MATERIALS AND METHODS: We extracted data from a multicentre Asian pediatric (onset <18 years) IBD registry. VEO- and later-onset pediatric (LO-p) IBD were defined as onset of disease <6 years and ≥6 years, respectively. We excluded monogenic IBD.
RESULTS: Of 440 children with IBD cases; 112 (25.5%) were VEO-IBD; Crohn's disease (CD) 36 (32.1%); ulcerative colitis (UC) 68 (60.7%), and IBD-unspecified 7 (7.1%). UC was more common in VEO-IBD while CD more common in LO-pIBD (CD = 68.9% vs. UC = 25.9%; p
MATERIALS AND METHODS: This study used a mixed methodological approach, which combined an evaluation method and an experimental quantitative design. The content validity of the module used was carried out using professional judgment, involving competent experts in the bahteramas hospital in southeast Sulawesi, Indonesia. The sample population consisted of sixty-five randomly selected respondents, who participated in the validation of the summary of Diabetes Self-Care Activities (SDSCA) questionnaire, which had three phases, namely pre-test, during, fieldwork, and post-test.
RESULTS: The content validity of the module was tested using Aiken's v, and the results ranged from 0.82 to 0.88 for each session, indicating that it was valid. Furthermore, the internal consistency (Cronbach's alpha) obtained in this study was acceptable, with values ranging from 0.60 to 0.92.
CONCLUSIONS: The results showed that the diabetes mellitus discharge planning module could be used to improve self-care among patients.
METHODS: We conducted a qualitative systematic review on published literature using AI on retina images to detect systemic diabetes complications. We searched three main databases: PubMed, Google Scholar, and Web of Science (January 1, 2000, to October 1, 2024). Research that used AI to evaluate the associations between retinal images and diabetes-associated complications, or research involving diabetes patients with retinal imaging and AI systems were included. Our primary focus was on articles related to AI, retinal images, and diabetes-associated complications. We evaluated each study for the robustness of the studies by development of the AI algorithm, size and quality of the training dataset, internal validation and external testing, and the performance. Quality assessments were employed to ensure the inclusion of high-quality studies, and data extraction was conducted systematically to gather pertinent information for analysis. This study has been registered on PROSPERO under the registration ID CRD42023493512.
FINDINGS: From a total of 337 abstracts, 38 studies were included. These studies covered a range of topics related to prediction of diabetes from pre-diabetes or non-diabeticindividuals (n = 4), diabetes related systemic risk factors (n = 10), detection of microvascular complications (n = 8) and detection of macrovascular complications (n = 17). Most studies (n = 32) utilized color fundus photographs (CFP) as retinal image modality, while others employed optical coherence tomography (OCT) (n = 6). The performance of the AI systems varied, with an AUC ranging from 0.676 to 0.971 in prediction or identification of different complications. Study designs included cross-sectional and cohort studies with sample sizes ranging from 100 to over 100,000 participants. Risk of bias was evaluated by using the Newcastle-Ottawa Scale and AXIS, with most studies scoring as low to moderate risk.
INTERPRETATION: Our review highlights the potential for the use of AI algorithms applied to retina images, particularly CFP, to screen, predict, or diagnose the various microvascular and macrovascular complications of diabetes. However, we identified few studies with longitudinal data and a paucity of randomized control trials, reflecting a gap between the development of AI algorithms and real-world implementation and translational studies.
FUNDING: Dr. Gavin Siew Wei TAN is supported by: 1. DYNAMO: Diabetes studY on Nephropathy And other Microvascular cOmplications II supported by National Medical Research Council (MOH-001327-03): data collection, analysis, trial design 2. Prognositc significance of novel multimodal imaging markers for diabetic retinopathy: towards improving the staging for diabetic retinopathy supported by NMRC Clinician Scientist Award (CSA)-Investigator (INV) (MOH-001047-00).
MATERIALS AND METHODS: A total of 82 human dry skulls and 82 sets of dry cervical vertebrae were examined for the presence of atlanto-occipital and atlantoaxial assimilation. Detailed morphometric analysis was performed to document the fusion patterns and variations in anatomical structures. The data were analyzed to determine the prevalence of these congenital anomalies and their implications for craniovertebral stability and neurological function.
RESULTS: Among the 82 skulls and 82 cervical vertebrae examined, atlanto-occipital assimilation was identified in 3 skulls (3.65%), whereas atlantoaxial assimilation was observed in 2 cases (2.43%). Combined occurrences of both anomalies were found in 2 skulls (2.43%) of the sample.
CONCLUSION: A thorough understanding of atlanto-occipital and atlantoaxial assimilation is clinically crucial due to its potential impact on the structural and functional dynamics of the craniovertebral junction. These congenital anomalies, though infrequent, can pose considerable clinical challenges, including compromised craniovertebral stability and an increased risk of neurological symptoms. Early diagnosis and careful clinical evaluation are crucial for managing potential complications associated with these conditions.
METHODS AND RESULTS: Five pathogen: antagonist inoculum ratios (100:0, 75:25, 50:50, 25:75, and 0:100) were employed. Non-aflatoxigenic Aspergillus flavus Af1KD and Af5TD, and Penicillium janthinellum were used against aflatoxin B1 (AFB1) and aflatoxin B2 (AFB2) by A. flavus. Against OTA by A. niger, and fumonisin B1 (FB1) and fumonisin B2 (FB2) by Fusarium verticillioides and F. proliferatum, respectively, the antagonists Trichoderma asperelloides, T. asperellum, and T. harzianum were used. Non-aflatoxigenic A. flavus Af1KD was the most effective against AFB1 and AFB2 at all tested ratios and substrates. All Trichoderma spp. were effective against OTA by A. niger on grain corn agar at all tested ratios. Trichoderma asperelloides and T. asperellum were effective against FB1 and FB2 produced by F. verticillioides at all tested ratios and substrates. Trichoderma asperelloides was effective against FB1 and FB2 by F. proliferatum at all tested ratios and substrates.
CONCLUSION: The native biocontrol candidates were effective against mycotoxigenic fungi and mycotoxin production on grain corn agar and grain corn kernels, and could be developed into biocontrol agents.
OBJECTIVES: This study aimed to evaluate the comparative effectiveness of psychosocial interventions in enhancing family function and resilience among caregivers of cancer patients based on data derived from randomized controlled trials.
METHODS: A systematic review was performed by searching 6 electronic databases and clinical trial registries until July 12, 2024. Pairwise and network meta-analyses (NMA) were performed using the network package in STATA 16.
RESULTS: This review identified 12 studies with a total of 1162 participants. The pairwise meta-analysis revealed a significant positive impact of psychosocial interventions on family function: standardized mean difference (SMD), 1.34; 95% confidence interval [CI], 0.16-2.52. NMA showed family interaction approaches (SMD, 0.69; 95% CI, 0.22-1.15) and psychoeducation interventions (SMD, 0.66; 95% CI, 0.24-1.08) both led to improvements in family function. However, neither the pairwise meta-analysis nor the NMA revealed the positive effects of psychosocial interventions on resilience.
CONCLUSION: Evidence suggests that psychosocial interventions can moderately improve family function. Among the various interventions explored, the family interactions demonstrated the most significant potential for effectiveness. However, resilience meta-analyses have not supported our psychosocial intervention recommendations.
IMPLICATIONS FOR PRACTICE: This study offers valuable insights for nursing practice, emphasizing the need for nurses to consider the relationships and resources available within the families of cancer patients while providing care.
OBJECTIVE: This article aims to provide a primary care update on the maintenance or discontinuation of antidepressant medication for the treatment of moderate-to-severe depression in adults. To this end, we performed a qualitative narrative review and provide commentary on recent research and systematic reviews.
DISCUSSION: In primary care, recent research has shown that there are substantial risks of depressive relapse resulting from antidepressant discontinuation. For a first episode of moderate-to-severe depression, antidepressants should be continued for 9-12 months after remission. Systematic reviews indicate that, overall, there is limited evidence of benefits from ceasing antidepressant treatment for recurrent depression. The existing evidence base on antidepressant withdrawal is limited in quality and extent, providing some evidence of harms, such as relapse, and not necessarily any gains, although reducing the burden of adverse effects is a consideration. There is a benefit-to-risk ratio in any decision to continue or withdraw antidepressant treatment.
METHODS: We prospectively enrolled 600 patients from a single medical center between October 2015 and June 2021. The stones were analyzed using Fourier transformation infrared spectrometer (Bruker, Karlsruhe, Germany). Calculi were classified based on their primary component. Ultimately, a total of 520 patients met the criteria and entered the final analyses. The stone composition between the 2 stages of surgery was compared.
RESULTS: Of the 520 patients, 277 were male and the mean age was 52.9±12.8 years. The average time delay between 2 stone analyses was approximately 33.2 days. One hundred and eighty-six cases (35.8%) had different compositions on the second-stage analyses, with a total of 67 (36.0%) cases transitioning to a totally different type of stones. Forty-one (16.5%) cases initially identified as infection stones changed to non-infection stones and 35 (12.9%) cases transformed from non-infection stones to infected stones.
CONCLUSION: Up to 35.8% of stones underwent changes during the second stone composition analysis, and up to 36.0% of these altered stones had transformed to a totally different type. Conducting stone composition analysis between 2 stages of surgery is essential for the development of follow-up treatment and drug prevention plans.
OBJECTIVE: This study aimed to establish a predictive model including exhaled volatile organic compounds for the diagnosis of colorectal cancer.
DESIGN: Prospective comparative study.
SETTINGS: Single academic medical center.
PATIENTS: Exhaled breath was collected prospectively from 112 colorectal cancer patients and 51 healthy controls. The exhaled breath of the research participants was collected under the control of various conditions, such as eating or smoking prior to collection.
INTERVENTIONS: A total of 53 volatile organic compounds was analyzed in exhaled breath using thermal desorption-gas chromatography/mass spectrometry.
MAIN OUTCOME MEASURES: After correcting various clinical variables that may affect volatile organic compound, the concentrations detected in the colorectal cancer group and the healthy control group were compared.
RESULTS: Four predictive models were established using both matched clinical variables and volatile organic compound values to differentiate between colorectal cancer and healthy controls. In the four models, clinical variables of age, gender, room temperature, heating and cooling, fasting duration, intake of grilled meat or fish, and bowel preparation were included, along with levels of eight volatile organic compounds (ethanol, decanal, 1-iodononane, dodecane, hexanal, 1-nonene, (1S)-(-)-alpha-pinene, and acetophenone). The sensitivity of the four prediction models ranged from 84.0% to 98.2%, the specificity ranged from 89.2% to 93.8%, and the area under the receiver operating characteristic curve ranged from 92.1% to 98.3%.
LIMITATIONS: The demographics of the participants in the groups were different.
CONCLUSIONS: Eight types of volatile organic compounds in the exhaled breath of the colorectal cancer group were significantly different from those of the healthy control group. Our results support the diagnosis of colorectal cancer using a predictive model combining volatile organic compounds and specific clinical variables. See Video Abstract.