title stringlengths 1 1.19k | keywords stringlengths 0 668 | concept stringlengths 0 909 | paragraph stringlengths 0 61.8k | PMID stringlengths 10 11 |
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Results | PMC10199342 | |||
Characteristics | The study population comprised 346 children (164 females [47.4%]; mean [SD] age at follow-up, 7.1 [0.4] years), including 169 children (80 females [47.3%]) in the 400-IU and 177 children (84 females [47.5%]) in the 1200-IU supplementation group. | PMC10199342 | ||
Baseline Characteristics by Intervention Group | depression, Depression | Abbreviations: 25(OH)D, serum 25-hydroxyvitamin D; CES-D, Center for Epidemiological Studies Depression Scale.SI conversion factor: To convert 25(OH)D to nanomoles per liter, multiply by 2.496.Parental education was categorized from 1 (comprehensive school) to 6 (university degree) and dichotomized into 2 levels: low (... | PMC10199342 | |
Vitamin D | There were 20 children (11.8%) in the 400-IU group and 10 children (5.6%) in the 1200-IU group with clinically significant internalizing problems ( | PMC10199342 | ||
Levels of 25(OH)D at 1 and 2 Years and Psychiatric Problems at Ages 6 to 8 Years | Higher 25(OH)D levels at ages 1 and 2 years resulted in lower risk for clinically significant internalizing problems (1 year: OR, 0.93; 95% CI, 0.90 to 0.97; | PMC10199342 | ||
Maternal Vitamin D | psychiatric | Among 291 families with data on maternal 25(OH)D levels, there were 96 children whose mothers had levels less than 30 ng/mL (33.0%) compared with 208 of 517 nonparticipating families with these data (40.2%). We found no effect of maternal 25(OH)D levels on child psychiatric problems (eTable 2 in | PMC10199342 | |
Association of Supplementation and Maternal Vitamin D Level Subgroup With Psychiatric Symptoms | internalizing problems, Depression, Psychiatric, depressive symptoms | REGRESSION | Abbreviations: ; CBCL, Childhood Behavior Checklist; MD, mean difference; OR, odds ratio.Psychiatric symptoms were assessed at ages 6 to 8 years using the CBCL.Groups 1 and 2 had maternal serum 25-hydroxyvitamin D (25[OH]D) levels less than 30 ng/mL (to convert to nanomoles per liter, multiply by 2.496), with child sup... | PMC10199342 |
Discussion | SECONDARY | In this secondary analysis of the VIDI RCT, we explored the potential impact of higher-than-standard vitamin DFurthermore, internalizing problem scores were significantly higher for children from the 400-IU group with maternal 25(OH)D levels less than 30 ng/mL, compared with children from the 1200-IU group regardless o... | PMC10199342 | |
Strengths and Limitations | internalizing behaviors | MAY | This study has several strengths, among them the double-blind RCT setting, standardized data collection, and well-characterized study population. Outcomes were assessed using CBCL, a widely used, validated questionnaireThis study has several limitations as well. Of the original study population (987 families), 546 fami... | PMC10199342 |
Conclusions | SECONDARY | This secondary analysis of an RCT found that a higher-than-standard vitamin D | PMC10199342 | |
Abstract | PMC10587942 | |||
Introduction | prostate cancer, Prostate | SECONDARY, PATHOLOGY, PROSTATE CANCER, PROSTATE | The Oncotype Dx Genomic Prostate Score (GPS) is a 17‐gene relative expression assay that predicts adverse pathology at prostatectomy. We conducted a novel randomized controlled trial to assess the impact of GPS on urologist's treatment preference for favorable risk prostate cancer (PCa): active surveillance versus acti... | PMC10587942 |
Methods | REGRESSIONS | Ten urologists along with men with very low to favorable‐intermediate risk PCa were included in the study. Participants were randomly assigned to standardized counseling with or without GPS assay. The main outcome was urologists' preference for active treatment at Visit 2 by study arm (GPS versus Control). Multivariabl... | PMC10587942 | |
Results | Two hundred men (70% Black) were randomly assigned to either the Control (96) or GPS arm (104). At Visit 2, urologists' preference for prostatectomy/radiation almost doubled in the GPS arm to 29.3% (29) compared to 14.1% (13) in the Control arm ( | PMC10587942 | ||
Discussion | Limitations included sample size and number of urologists. In this study, we found that GPS testing reduced urologists' likelihood to prefer active surveillance. | PMC10587942 | ||
Conclusions | Zequn | These findings demonstrate how obtaining prognostic biomarkers that predict negative outcomes before treatment decision‐making might influence urologists' preference for recommending aggressive therapy in men eligible for active surveillance.
Samuel Carbunaru and Zequn Sun contributed equally to the manuscript as cofir... | PMC10587942 | |
INTRODUCTION | ®, Cancer, prostate cancer, Prostate | CANCER, PROSTATE CANCER, PROSTATE | Active Surveillance (AS) has increased dramatically over the last decade as a safe alternative to immediate treatment for patients with favorable risk prostate cancer (PCa). This strategy, however, has not been equally adopted across all racial/ethnic arms, with lower rates seen particularly in Black men.Genomic tests ... | PMC10587942 |
MATERIALS AND METHODS | PMC10587942 | |||
Study design and participants | tumor, death, Anxiety, postbiopsy, Prostate, Depression, Cancer | CANCER, TUMOR, METASTASIS, PROSTATE, PROSTATE CANCER, BROWN | From 2016 to 19 we enrolled 200 men into a randomized controlled trial, ENACT (Engaging Newly Diagnosed Men About Cancer Treatment Options) from three sites: the University of Illinois at Chicago (UIC), John H. Stroger Jr Hospital of Cook County (Cook County), and the Jesse Brown VA Medical Center.At their first postbi... | PMC10587942 |
Participating urologists | postbiopsy | A total of 10 urologists participated in the study. At Visit 1, coordinators ascertained the urologists' initial treatment preference prior to evaluating the patient. The only information presented at the time was the patient's name, age, PSA, clinical stage/digital rectal exam results, and their NCCN risk group. Respo... | PMC10587942 | |
Statistical analysis | REGRESSION | In order to assess randomization, A minimally adjusted binary logistic regression model for active treatment versus AS was developed by adjusting for the urologist's treatment preference at Visit 1. Watchful waiting ( | PMC10587942 | |
RESULTS | PMC10587942 | |||
The trial population | Prostate, Cancer | PROSTATE CANCER, PROSTATE, CANCER | The details of the study population and methods are in included in our primary endpoint paper from 2021.Clinical and demographic characteristics of the ENACT trial study arms at baseline.
Abbreviations: AS/WW, active surveillance/watchful waiting; ENACT, Engaging Newly Diagnosed Men About Cancer Treatment Options; GG, ... | PMC10587942 |
Urologists' treatment preference | Cancer, Prostate Cancer, Anxiety, Prostate | BROWN, PROSTATE CANCER, REGRESSIONS, PROSTATE, REGRESSION, CANCER | The ten urologists that participated in ENACT practiced at academic medical centers classified as safety net hospitals: five urologists were from Cook County Health, two from Jesse Brown VA, and three from University of Illinois at Chicago (UIC). Their ages ranged from 38 to 76 years old, and seven (70%) practice as ur... | PMC10587942 |
DISCUSSION | Chicago‐based, death, tumor | TUMOR, METASTASIS, RECRUITMENT, SECONDARY, EVENTS, PATHOLOGY | Compared to previous retrospective studies, this study provides prospective level evidence through a randomized controlled trial to examine the clinical utility of genomic assays on provider treatment preference for PCa. Adding to its uniqueness, it also takes place in a safety net setting with a large percentage of Bl... | PMC10587942 |
CONCLUSION | In this randomized controlled trial, we report how urologists' treatment preference for prostatectomy/radiation increased in men who received GPS score. These findings demonstrate how obtaining prognostic biomarkers at the time of diagnosis might influence urologists' preference for recommending immediate therapy, espe... | PMC10587942 | ||
AUTHOR CONTRIBUTIONS | PMC10587942 | |||
CONFLICT OF INTEREST STATEMENT | The authors certify that all conflicts of interest, including specific financial interests and relationships and affiliations relevant to the subject matter or materials discussed in the manuscript (e.g., employment/ affiliation, grants or funding, consultancies, honoraria, stock ownership or options, expert testimony,... | PMC10587942 | ||
ETHICS STATEMENT | The authors confirm that ethical approval was sought from all relevant Institutional Review Board (IRB) or Ethics Committee prior to commencing this study. | PMC10587942 | ||
INFORMED CONSENT STATEMENT | The authors confirm that written informed consent was obtained from all participants of this study. | PMC10587942 | ||
Supporting information | APPENDIX |
Appendix S1
Click here for additional data file. | PMC10587942 | |
ACKNOWLEDGMENTS | This study was supported by grants W81XWH‐15‐1‐0533, W81XWH‐15‐1‐0534, W81XWH‐21‐1‐0849, AND W81XWH‐21‐1‐0850 awarded by the Department of Defense. | PMC10587942 | ||
DATA AVAILABILITY STATEMENT | The data that support the findings of this study are available from the corresponding author upon reasonable request. | PMC10587942 | ||
REFERENCES | PMC10587942 | |||
Background | milk insufficiency | The World Health Organization recommends mothers breastfeed exclusively for the first six months of their infant’s life. However, women living with HIV in low resource settings face many barriers to recommended infant feeding practices such as fear of HIV transmission and perceived milk insufficiency. Moreover, current... | PMC10557183 | |
Results | Participation in the sessions was high and at three months postpartum all participants reported exclusive breastfeeding as recommended despite experiencing a myriad of challenges. Having face-to-face and frequent early postpartum sessions, being available to field participant concerns between sessions and measuring inf... | PMC10557183 | ||
Conclusions | The personalized professional infant feeding support sessions were highly acceptable and feasible to implement. In-person sessions, in a clinic setting provided opportunities to evaluate and adjust breastfeeding technique and led to successful exclusive breastfeeding practice. Future interventions should consider integ... | PMC10557183 | ||
Keywords | PMC10557183 | |||
Background | Breastfeeding exclusively for the first six months of an infant’s life followed by safe and adequate complementary feeding in addition to continued breastfeeding for 24 months or beyond is the recommended practice for all women [In Kenya where 890,000 women are living with HIV, the Ministry of Health has widely promote... | PMC10557183 | ||
Methods | PMC10557183 | |||
Infant feeding support component of Supporting Healthy Mothers | Debunk myths and misconceptions• Identify, HIV transmission• Breast, thrush, pains•, body•, foremilk/ | COLD, BREAST, THRUSH | Using findings from a longitudinal qualitative exploration of women’s perinatal experiences in this setting, [Specific content and educational materials for the
Prenatal Breastfeeding Support Session• Ensure the important benefits of exclusive breastfeeding for the first six months after birth are understood, benefits... | PMC10557183 |
Documentation of the infant feeding support sessions | After each session, the Lactation Specialist wrote or dictated a summary of her encounter with participants including her focused assessment of the participant and her infant, any problems or challenges the participant was facing and the interventions or recommendations she provided. The Research Coordinator, experienc... | PMC10557183 | ||
Analysis | The aim of our analysis was to assess feasibility—to what extent we executed the infant feeding support sessions according to our plan. We considered whether or not the Lactation Specialist delivered the developed curriculum as planned and if changes to our intervention design were required. We also assessed acceptabil... | PMC10557183 | ||
Results | PMC10557183 | |||
Participants | Twenty women, from the Luo [ | PMC10557183 | ||
Observations from the infant feeding support sessions | We planned for the Lactation Specialist to meet with 20 women for 5 sessions each from pregnancy through 12 weeks postpartum for a total of 100 infant feeding support sessions. Participants attended 94 of 100 sessions (2 sessions were missed at 2 weeks postpartum and 4 sessions were missed at 4 weeks postpartum). Thus,... | PMC10557183 | ||
Prenatal: 1st breastfeeding support session during third trimester | myths, colic, pain | During the prenatal session, the Lactation Specialist and Research Coordinator noted a number of fears/worries women were facing: fear of not producing enough breastmilk, fear of pain during breastfeeding, fear of transmitting HIV to their baby, worry that their baby will suffer from colic and worry that others will di... | PMC10557183 | |
Early postpartum needs | ’ gums | Around the time women gave birth, and between 2–4 weeks postpartum, our Research Coordinator received many phone calls from women with questions or concerns. Though it was not part of the intervention design that our Research Coordinator or Lactation Specialist would be available outside of the scheduled visits, partic... | PMC10557183 | |
2 weeks postpartum: 2nd breastfeeding support session | milk, fatigue, burping, infection, pains, colic pains, breast milk, rashes | ENGORGEMENT, INFECTION | At around two weeks postpartum, women met with the Lactation Specialist and Research Coordinator again, this time with their babies in arm, and all women reported exclusively breastfeeding. After observing the participant breastfeeding, the Lactation Specialist assisted nearly all women to improve their breastfeeding t... | PMC10557183 |
4-weeks postpartum: 3rd breastfeeding support session | milk insufficiency, rashes, bowel patterns, weight gain, thrush, colic | ORAL THRUSH, HEAT RASH, THRUSH | The 4-week postpartum visit followed a similar flow to week 2 where the Lactation Specialist observed a feeding, gave feedback on technique, and addressed questions and concerns. All women still reported practicing exclusive breastfeeding at this time. The Lactation Specialist identified fewer issues with latch and pos... | PMC10557183 |
6-weeks postpartum: 4th breastfeeding session | milk, myths, flu-like, pain, weight gain, milk insufficiency, thrush | ENGORGEMENT, COLD, THRUSH | At the six-week postpartum visit, all the women in our cohort still reported exclusively breastfeeding and the Lactation Specialist made very few adjustments to women’s position or latch. Of the two infants who struggled to breastfeed and gain weight at previous visits, both had gained weight as expected. One mother co... | PMC10557183 |
3-months (12-weeks) postpartum: 5th infant feeding session | milk insufficiency, weight gain | During this final session, all women reported exclusively breastfeeding. The Lactation Specialist assessed the health of women and their infants. When following up on participants with significant concerns the Lactation Specialist found the participant who had been primarily expressing milk and feeding her baby with a ... | PMC10557183 | |
Discussion | milk insufficiency | Our findings reveal that the infant feeding support component of the The Lactation Specialist delivered the planned curriculum and was also able to personalize the sessions addressing a number of specific questions and concerns outside the curriculum during the sessions. Good rapport with the Lactation Specialist likel... | PMC10557183 | |
Limitations | Our assessment of feasibility does not include a cost benefit analysis which may be important when looking at ways to scale up this type of high-quality intensive support. Our assessment of acceptability includes limited direct input from participants in term of what they did or did not like and the perceived benefits ... | PMC10557183 | ||
Acknowledgements | We would like to thank the staff at Lumumba sub-County hospital for supporting our study, mentor mothers as well as the participants who kindly shared their experiences with us. | PMC10557183 | ||
Authors’ contributions | RS | AEM participated in data analysis and contributed to writing the manuscript. BCO participated in data collection and analysis and contributed to the review of the manuscript. MN participated in data analysis and contributed to the review of the manuscript. RS contributed to the data collection and provided expert revie... | PMC10557183 | |
Funding | ELT was supported by the National Institutes of Health under Grants K23MH116807 (ELT). | PMC10557183 | ||
Data Availability | The data on which this manuscript is based are not publicly available due to the need to protect the privacy of individual participants, but are available from the corresponding author on reasonable request. | PMC10557183 | ||
Declarations | PMC10557183 | |||
Ethics approval and consent to participate | All participants provided written and informed consent prior to participation. All pilot procedures were carried out in accordance with relevant guidelines and regulations on the protection of human subjects. | PMC10557183 | ||
Consent for publication | This manuscript does not contain personally identifiable information and/or media. | PMC10557183 | ||
Competing interests | The authors declare that they have no competing interests. | PMC10557183 | ||
Authors ’ information (optional) | RS | RS is the Lactation Specialist (LS) referred to throughout the manuscript. BCO is the Research Coordinator referred to throughout the manuscript. | PMC10557183 | |
Abbreviations | MOTHER TO CHILD TRANSMISSION | Human Immunodeficiency VirusWorld Health OrganizationWomen Living with HIVAntiretroviral TherapyPrevention of Mother to Child Transmission of HIV | PMC10557183 | |
References | PMC10557183 | |||
Background | respiratory muscle electromyographic | The patient’s neuro-respiratory drive, measured as electrical activity of the diaphragm (EAdi), quantifies the mechanical load on the respiratory muscles. It correlates with respiratory effort but requires a dedicated esophageal catheter. Transcutaneous (surface) monitoring of respiratory muscle electromyographic (sEMG... | PMC10010013 | |
Methods | SECONDARY | This is a secondary analysis of data from a randomized cross-over trial in ventilated patients aged < 5 years. sEMG recordings of the diaphragm and parasternal intercostal muscles (ICM), esophageal pressure tracings and ventilator scalars were simultaneously recorded during continuous spontaneous ventilation and pressu... | PMC10010013 | |
Results | Twenty-nine patients were included (median age: 5.9 months). In response to decreasing pressure support, both amplitude of sEMG (diaphragm: | PMC10010013 | ||
Conclusions | sEMG allows for the quantification of the electrical activity of the diaphragm and ICM in mechanically ventilated children. Both neuro-respiratory drive and neuro-mechanical efficiency increased in response to lower inspiratory assistance. There was poor correlation between neuro-respiratory drive and respiratory effor... | PMC10010013 | ||
Supplementary Information | ClinicalTrials.gov ID NCT05254691. Registered 24 February 2022, registered retrospectively.The online version contains supplementary material available at 10.1186/s12931-023-02374-w. | PMC10010013 | ||
Keywords | PMC10010013 | |||
Background | Acute respiratory failure | ACUTE RESPIRATORY FAILURE | Acute respiratory failure necessitating mechanical ventilation (MV) is one of the main indications for pediatric intensive care unit (PICU) admissions. Although the technique of MV itself is lifesaving for patients with impaired gas exchange, it can also cause lung and diaphragm injury by a variety of interacting mecha... | PMC10010013 |
Materials and methods | PMC10010013 | |||
Study population | congenital or acquired neuromuscular disorders, Coma, traumatic brain injury, congenital heart disorder, paralysis, chronic lung disease | SECONDARY, CHRONIC LUNG DISEASE, SEVERE PULMONARY HYPERTENSION, COMA | This study is a secondary analysis of data from mechanically ventilated children enrolled in a randomized cross-over trial investigating pediatric ventilation liberation. The study was performed in the 20-bed tertiary medical-surgical PICU of the Beatrix Children’s Hospital, University Medical Center Groningen (Groning... | PMC10010013 |
Study protocol | In the parent study, the effects of two different ventilator modes and down tapering the level of pressure support (PS) were studied [ | PMC10010013 | ||
Data acquisition | sEMG recordings, Pes manometry and ventilator scalars were acquired at baseline and subsequently during each intervention according to the randomization outcome [Electrical activity of the diaphragm and parasternal intercostal muscles (ICM) was measured transcutaneous using pairs of single Ag/AgCl electrodes (EasyTrode... | PMC10010013 | ||
Offline signal processing and parameter calculation | The recorded sEMG signals of both diaphragm and ICM were processed as described previously [We visually selected a period of 30 consecutive breaths free of artifacts from each series of measurements. Onset, peak, and termination of inspiratory muscle activity were determined in sEMG signals as reported by us previously... | PMC10010013 | ||
Statistical analysis | Statistical analyses were performed using Prism 5 (Graphpad software, San Diego, CA, USA) and Matlab R2018a (Mathworks, Natick, MA, USA). The Shapiro–Wilk test was used to test data for normality. Descriptive data were expressed as median [interquartile range (IQR)] or percentage (%) of total. The neuro-respiratory dri... | PMC10010013 | ||
Neuro-respiratory drive | Figure Inspiratory muscle activity of diaphragm and parasternal intercostal muscle (ICM) during | PMC10010013 | ||
Neuro-mechanical coupling | Neuro-mechanical coupling of the diaphragm was estimated by a median PesNeuro-mechanical coupling (NMC) of diaphragm and parasternal intercostals (ICM) during two different weaning methods (Correlation for the global population between inspiratory muscle activity of diaphragm ( | PMC10010013 | ||
Discussion | The main finding of this study is that it was possible to quantify the electrical activity of the diaphragm and parasternal intercostal muscles in mechanically ventilated children through transcutaneous recordings (sEMG). Breath-by-breath analysis showed a time-dependent relation between inspiratory sEMG and the ventil... | PMC10010013 | ||
Neuro-respiratory drive | In clinical practice, monitoring of the electrical activity of inspiratory muscles may facilitate in identifying patient-ventilator asynchrony [To our best knowledge, this is the first study examining several neuro-respiratory drive parameters of the diaphragm and ICM in MV pediatric patients. We found that EMGBased on... | PMC10010013 | ||
Timing of respiratory muscles | In mechanically ventilated children, the patient ventilator interaction is often asynchronous [ | PMC10010013 | ||
Neuro-mechanical coupling | muscle contraction | We found that NME indices for both diaphragm and ICM were affected by the level of assistance. Such a relation has also been described by the level by Essouri et al. [In each condition of ventilator assistance, a poor correlation was observed between neuro-respiratory drive and respiratory effort in the global populati... | PMC10010013 | |
Limitations | Several limitations of our study need to be addressed. First, this study was designed a single center study potentially limiting the generalizability of our findings, although our unit is comparable to most large PICUs globally. Second, patients could be enrolled in our study when the attending physician deemed the pat... | PMC10010013 | ||
Conclusions | In summary, monitoring sEMG of parasternal intercostal muscles and diaphragm in the weaning phase of ventilated children is feasible and it might be helpful in a better understanding of the pediatric ventilation liberation process. We demonstrated that both neuro-respiratory drive and neuro-mechanical efficiency increa... | PMC10010013 | ||
Acknowledgements | Not applicable. | PMC10010013 | ||
Author contributions | AAK Conceptualization and design of the study, data analysis and interpretation, and writing the manuscript. JvD Conceptualization and design of the study, data collection and analysis, and writing the manuscript. RGTB Conceptualization and design of the study, data interpretation, and provided intellectual content to ... | PMC10010013 | ||
Funding | Not applicable. | PMC10010013 | ||
Availability of data and materials | Data sharing requests will be considered by the research group upon written request to the corresponding author. | PMC10010013 | ||
Declarations | PMC10010013 | |||
Ethics approval and consent to participate | The trial protocol was approved by the local Institutional Review Board (Medische Ethische Toetsingscommissie UMC Groningen, Groiningen, the Netherlands), NL38361.042.11. Written informed consent was obtained from the parents or legal caretakers. The current study was performed in accordance with Dutch a wand the Decla... | PMC10010013 | ||
Consent for publication | Not applicable. | PMC10010013 | ||
Competing interests | Martin C.J. Kneyber received lecture fees from Vyaire, Mettawa, Ill, USA and has received technical support from Vyaire, Mettawa, Ill, USA and Applied Biosignals, Weener, Germany. The remaining authors declare that they have no competing interests. | PMC10010013 | ||
References | PMC10010013 | |||
Subject terms | decreases in blood oxygen, CM | CARDIOPULMONARY | The use of face masks became mandatory during SARS-CoV-2 pandemic. Wearing masks may lead to complaints about laboured breathing and stress. The influence of different masks on cardiopulmonary performance was investigated in a partially double-blinded randomized cross-over design. Forty subjects (19–65 years) underwent... | PMC10141827 |
Introduction | decreases in blood oxygen | Face masks have been confirmed as adequate protection against SARS-CoV-2 infectionNumerous studies showed that wearing masks during physical exercise causes non-health relevant decreases in blood oxygen as well as slight increases in blood carbon dioxideTo address the gap of knowledge regarding these questions, we crea... | PMC10141827 | |
Materials and methods | PMC10141827 | |||
Subjects | DISEASES, MUSCULOSKELETAL DISORDERS | Eligibility criteria included being between 18 and 65 years of age with no (medical or psychosocial) contraindication against vigorous exercise. Exclusion criteria were absolute and relative contraindications for CPET as well as intake of psychoactive substances, renal, neurological, or mental diseases, musculoskeletal... | PMC10141827 | |
Study design | CM | BLOOD, LEAKAGE | Each subject was tested with four different mask situations (surgical mask (SM), community cloth mask (CM), a filtering face piece (FFP2) and without wearing a mask (NM) as reference) in a randomized order. The cross-over study design was based on four different modules performed also in a randomized order to investiga... | PMC10141827 |
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