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1.
Artigo em Inglês | MEDLINE | ID: mdl-38963826

RESUMO

DISCLAIMER: In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. PURPOSE: Compared to estimated population prevalence rates, relatively few patients at risk are diagnosed with and treated for transthyretin cardiac amyloidosis (ATTR-CA). Where along the clinical pathway patient drop-off occurs, as well as the association of drop-off with patient sociodemographic characteristics, remains unknown. METHODS: Using data from a healthcare system-wide cardiovascular imaging repository and specialty pharmacy, we characterized the clinical pathway from diagnosis with pyrophosphate scintigraphy (PYP) to tafamidis prescription, initiation, and adherence. Standardized differences (d values of ≥0.20, indicating at least a small effect size) were used to compare sociodemographics (age, sex, race, Area Deprivation Index) among patients with PYP-identified ATTR-CA by tafamidis prescription status and among patients prescribed tafamidis by initiation status. Tafamidis adherence was measured with the proportion of days covered (PDC). RESULTS: Of 97 patients with ATTR-CA, 58.8% were prescribed tafamidis, with 80.7% of those initiating therapy. Patients with ATTR-CA prescribed tafamidis were younger than those not prescribed tafamidis (d = -0.30). Utilization of a specialty pharmacy resulted in enrichment of treatment in subgroups traditionally undertreated in cardiovascular medicine, with higher rates of tafamidis initiation among women (100% initiation), patients of Black/African American race (d = 0.40), and those living in more economically disadvantaged areas (d ≥ 0.30). Adherence was high (PDC of >80%) in 88.4% of those initiating tafamidis. CONCLUSION: These findings highlight the tremendous opportunity for more robust ATTR-CA clinical programs, identifying potential patient subgroups that should be targeted to reduce disparities. For patients diagnosed with ATTR-CA, utilization of a specialty pharmacy process appears to ensure equitable provision of tafamidis therapy.

3.
Sci Total Environ ; : 174699, 2024 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-38997010

RESUMO

In the terrestrial environment, microplastics in specialty cropping systems have not been studied so far. Viticulture as a potential plastic-intensive management form and a land use with high erosion risks, plays an important role in transport and distribution of material to other terrestrial and aquatic systems. This paper is a first investigation of microplastics in vineyard soils, assessing the spatial distribution and composition of microplastics in organically and conventionally managed viticulture, and relates it to the macroplastic collected at the vineyards. Topsoils (0-10, 10-30 cm) and plastic particles on soil surfaces from eight vineyard lots were sampled. Four of the vineyards were under organic and four underconventional management and they were all located in the Moselle and Saar Wine Region (Rhineland-Palatinate, Germany). Microplastic analysis was performed via µFTIR chemical imaging after wet-chemical microplastic extraction from soil samples. The mean microplastic concentration was 4200 ±â€¯2800 p kg-1 (mean ±â€¯SD), with detected mean sizes of 230 µm ±â€¯300 µm. Most abundant polymers were PP (35.2 %), PA (25.3 %) and PE (15.5 %). The distribution pattern showed higher microplastic concentration in topsoil, at middle and bottom slope position. The smallest particle sizes were found in subsoil samples and bottom position. Thus, erosion is assumed to be a potential downhill transport pathway. According to our dataset, management seems to have no significant influence on microplastic abundance, but affects polymer composition. Polymer composition of micro- and macroplastics partly coincide, thus in-situ fragmentation, is considered the major input source. Based on our findings, we recommend further investigation of plastic pathways in speciality crop systems like viticulture.

4.
J Clin Med ; 13(13)2024 Jun 25.
Artigo em Inglês | MEDLINE | ID: mdl-38999274

RESUMO

(1) Background: High-intensity gait training (HIT) is a recommended intervention that improves walking function (e.g., speed and distance) in individuals who are undergoing stroke rehabilitation. This study explored clinicians' perceived barriers and facilitators to implementing HIT utilizing a mixed-methods approach comprising a survey and exploratory qualitative research. (2) Methods: Clinicians (n = 13) who were implementing HIT at three facilities participated. We collected and analyzed data using the consolidated framework for implementation research. Three focus groups were recorded and transcribed, and data were coded and thematically categorized. (3) Results: Survey results identified that the facilitators with a strong impact on implementation were access to knowledge/resources and intervention knowledge/beliefs. The only agreed-upon barrier with a strong impact was lack of tension for change. The focus groups resulted in 87 quotes that were coded into 27 constructs. Frequently cited outer setting facilitators were cosmopolitanism and peer pressure, and the only barrier was related to the patient needs. Innovation characteristics that were facilitators included relative advantage and design quality and packaging, and complexity was a barrier. Inner setting facilitators included networks and communication, learning climate, leadership engagement, and readiness for implementation. However, communication, leadership engagement, and available resources were also barriers. Regarding characteristics of individuals, knowledge and beliefs were both barriers and facilitators. In the implementation process domain, common facilitators were formally appointed implementation leaders and innovation participants. Barriers in this domain were related to the patients. (4) Conclusions: Clinicians identified many barriers and facilitators to implementing HIT that often varied between facilities. Further research is warranted to deepen our understanding of clinicians' experiences with HIT implementation.

5.
Psychiatr Serv ; : appips20240041, 2024 Jul 03.
Artigo em Inglês | MEDLINE | ID: mdl-38957052

RESUMO

Attention to inclusivity and equity in health research and clinical practice has grown in recent years; however, coordinated specialty care (CSC) for early psychosis lags in efforts to improve equity despite evidence of ongoing disparities and inequities in CSC care. This Open Forum argues that marginalization and disparities in early psychosis research and clinical care are interrelated, and the authors provide suggestions for paths forward. Commitment to equity and justice demands recentering the perspectives of those most affected by early psychosis services and investing in the integration of historically excluded perspectives across all aspects of practice, policy, and research.

6.
Artigo em Inglês | MEDLINE | ID: mdl-39046688

RESUMO

OBJECTIVE: Proximity to mental health services is a predictor of timely access to services. The present study sought to investigate whether travel time was associated with engagement in coordinated specialty care (CSC) for early psychosis, with specific attention to whether the interaction of travel time by race and ethnicity had differential impact. DATA SOURCE/STUDY SETTING: Data collected between 2019 and 2022 as part of the New Journeys evaluation, the CSC model in Washington State. STUDY DESIGN: This cross-sectional study included a sample of 225 service users with first episode psychosis (FEP) who had received services from New Journeys. DATA COLLECTION: Service users' addresses, and the physical location of CSC were geocoded. Spatial proximity was calculated as travel time in minutes. Scheduled appointments, attendance and program status were captured monthly by clinicians as part of the New Journeys measurement battery. PRINCIPAL FINDINGS: Proximity was significantly associated with the number of appointments scheduled and attended, and program status (graduation/completion and disengagement). Among Hispanic service users with spatial proximity further away from CSC (longer commutes) was associated with a lower likelihood of graduating/completing CSC compared to non-Hispanic service users (p = .04). Non-white services users had a higher risk of disengagement from CSC compared to white service users (p = .03); additionally, the effects of spatial proximity on disengagement were amplified for non-White service users (p = .03). CONCLUSIONS: Findings suggest that proximity is associated with program engagement and partially explains potential differences in program status among ethnoracial group.

7.
Hand (N Y) ; : 15589447241262055, 2024 Jul 24.
Artigo em Inglês | MEDLINE | ID: mdl-39045649

RESUMO

BACKGROUND: The purpose of this individual cohort study is to demonstrate safety and efficacy in removing the trapezium through minimally invasive arthroscopy. METHODS: A prospective case series was performed on all arthroscopic total trapeziectomy procedures for thumb basal joint arthrosis between 2018 and 2022. Patients were followed for up to 1 year. All patients received an examination at each visit to include pain, range of motion, strength, and metacarpal height. Complications, concomitant procedures, and revision procedures were recorded as well. RESULTS: A total of 49 arthroscopic trapeziectomy procedures were recorded for 46 patients. The average preoperative visual analog pain scale score was 8.8 out of 10, and the postoperative score was 1 out of 10. All patients had a resolution of the carpometacarpal grind test postoperatively. The average preoperative key pinch, 3-point chuck, and grip strength were 9.8 lbs/in2, 7.8 lbs/in2, and 45 lbs/in2, respectively. Final 6-month postoperative key pinch, 3-point chuck, and grip strength were 11.0 lbs/in2, 9.8 lbs/in2, and 49.2 lbs/in2, respectively. Metacarpal height subsided on average 50%. We report one revision and no cases of radial sensory neuritis or flexor tendon rupture. CONCLUSIONS: Arthroscopic total trapeziectomy appears to be a safe and effective treatment for end-stage arthrosis of the thumb basal joint. LEVEL OF EVIDENCE: 2b Therapeutic; Individual Cohort Study.

8.
Artigo em Inglês | MEDLINE | ID: mdl-39042519

RESUMO

OBJECTIVES: Outpatient rehabilitation (rehab) physical, occupational, and speech therapists use electronic health records (EHR), yet their documentation experiences, including any documentation burden, are not well researched. Therapists are a growing portion of the U.S. healthcare workforce, whose need is critical to the health of an aging population. We aimed to describe outpatient rehab therapists' documentation experiences and identify strategies for mitigating any documentation burden. MATERIALS AND METHODS: We used qualitative descriptive methodology to conduct 4 focus groups with outpatient rehab therapists at Hospital for Special Surgery, a multi-site orthopedic institution. Transcripts were inductively coded to identify themes and actionable strategies for improving the therapists' documentation experiences. Therapists provided feedback and prioritization of proposed strategies. RESULTS: A total of 13 therapists were interviewed. Five themes and 10 subthemes characterize the therapists' documentation experience by a feeling that documentation inhibits clinical care and work/life balance, a perceived lack of support and efficiencies, the desire to document to communicate clinical care, and a design vision for improving the EHR. Top prioritized strategies for improvement included use of timesaving templates, expanding dictation, decluttering the EHR interface, and support for free texting over discrete data capture. DISCUSSION: Outpatient rehab therapists experience documentation burden similar to that documented of physicians and nurses. Manual data entry imposes burden on therapists' time and clinical care. CONCLUSION: A multi-faceted approach is needed for improving therapists' experiences including EHR redesign, technology supporting dictation and narrative to discrete data capture, and support from leadership and regulators.

9.
J Gastrointest Surg ; 2024 Jul 21.
Artigo em Inglês | MEDLINE | ID: mdl-39043323

RESUMO

BACKGROUND/PURPOSE: The 2024 GI Surgery Summit brought together Society for Surgery of the Alimentary Tract (SSAT), Society of Surgical Oncology (SSO), and Society of University Surgeons (SUS) members to assess the current state of gastrointestinal (GI) surgery. This report reviews the key discussions and recommendations following the dedicated plenary session which addressed challenges in providing high-quality, accessible GI surgery for all patients. METHODS: The Summit took place from January 14-16. During the plenary session "Defining the role and impact of specialty surgeons in ensuring high-quality, accessible abdominal surgery," leaders, rising leaders and members of SSAT, SSO and SUS met and discussed challenges in providing high quality, accessible GI surgery. RESULTS: Actionable recommendations to address the challenges in providing high-quality, accessible GI surgical care were made, including engaging communities and patients, building alliances across hospitals and surgeons, and establishing standards of GI surgical care. DISCUSSION/CONCLUSION: Surgeons, hospital systems and surgical societies can improve health care access and outcomes for all GI surgical patients.

10.
J Parkinsons Dis ; 2024 Jul 17.
Artigo em Inglês | MEDLINE | ID: mdl-39031380

RESUMO

People with Parkinson's disease (PD) experience a range of progressive motor and non-motor symptoms, that negatively affect their daily functioning, social participation and quality of life. Allied health therapies have emerged as an effective treatment approach-complementary to pharmacological and neurosurgical treatments-which reduces the impact of PD in daily life. In this article, we propose criteria for what constitutes specialized allied health care for PD, and we review allied health research in PD in terms of meeting these criteria and its outcomes for monodisciplinary approaches as well as multi- or interdisciplinary allied health interventions. We focus on the three most studied allied health disciplines in PD: physical therapy, occupational therapy and speech-language therapy. Overall, the available evidence underscores the importance and potential benefits of specialized allied health care for people with PD. Our proposed criteria and recommendations for future research might help in further delineating specialized allied health care.

11.
Eur J Dent Educ ; 2024 Jul 20.
Artigo em Inglês | MEDLINE | ID: mdl-39032160

RESUMO

INTRODUCTION: The curricula for UK dental specialty training have recently been under review and until 2024, completion of a research component during training in Dental Public Health, Oral Microbiology and Orthodontics has been mandatory (with an alternative route for Orthodontics involving the submission of two scientific papers for those trainees not wishing to undertake a higher degree). Anecdotally, some trainees in other dental specialties choose to undertake higher degrees alongside specialty training. AIMS: The aims were to investigate how many dental specialty registrars study for higher degrees alongside specialty training, and whether undertaking a higher degree alongside specialty training has an impact on completion of training, research skills, research experience, patient care and career opportunities. MATERIALS AND METHODS: This was a cross-sectional study design, involving the distribution of an online, anonymous questionnaire-based survey to UK dental specialty registrars in November and December 2022. RESULTS: In total, 38 questionnaires were completed, representing a 7.7% response rate of the entire dental specialty registrar cohort in the UK and 42% of those who received it. Most respondents (76.3%) were either studying or had completed a clinically relevant higher degree prior to specialty training. Most respondents (76.3%) reported that the higher degree increased career opportunities and gave them additional skills. CONCLUSIONS: Dental specialty trainees who responded to this survey perceived the higher degree to be beneficial in terms of preparing for exams, gaining skills in critical appraisal and for increasing future career opportunities.

12.
Artigo em Inglês | MEDLINE | ID: mdl-39037225

RESUMO

OBJECTIVE: To determine the prevalence of veterinary emergency service pause systems (VESPSs) and describe aspects of implementation and perceived impact. DESIGN: Electronic questionnaire SETTING: Membership of the Veterinary Emergency and Critical Care Society (VECCS). ANIMALS: None. INTERVENTIONS: None. MEASUREMENT AND MAIN RESULTS: A questionnaire was distributed to 6176 VECCS members with 1168 responses. Seventy-six percent of the respondents were veterinarians. Ninety-one percent of respondents practice in the United States, with 74% of them working at 24/7 multispecialty practices. Eighty-seven percent of respondents indicated patient volume had increased, and 75% reported that a VESPS had been implemented between September 2020 and December 2021. Sixty-two percent reported that their emergency service had been paused or closed once per week or more. The top reasons for implementing a VESPS included excessive caseload and staffing shortages. A variety of methods were utilized to implement a pause. Sixty-nine percent reported their VESPS was less than ideal for effectiveness. Pause systems were reported to be highly supported by medical staff. Seventy-seven percent reported increased client frustration and complaints, and 57% reported staff were stressed from denying care. Of those who do not currently have a VESPS in place, 74% would prefer to have one. CONCLUSIONS: VESPSs were in widespread use at the time of this survey, and most have been implemented between September 2020 and December 2021. The majority of VESPSs were employed to mitigate increased caseload and staffing shortages. Although VESPSs are largely supported by medical staff, drawbacks may include staff stress and client frustrations, and improvements are warranted.

13.
Turk J Phys Med Rehabil ; 70(2): 233-240, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38948653

RESUMO

Objectives: This study aimed to investigate the publication rates of physical medicine and rehabilitation specialty training theses, which are required to complete a residency in Türkiye, and determine the factors that affect publication. Materials and methods: Residency theses involved in this descriptive study were detected from the database of Higher Education Council Thesis Center (tez.yok.gov.tr) between January 2010 and December 2020. Publication of theses and date of publication were investigated by the writer's and supervisor's names on PubMed and Google Scholar. Results: Three hundred eighty-eight of 1,130 theses were turned into publications. Two hundred seventy-seven (24.5%) were published in SCI (Science Citation Index)/SCI Expanded indexed journals. The publication rates of residents were 47.1% in private universities, 34.2% in public universities, and 32.3% in training and research hospitals. The trainees who published their theses were more likely to become associate and assistant professors. Conclusion: Although approximately one-third of the theses defended were published, this rate is insufficient for sharing the knowledge. Considering that publishing their theses affected the residents' current academic careers positively, supervisors should provide the residents supportive facilitation to give the knowledge in research and publish their theses.

14.
Ann Palliat Med ; 2024 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-38988075

RESUMO

Palliative care (PC) is a health care specialty that is focused on the holistic care of individuals with serious illness. It requires interprofessional collaboration and expertise to meet the physical, psychosocial, social, cultural, and spiritual needs of patients experiencing serious illness and their families. The interprofessional team (IPT) is most often composed of Advanced Practice Providers (APPs) [including Nurse Practitioners (NPs), Clinical Nurse Specialists (CNSs), and Physician Associates/Assistants (PAs)], Chaplains, Registered Nurses (RNs), Doctors of Medicine and Doctors of Osteopathic Medicine (MDs/ DOs), Registered Pharmacists (RPhs), Social Workers (SWs) and other professions depending on site of care, the age of the patient, and the illness. The United States has specialty palliative care (SPC) IPT members who have completed advanced education and training and obtained specialty certification. However, there is currently no interprofessional consensus education and training resulting in interprofessional variability of definitions of education and requirements for academic preparation into the specialty. This article offers the results of an online review and survey of the current availability of SPC education in the United States which includes certificate programs, residencies, fellowships, and immersion programs available to each profession. The purpose of this review is to unify the available information regarding SPC programs, providing a succinct, yet thorough, overview of the SPC educational landscape. It emphasizes the length of time, cost, and delivery method for IPT members in choosing programs.

15.
Explor Res Clin Soc Pharm ; 15: 100462, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-38983636

RESUMO

Background: Compass Rose™, a case management tool developed by Epic®, was designed to track various patient coordination tasks, outreaches, and outcomes. This report describes the implementation of Compass Rose™ within an internal health-system specialty pharmacy (HSSP) and changes in care coordination metrics before and after implementation. To the best of our knowledge, this is the first study of its kind to discuss the implementation of Compass Rose™. Objectives: The goals of this study were to describe the implementation process of Compass Rose™ at an internal HSSP and compare staff satisfaction before and after Compass Rose™ as the primary outcome. Methods: This was an Institutional Review Board exempt, retrospective cohort study conducted between June 2022 to December 2022 that assessed staff satisfaction, refill documentation time, prescription turnaround time, and patient satisfaction pre- and post- Compass Rose™ implementation through survey administration, observed time studies, and internal data reports. The process of Compass Rose™ implementation was also described and discussed. Results: 24 specialty pharmacy staff members participated in the Compass Rose™ implementation survey. No statistically significant differences were observed in either staff satisfaction (3.96 ± 0.95 versus 3.70 ± 0.69, p = 0.29) or predicted versus actual challenge of implementation (3.67 ± 1.17 versus 3.09 ± 0.96, p = 0.064). There was no significant difference in refill documentation time pre- versus post- Compass Rose™ implementation (4.22 ± 3.15 minutes versus 4.10 ± 2.36 minutes, p = 0.82); however, there was a statistically significant increase in prescription turnaround time post implementation (2.59 ± 2.85 days versus 2.69 ± 2.35 days, p = 0.002). Conclusion: Compass Rose™ implementation had no significant impact on staff satisfaction, patient satisfaction, or overall refill documentation time. Prescription turnaround time increased, which could be due to significant workflow changes with Compass Rose™ or several other contributing factors such as increased prescription volume and training new staff during this period.Benefits of Compass Rose™ included standardization of workflow, ability to quantify staff performance and clinical impact, and increased transparency regarding care provided by the specialty pharmacy team.

16.
Malays J Med Sci ; 31(3): 1-17, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38984245

RESUMO

Mapping the distribution of medical specialists in the Ministry of Health (MOH) Malaysia facilities is expected to be more complex as the demand for specialty and subspecialty services increases in the future. A more robust and definitive gap analysis is needed to facilitate planning and resource allocation. The Medical Development Division developed a master list of framework of specialties, subspecialties and areas of interest, and Specialist Database Module in the Medical Programme Information System (MPIS) as tools to facilitate mapping of services. Relational database of specialists' location, facilities, workload, population profile and other relevant parameters were developed to provide data visualisation in specific dashboard. Needs versus supply ratio is proposed as one of parameters to visualise specialised medical services distribution by geographical localities.

17.
Rev Cient Odontol (Lima) ; 12(1): e183, 2024.
Artigo em Espanhol | MEDLINE | ID: mdl-39015304

RESUMO

Objective: To determine the participation of female dentists in the evolution of dental specialties in Peru and establish the gender distribution in each specialty. Materials and Methods: A descriptive and retrospective cross-sectional study was conducted using data from the National Registry of Specialists of the Peruvian College of Dentists in August 2023. The relative frequency of female gender and the femininity index were calculated in the total population of specialists and in each specialty to assess their respective evolution over the last 25 years. Results: Currently, 51.74% of the 3,827 specialty registrations correspond to female dentists, with a femininity index of 1.072. Nine specialties with a female predominance were identified, including Pediatric Dentistry, Family and Community Health in Dentistry, and Restorative and Esthetic Dentistry. On the other hand, areas with a higher male presence are Orthodontics and Maxillary Orthopedics, and Oral and Maxillofacial Surgery. Upon analyzing the temporal evolution, a shift from the historical male majority to the current female predominance in the last fifteen years is observed, and gender parity was reached in 2019. Conclusion: There is evidence of a change in the gender composition of Peruvian dental specialties, currently with a female predominance.

18.
BMC Med Educ ; 24(1): 767, 2024 Jul 16.
Artigo em Inglês | MEDLINE | ID: mdl-39014422

RESUMO

BACKGROUND: Comprehensive cancer care requires effective collaboration by interprofessional healthcare teams. The need to develop educational initiatives to improve interprofessional collaboration is increasingly recognised. However, there is no agreement regarding the interprofessional competencies required for effective cancer care leading to much variation on the focus of research, planning and managing change. A scoping review was conducted to identify the current status of IPE in cancer care and to summarise the results of previous research in order to guide the development of interprofessional education in cancer care. METHODS: The JBI Scoping Review guidelines were used to guide the process of the review. A search of the available literature was conducted in CINAHL, MEDLINE (Ovid), PubMed, PsycInfo, Scopus databases from January 2012 to March 2023 to investigate IPE for health professional clinicians working in cancer care. RESULTS: Of the 825 initial references and 153 studies imported for screening, a total of 28 studies were included in the final review. From those studies, seven focused on the need for IPE and interprofessional competence for oncology healthcare professionals, four reviewed existing IPE programs and 17 described the development and evaluation of interprofessional education. Findings show variation and lack of concept definitions underpinning research in IPE in cancer care settings. Variation also exists in the range of research activities in IPE, most notably related to communication, teamwork and the development of interprofessional practice. The evaluation of impact of IPE is mainly focused on health care professionals' self-evaluation and general feedback. Impact on patient care was only evaluated in one study. CONCLUSIONS: Based on the results, interprofessional education research in the field of cancer care is limited in Europe. Thus, there is a significant increase in publications in the last five years. A more systematic focus on the theoretical framework and definition of concepts would be of value. Research and programme development should be based on a shared understanding on what constitutes the interprofessional competences and IPE. Programmes to develop interprofessional practice should be developed and implemented systematically with inclusion of validated assessment methods, and evaluated and improved regularly.


Assuntos
Relações Interprofissionais , Neoplasias , Equipe de Assistência ao Paciente , Humanos , Neoplasias/terapia , Educação Interprofissional , Oncologia/educação , Pessoal de Saúde/educação , Comportamento Cooperativo
19.
iScience ; 27(7): 110240, 2024 Jul 19.
Artigo em Inglês | MEDLINE | ID: mdl-39021802

RESUMO

Although more and more evidence has supported that metabolic syndrome (MS) is linked to ischemic stroke (IS), the molecular mechanism and genetic association between them has not been investigated. Here, we combined the existing single-cell RNA sequencing (scRNA-seq) data and mendelian randomization (MR) for stroke to understand the role of dysregulated metabolism in stroke. The shared hub genes were identified with machine learning and WGCNA. A total of six upregulated DEGs and five downregulated genes were selected for subsequent analyses. Nine genes were finally identified with random forest, Lasso regression, and XGBoost method as a potential diagnostic model. scRNA-seq also show the abnormal glycolysis level in most cell clusters in stroke and associated with the expression level of hub genes. The genetic relationship between IS and MS was verified with MR analysis. Our study reveals the common molecular profile and genetic association between ischemic stroke and metabolic syndrome.

20.
J Pak Med Assoc ; 74(7): 1384-1386, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-39028081

RESUMO

Segmental Stabilisation Training (SST) a programme initially conceived by Carolyn Richardson and her team, serves as a specialised approach tailored to alleviate mechanical low back pain. Built upon decades of rigorous research, this exercise model rests upon the foundational principles of core stability. SST is unique due to its singular focus on addressing the root cause of low back pain, thereby presenting a promising avenue for averting the frequent relapses characteristic of this condition. Many fitness regimens that emphasize core stability incorporate the Abdominal Drawing-in manoeuver. However, the efficacy of this technique often remains unrealized due to a lack of awareness regarding its correct execution. It is imperative to note that the true benefits of the Abdominal Drawing-in manoeuver manifest only when performed accurately, ensuring the activation of deep core muscles and, in turn, preventing the recurrence of low back pain. The SST programme offers clear and precise guidance, enabling both clinicians and patients to acquire the requisite skills for its correct implementation. This minireview highlights the significance of SST in low back pain management and also elucidates the crucial role of precise technique execution.


Assuntos
Terapia por Exercício , Dor Lombar , Humanos , Dor Lombar/terapia , Terapia por Exercício/métodos , Músculos Abdominais
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