preliminary nature of this pilot study, further research is needed to confirm the effects of 5G exposure.

Non-destructive Analytical Study of Raman Spectra Variations and Mechanisms of Calcite and Aragonite in Modern and Fossilized Oysters.

Oyster fossils are some of the most common bivalve mollusk fossils found all over the world, they are different from other fossils because the oyster is still alive in the present day, and the body structure of modern oyster is almost the same as that of ancient one. Therefore, we designed a control experiment comparing the Raman spectra of minerals from both modern oysters and fossil oysters to explore the mechanism of oyster's fossilization process, which is considered to be helpful for investigating biological evolution or paleoenvironment. The oyster fossil sample was found in Nagi-Cho, Okayama Prefecture, Japan. We focused on the variations of band position and full width half-maximum of ν1 Raman band (symmetric stretching mode) of calcite (CaCO3) from modern and fossil oysters and the mineral conversion between calcite and aragonite (CaCO3) around the adductor muscle inside the oyster. Compared to modern oysters, the ν1 band at around 1086 cm-1 of calcite from oyster fossils shifted to a high wavenumber region, and the possible reason for this phenomenon is considered an elemental substitution between Ca2+ and Mg2+. As for aragonite around adductor muscle in fossil oysters, it has been found by Raman spectra that most of the aragonite has been converted into calcite because calcite has a relatively more stable structure.

Therapy strategies for repetitive vocalizations in dementia : Asystematic review

Vocalizations in dementia patients are repetitive verbal expressions that, due to their volume, frequency, and/or social inappropriateness, cause negative effects on patients and other individuals present. The prevalence ranges up to 30%. Given the increasing global incidence of dementia and the limited number of randomized controlled trials about treating repetitive vocalizations, this systematic review provides asummary of existing works on the effectiveness of potential pharmacotherapeutic and nonpharmacological therapies. The systematic review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and was registered on the International Prospective Register of Systematic Reviews (PROSPERO) registration page (registration number: CRD42023486344). Literature search was conducted in PubMed and Embase databases. Due to insufficient data, case reports were also included. Of 2635 articles, 25studies were included in the review. Efficacy was demonstrated for selective serotonin reuptake inhibitors (SSRIs), pregabalin, gabapentin, and the antipsychotics haloperidol and risperidone based on afew case reports, albeit with associated side effects. Nonpharmacological interventions also showed efficacy. Both pharmacological and nonpharmacological interventions are effective treatment approaches for repetitive vocalizations in dementia patients. Due to the fact that there are hardly any randomized controlled studies available, the results of this systematic review must be interpreted with caution. The results of this review show that randomized controlled trials are required for many interventions.

The associations of post-stroke delirium with outcomes: a systematic review and meta-analysis

BackgroundPublished data on whether post-stroke delirium (PSD) is an independent predictor of outcomes in patients with acute stroke are inconsistent and have not yet been synthesized and quantified via meta-analyses.MethodsThis systematic review and meta-analysis followed the Meta-analysis of Observational Studies in Epidemiology (MOOSE) and Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. The study protocol involved a search of the PubMed, Embase, PsycINFO, and Medline databases from 1946 to November 1, 2023, of which prospective observational and case–control studies were included. The quality of the included studies was rated using the Newcastle Ottawa Scale. Pooled effect estimates calculated using a random-effects model were expressed as the odds ratios (ORs), hazard ratios (HRs), and standardized mean differences (SMDs) with 95% confidence intervals (CIs). The protocol was registered in PROSPERO (CRD42023472551).ResultsThe search yielded 39 eligible articles comprising 3295 and 9643 patients with and without PSD, respectively. Thirty studies were high quality, while 9 had moderate quality. The primary analyses, adequately adjusting for predefined confounders, showed that PSD was significantly associated with mortality risk (average follow-up of 19.50 months; OR, 3.47; 95% CI, 2.35–5.12; I2, 26.0%) and poor neurological function (average follow-up of 21.75 months; OR, 3.62; 95% CI, 2.15–6.09; I2, 0). Secondary analyses, with or without inadequate adjustment, showed that PSD was significantly associated with prolonged hospital length of stay, increased risk of institutionalization, poor cognitive outcomes, and quality of life after discharge.ConclusionsThis systematic review and meta-analysis provides evidence that PSD was independently associated with mortality and poor neurological function after controlling for pre-specified confounders. The prevention of PSD remains a high clinical and research priority.

Individualised computerised cognitive training (iCCT) for community-dwelling people with mild cognitive impairment (MCI): results on cognition in the 6-month intervention period of a randomised controlled trial (MCI-CCT study)

BackgroundComputerised cognitive training (CCT) can improve the cognitive abilities of people with mild cognitive impairment (MCI), especially when the CCT contains a learning system, which is a type of machine learning (ML) that automatically selects exercises at a difficulty that corresponds to the person’s peak performance and thus enables individualised training.MethodsWe developed one individualised CCT (iCCT) with ML and one basic CCT (bCCT) for an active control group (CG). The study aimed to determine whether iCCT in the intervention group (IG) resulted in significantly greater enhancements in overall cognitive functioning for individuals with MCI (age 60+) compared with bCCT in the CG across a 6-month period. This double-blind randomised controlled study was conducted entirely virtually. The 89 participants were community-dwelling people with a psychometric diagnosis of MCI living in Germany. The iCCT stimulates various cognitive functions, especially working memory, visuo-constructional reasoning, and decision-making. The bCCT includes fewer and simpler tasks. Both CCTs were used at home. At baseline and after 6 months, we assessed cognitive functioning with the Montreal Cognitive Assessment (MoCA). A mixed-model ANCOVA was conducted as the main analysis.ResultsBoth CCTs led to significant increases in average global cognition. The estimated marginal means of the MoCA score increased significantly in the CG by an average of 0.9 points (95% CI [0.2, 1.7]) from 22.3 (SE = 0.25) to 23.2 (SE = 0.41) points (p = 0.018); in the IG, the MoCA score increased by an average of 2.2 points (95% CI [1.4, 2.9]) from 21.9 (SE = 0.26) to 24.1 (SE = 0.42) points (p < 0.001). In a confound-adjusted multiple regression model, the interaction between time and group was statistically significant (F = 4.92; p = 0.029). The effect size was small to medium (partial η2 = 0.057). On average, the participants used the CCTs three times per week with an average duration of 34.9 min per application. The iCCT was evaluated as more attractive and more stimulating than the bCCT.ConclusionsBy using a multi-tasking CCT three times a week for 30 min, people with MCI living at home can significantly improve their cognitive abilities within 6 months. The use of ML significantly increases the effectiveness of cognitive training and improves user satisfaction.Trial registrationISRCTN14437015; registered February 27, 2020.

A prospective randomized controlled study on probiotics for the prevention of antibiotic-associated diarrhea in infants and young children

To evaluate the preventive effects of Saccharomyces boulardii powder and tetragenous viable Bifidobacterium tablets on antibiotic-associated diarrhea (AAD) in infants and young children. Children under three years old admitted to the Department of Pediatrics, Affiliated Hospital of Xuzhou Medical University due to non-gastrointestinal infections and requiring antibiotic treatment from July to December 2023 were enrolled. The children were randomly divided into a control group (n=47), a Saccharomyces boulardii group (n=70), and a Bifidobacterium group (n=65) using a random number table method. The control group received antibiotics and symptomatic supportive treatment according to relevant clinical guidelines. In addition to the treatment given to the control group, the Saccharomyces boulardii group and the Bifidobacterium group were respectively administered with Saccharomyces boulardii powder and tetragenous viable Bifidobacterium tablets. Based on the duration of probiotic use (7 days, 14 days, and 21 days), the Saccharomyces boulardii group was further divided into 7 d, 14 d, and 21 d subgroups, and similarly for the Bifidobacterium group. The incidence of AAD and ratio of cocci to bacilli in feces were compared among the groups after treatment. The incidence rate of AAD in both the Saccharomyces boulardii group and the Bifidobacterium group was lower than that in the control group (P<0.017). The duration of AAD and the length of hospital stay were shorter in the Saccharomyces boulardii and Bifidobacterium groups compared to the control group (P<0.05). In the control group, the ratio of cocci to bacilli in feces on days 7, 14, and 21 was higher than on day 1 (P<0.05). Within-group comparisons showed that the ratio of cocci to bacilli in feces on day 14 in the Bifidobacterium 14 d and 21 d groups were lower than on day 1 (P<0.05); and the ratios on day 14 in the control group, Saccharomyces boulardii 14 d group, Saccharomyces boulardii 21 d group, Bifidobacterium 14 d group, and Bifidobacterium 21 d group were lower than on day 7 (P<0.05). The ratios on day 21 in the control group and the Saccharomyces boulardii 21 d group were lower than on days 7 and 14 (P<0.05). Between-group comparisons indicated that on day 7, the ratios of cocci to bacilli in feces in the Saccharomyces boulardii 7 d, 14 d, 21 d groups, and Bifidobacterium 7 d, 14 d, 21 d groups were all lower than in the control group (P<0.05); on day 14, the ratios of cocci to bacilli in feces 14 d and 21 d groups were lower than in the control group and the Bifidobacterium 7 d group (P<0.05). Both Saccharomyces boulardii and tetragenous viable Bifidobacterium can effectively improve gut microbiota and prevent the occurrence of AAD in infants and young children. Compared to short-term treatment, appropriately extending the duration of probiotic therapy can further improve the structure of gut microbiota.

Refining delivery and positioning: A modified approach to FIL SSF intraocular lens implantation using the "full reverse" technique.

To present a modified surgical technique for implantation of the sutureless scleral-fixated hydrophilic intraocular lens (FIL SSF). Single surgeon retrospective case series and review of surgical videos with step-by-step technique analysis. Uncorrected and best corrected visual acuity (UCVA and BCVA), refractive error (spherical equivalent), full clinical examination with intraocular pressure (IOP) measurement, endothelial cell density on corneal specular microscopy and macular optical coherence tomography (OCT) were recorded at baseline, 1, 4 and 8 weeks postoperatively. The FIL SSF IOLs were successfully implanted using the so-called "full reverse" technique, having the lens loaded in the injector in an upside-down fashion, as opposed to IOL technical specifications. In all cases, the FIL SSF IOL was properly placed in the ciliary sulcus, well-centered and without signs of tilt. Follow up figures at 2 months are consistent with published data, confirming the potential benefits of the new implantation technique. In our preliminary experience, the "full reverse" technique of the FIL SSF IOL has proven effective in preventing incorrect IOL orientation in 100% of cases. However, larger prospective controlled studies and longer follow up are required to either support or disprove our results.

A controlled study of MR DWI, FS-PDW, and CE-T1W imaging for the evaluation of the internal opening of anal fistulas.

Anal fistula (AF) is an abnormal tunnel under the skin connecting the anal canal in the colon to the skin of buttocks. Fat-suppressed (FS) proton density-weighted (PDW) imaging is mainly used for the diagnosis of diseases involving bones and joints. Until now, its value in the diagnosis of anal fistula has been rarely reported. To compare three magnetic resonance imaging (MRI) sequences - diffusion-weighted imaging (DWI), FS-PDW), and contrast-enhanced (CE) T1-weighted (T1W) imaging - for the diagnostic value of the internal opening of AF. MRI scans of 132 patients suspected of having AF between December 2021 and April 2023 were retrospectively analyzed. In total, 65 patients who underwent preoperative MRI and were treated surgically were included. The lesion conspicuity and accuracy for featuring AF were calculated by evaluating the three imaging datasets DWI, FS-PDW, and CE-T1W imaging, with surgical findings serving as the reference standard for the presence of fistulas. The statistical analysis included the application of the chi-square test and Kruskal-Wallis test. In 65 patients with AF, 87 internal openings of AF were confirmed. In terms of the diagnostic accuracy of the internal openings, both FS-PDW and CE-T1W imaging sequences were significantly better than DWI sequences, and the difference was statistically significant (P < 0.05). The FS-PDW imaging sequence showed comparable diagnostic performance of the internal opening of AF to CE-T1W imaging, which can provide an important diagnostic basis for clinical procedures.

Exploring seed characteristics and performance through advanced physico-chemical techniques

Simple physico-chemical techniques can be used to evaluate the composition, structure, and characteristics of plant seeds to determine their viability, quality, and possible uses in agriculture. Advanced analytical techniques, including thermo gravimetric analysis (TGA), electron paramagnetic resonance (EPR), and high-pressure liquid chromatography (HPLC), provide completely new insights and more precise information. They can be integrated to build up seed quality profiles, with great advantage to assess water content, organic compounds, and inorganic metals without the need to carry out many extraction procedures, as requested by more conventional methods. In this study, seed lots from three different plant species such as Triticum turgidum L. subsp. durum (wheat), Trigonella foenum graecum L. (trigonella or fenugreek), and Atriplex halimus L. (saltbush or sea orach) have been used to test the potential of TGA, EPR, and HPLC to discriminate between seed-specific features. A key finding of this study is that HPLC is essential in Principal Component Analysis (PCA) because various seeds (from the same species or other species) may contain compounds with varying polarity groups. The reported data confirm the efficacy of this approach. These data, fully available for other users, are coherently constructed and provide a proof of concept for future seed quality control studies.

Efficacy of wooden toy training in alleviating cognitive decline in elderly individuals with cognitive impairment: A cluster randomized controlled study.

With the increasing global aging population, the health and welfare of elderly individuals, especially individuals with prevalent mild cognitive impairment (MCI) living in nursing homes, have become critical concerns. These concerns highlight the urgency of developing effective interventions to address the cognitive and psychological needs of elderly individuals, ensuring their well-being and alleviating the burden on their caregivers. This study investigates the impact of wooden toy training on mitigating cognitive decline in elderly individuals with cognitive impairment. It evaluates how this training influences cognitive functions and psychological well-being, exploring whether it can slow or reverse the progression of cognitive decline. This outcome will be assessed in a randomized controlled trial, in which changes in cognitive ability and psychological health indicators among the participants will be measured. A two-arm, open-label, cluster-randomized controlled trial. The study was conducted in two nursing homes, which served as both the recruitment sites for participants and the intervention locations. These nursing homes were selected for their ability to facilitate the intervention and for their representative demographic characteristics of the elderly population. The settings provided a controlled environment that was conducive to implementing the wooden toy training program and observing its effects on the participants. A total of 76 elderly participants with mild cognitive impairment but functional independence were recruited. Participants were randomized into an intervention group and a control group. The intervention group engaged in an 8-week wooden toy training program, whereas those in the control cohort received customary nursing care. Standardized cognitive and psychological well-being measures were used to assess improvements in cognitive performance and mental health. Significant improvements were observed in the cognitive functions of the intervention group from a baseline score of M = 13.11 to M = 16.29 postintervention (95% CI [-4.44, -1.93]), along with reductions in depressive symptoms from a baseline score of M = 8.63 to M = 7.18 (95% CI [0.38, 2.51]). Additionally, engagement in activities with wooden toys significantly satisfied their need for competence, increasing from a baseline of M = 16.29 to M = 20 postintervention (95% CI [-5.92, -1.51]), and relatedness, which improved from a baseline of M = 20.32 to M = 22.95 (95% CI [-4.73, -0.53]). This study underscores the potential of a wooden toy intervention in nursing homes that combines cognitive challenges with traditional cultural elements to improve cognitive functions in elderly individuals with mild cognitive impairment. Our findings suggest a novel method of promoting the cognitive and psychological health of nursing home residents through emotional comfort and social interaction.