8,812 research outputs found

    Associations of Appetitive Traits and Parental Feeding Style with Diet Quality During Early Childhood.

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    BackgroundAppetitive traits and parent feeding styles are associated with body mass index in children, yet their associations with child diet quality are unclear.ObjectiveThe objective was to examine relations of appetitive traits and parental feeding style with diet quality in 3.5-year-old children.DesignThe study was a secondary, cross-sectional analysis of data from Sprouts, a follow-up study of the Pregnancy Eating Attributes Study (PEAS). Birthing parents completed the Child Eating Behavior Questionnaire, Caregiver's Feeding Styles Questionnaire, and proxy 24-hour dietary recalls for their children from February 2019 to December 2020.Participants/settingParticipants were 162 birthing parents (early pregnancy BMI ≥18.5 kg/m2 and absence of pre-existing diabetes, any medical condition contraindicating study participation, self-reported eating disorder, and medications that could affect diet or weight) and their children living in North Carolina.Main outcome measuresHealthy Eating Index-2015 (HEI-2015) total scores were calculated.Statistical analyses performedPath modeling was conducted using PROC CALIS with full information maximum likelihood (FIML) to account for missing data (ResultsA 1-SD greater food fussiness was associated with a 2.4-point lower HEI-2015 total score [p = .02, 95% CI (-4.32, -0.48)] in children. When parental feeding style was authoritarian, a 1-SD greater food responsiveness was associated a 4.1-point higher HEI-2015 total score [p = .007, 95% CI (1.12, 7.01)] in children. When parental feeding style was authoritative, a 1-SD greater slowness in eating was associated with a 5.8-point lower HEI-2015 total score [p = .01, 95% CI (-10.26, -1.33)] in children.ConclusionsParental feeding style may modify the association of appetitive traits with diet quality in young children. Future research could determine whether matching parent feeding styles to child appetitive trait profiles improves child diet quality

    Association between Fluoride Exposure and Blood pressure

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    Objectives: This study investigated whether fluoride was associated with an increased prevalence of high blood pressure (BP) among adolescents in the United States. Methods: The study sample consisted of 2015–2016 National Health and Nutrition Examination Survey participants aged 13–17 years. Independent-samples t-tests, Chi-square tests, and regression models were used to analyze the data. Results: A total of 814 participants met the study criteria. The findings showed that the proportion of patients with high levels of water or plasma fluoride in the high BP group was higher than that in the normal BP group. However, after adjusting for sociodemographic covariates, neither water nor plasma fluoride levels were significantly associated with a high BP. Conclusions: This study did not find an association between either water or plasma fluoride levels and high BP. Further study is needed to exclude a dose dependent effect at higher levels of fluoride

    Interleukin-1β inhibitors for the management of acute gout flares: a systematic literature review

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    Abstract Objectives The objective of this systematic review was to assess the effects of interleukin-1β (IL-1β) inhibitors on gout flares. Methods Studies published between 2011 and 2022 that evaluated the effects of IL-1β inhibitors in adult patients experiencing gout flares were eligible for inclusion. Outcomes including pain, frequency and intensity of gout flares, inflammation, and safety were assessed. Five electronic databases (Pubmed/Medline, Embase, Biosis/Ovid, Web of Science and Cochrane Library) were searched. Two independent reviewers performed study screening, data extraction and risk of bias assessments (Cochrane Risk of Bias Tool 2 for randomised controlled trials [RCTs] and Downs and Black for non-RCTs). Data are reported as a narrative synthesis. Results Fourteen studies (10 RCTs) met the inclusion criteria, with canakinumab, anakinra, and rilonacept being the three included IL-1β inhibitors. A total of 4367 patients with a history of gout were included from the 14 studies (N = 3446, RCTs; N = 159, retrospective studies [with a history of gout]; N = 762, post hoc analysis [with a history of gout]). In the RCTs, canakinumab and rilonacept were reported to have a better response compared to an active comparator for resolving pain, while anakinra appeared to be not inferior to an active comparator for resolving pain. Furthermore, canakinumab and rilonacept reduced the frequency of gout flares compared to the comparators. All three medications were mostly well-tolerated compared to their comparators. Conclusion IL-1β inhibitors may be a beneficial and safe medication for patients experiencing gout flares for whom current standard therapies are unsuitable. Review protocol registration PROSPERO ID: CRD42021267670

    Influence of Skin Commensals on Therapeutic Outcomes of Surgically Debrided Diabetic Foot Infections-A Large Retrospective Comparative Study

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    In diabetic foot infections (DFI), the clinical virulence of skin commensals are generally presumed to be low. In this single-center study, we divided the wound isolates into two groups: skin commensals (coagulase-negative staphylococci, micrococci, corynebacteria, cutibacteria) and pathogenic pathogens, and followed the patients for ≥ 6 months. In this retrospective study among 1018 DFI episodes (392 [39%] with osteomyelitis), we identified skin commensals as the sole culture isolates (without accompanying pathogenic pathogens) in 54 cases (5%). After treatment (antibiotic therapy [median of 20 days], hyperbaric oxygen in 98 cases [10%]), 251 episodes (25%) were clinical failures. Group comparisons between those growing only skin commensals and controls found no difference in clinical failure (17% vs. 24 %, p = 0.23) or microbiological recurrence (11% vs. 17 %, p = 0.23). The skin commensals were mostly treated with non-beta-lactam oral antibiotics. In multivariate logistic regression analysis, the isolation of only skin commensals was not associated with failure (odds ratio 0.4, 95% confidence interval 0.1-3.8). Clinicians might wish to consider these isolates as potential pathogens when selecting a targeted antibiotic regimen, which may also be based on oral non-beta-lactam antibiotic agents effective against the corresponding skin pathogens

    From the Top of the Mountain to the Rock Bottom of Addiction: The Opioid Epidemic that Devastated Appalachia

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    The American opioid epidemic (1997 - present) has continued to ravage the United States, with its most acute impacts being witnessed in the towns and counties of Appalachia. OxyContin (a semi-synthetic opioid) was released by Purdue Pharma in 1996 and is largely to blame for the epidemic, as its release overlapped with changes in the medical system that encouraged the prescription of opioids for acute and even moderate pain management. Meanwhile, the Appalachian Mountains were beginning to see changes, as a new type of mining, Mountaintop Removal Mining (MTRM), introduced in the 1970s, was changing the economic landscape of the region. This thesis examines the connection between the environmental degradation caused by MTRM and its effect on the opioid epidemic. It was predicted that MTRM propagated the opioid epidemic in Appalachia due to its destabilization of the local economy and the effects that the environmental damage had on the community’s mental health. In order to test this, data was collected from a variety of databases and supported by additional field research. Data were analyzed in Excel and PAST4 for four primary variables; opioid overdose rate, number of coal mining jobs, unemployment rates, and rates of depression. While not all tests demonstrated statistical significance, published literature supports the idea that high unemployment rates due to MTRM contributed to a lack of financial stability and a sense of desperation that exacerbated drug diversion. Additionally, psychoterratic syndromes (earth-related illnesses) due to environmental destruction played a role in the reliance on OxyContin. The complexities present in the development and perpetuation of the opioid epidemic not only serve as a reminder of the connections between the natural world and human health, but as a way to hold the corporations and policies at play accountable for the harm they caused

    A National Study Exploring the Association Between Fluoride Levels and Dental Fluorosis

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    Importance: While the effects of fluoride on health have been widely researched, fewer high-quality studies examine the association of fluoride levels in water and dental fluorosis. Objective: To investigate the association between fluoride exposure from drinking water and dental fluorosis. Design, setting, and participants: This cross-sectional study used the 2013-2014 and 2015-2016 National Health and Nutrition Examination Survey (NHANES) data (January 1, 2013, through December 31, 2016). NHANES uses a complex sampling technique to develop nationally representative sample estimates of the US population that consists of interviews and physical assessments. Children and adolescents aged 6 to 15 years were included because NHANES contains their data for all 3 forms of fluoride measures: plasma fluoride levels, water levels of fluoride, and dietary fluoride supplementation. Data were analyzed from January 1 to April 30, 2023. Exposures: Water and plasma fluoride levels were measured by laboratory personnel. Dietary fluoride supplement data were self-reported. Main outcomes and measures: The Dean's Fluorosis Index was used to evaluate fluorosis status for each tooth. The dental fluorosis severity value was based on the second most affected tooth. Independent variables included plasma and water fluoride concentrations and dietary fluoride supplementation. An independent samples t test was used to compare fluoride exposures between groups, and Pearson correlation assessed the association between plasma and water fluoride levels. To assess whether fluoride exposures were associated with dental fluorosis, logistic regression analyses were conducted. Results: There were 1543 participants in the 2013-2014 NHANES cycle (weighted proportion male, 51.9%; mean [SD] age, 11.0 [2.7] years) and 1452 in the 2015-2016 cycle (weighted proportion male, 52.6%; mean [SD] age, 11.1 [2.8] years). A weighted 87.3% exhibited some degree of fluorosis in the 2013-2014 cycle and 68.2% in the 2015-2016 cycle. Higher fluoride levels in water and plasma were significantly associated with higher odds of dental fluorosis (adjusted odds ratios, 2.378 [95% CI, 2.372-2.383] in the 2013-2014 cycle and 1.568 [95% CI, 1.564-1.571] in the 2015-2016 cycle). Conclusions and relevance: The findings of this cross-sectional study suggest that exposure to higher concentrations of fluoride in water and having higher plasma levels of fluoride were associated with a greater risk of dental fluorosis. Further research can help policy makers develop policies that balance substantial caries prevention with the risk of dental fluorosis.</p

    Influence of Skin Commensals on Therapeutic Outcomes of Surgically Debrided Diabetic Foot Infections—A Large Retrospective Comparative Study

    No full text
    In diabetic foot infections (DFI), the clinical virulence of skin commensals are generally presumed to be low. In this single-center study, we divided the wound isolates into two groups: skin commensals (coagulase-negative staphylococci, micrococci, corynebacteria, cutibacteria) and pathogenic pathogens, and followed the patients for ≥ 6 months. In this retrospective study among 1018 DFI episodes (392 [39%] with osteomyelitis), we identified skin commensals as the sole culture isolates (without accompanying pathogenic pathogens) in 54 cases (5%). After treatment (antibiotic therapy [median of 20 days], hyperbaric oxygen in 98 cases [10%]), 251 episodes (25%) were clinical failures. Group comparisons between those growing only skin commensals and controls found no difference in clinical failure (17% vs. 24 %, p = 0.23) or microbiological recurrence (11% vs. 17 %, p = 0.23). The skin commensals were mostly treated with non-beta-lactam oral antibiotics. In multivariate logistic regression analysis, the isolation of only skin commensals was not associated with failure (odds ratio 0.4, 95% confidence interval 0.1–3.8). Clinicians might wish to consider these isolates as potential pathogens when selecting a targeted antibiotic regimen, which may also be based on oral non-beta-lactam antibiotic agents effective against the corresponding skin pathogens

    Timing of Revascularization and Parenteral Antibiotic Treatment Associated with Therapeutic Failures in Ischemic Diabetic Foot Infections

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    For ischemic diabetic foot infections (DFIs), revascularization ideally occurs before surgery, while a parenteral antibiotic treatment could be more efficacious than oral agents. In our tertiary center, we investigated the effects of the sequence between revascularization and surgery (emphasizing the perioperative period of 2 weeks before and after surgery), and the influence of administering parenteral antibiotic therapy on the outcomes of DFIs. Among 838 ischemic DFIs with moderate-to-severe symptomatic peripheral arterial disease, we revascularized 608 (72%; 562 angioplasties, 62 vascular surgeries) and surgically debrided all. The median length of postsurgical antibiotic therapy was 21 days (given parenterally for the initial 7 days). The median time delay between revascularization and debridement surgery was 7 days. During the long-term follow-up, treatment failed and required reoperation in 182 DFI episodes (30%). By multivariate Cox regression analyses, neither a delay between surgery and angioplasty (hazard ratio 1.0, 95% confidence interval 1.0–1.0), nor the postsurgical sequence of angioplasty (HR 0.9, 95% CI 0.5–1.8), nor long-duration parenteral antibiotic therapy (HR 1.0, 95% CI 0.9–1.1) prevented failures. Our results might indicate the feasibility of a more practical approach to ischemic DFIs in terms of timing of vascularization and more oral antibiotic use

    America’s Public Shell Trafficking Problem: Ripe for Reprocessing

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    The scourge of public shell trafficking has led to fraudsters taking advantage of and pilfering the hard-earned dollars of the American investing public for decades. These fraudsters seek to abuse the chapter 11 bankruptcy process by discharging the debt of such public shells, so that they can increase the profitability of schemes that target innocent investors, such as reverse mergers and pump-and-dump schemes. Regulators and lawmakers alike have fought back against this phenomenon through statutory reform and targeted regulatory programs; recently, their principal method of fighting back has been to consistently object to chapter 11 plans of reorganization that could potentially be used in such schemes. This Comment analyzes the strengths and weaknesses of the current regulatory approaches to combat public shell trafficking and proposes a new solution: the Shell Reprocessing Approach (“SRP Approach” or “Approach”). The SRP Approach involves regulators taking a more active role in debtor reorganization by moving for the appointment of a chapter 11 trustee and/or filing a competing plan as a party in interest. The Approach has the potential to enable regulators to stop bad actors seeking to abuse the bankruptcy process in a potentially more effective and innovative manner and to better protect the American public from fraudulent investment schemes. Ultimately, unlike objections to confirmation, the Approach promises to preserve the economic value of a debtor public shell by repurposing its ticker and to close the information gap by subjecting the entity to greater regulatory scrutiny via existing Special Purpose Acquisition Company (“SPAC”) regulations

    Timing of Revascularization and Parenteral Antibiotic Treatment Associated with Therapeutic Failures in Ischemic Diabetic Foot Infections

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    For ischemic diabetic foot infections (DFIs), revascularization ideally occurs before surgery, while a parenteral antibiotic treatment could be more efficacious than oral agents. In our tertiary center, we investigated the effects of the sequence between revascularization and surgery (emphasizing the perioperative period of 2 weeks before and after surgery), and the influence of administering parenteral antibiotic therapy on the outcomes of DFIs. Among 838 ischemic DFIs with moderate-to-severe symptomatic peripheral arterial disease, we revascularized 608 (72%; 562 angioplasties, 62 vascular surgeries) and surgically debrided all. The median length of postsurgical antibiotic therapy was 21 days (given parenterally for the initial 7 days). The median time delay between revascularization and debridement surgery was 7 days. During the long-term follow-up, treatment failed and required reoperation in 182 DFI episodes (30%). By multivariate Cox regression analyses, neither a delay between surgery and angioplasty (hazard ratio 1.0, 95% confidence interval 1.0-1.0), nor the postsurgical sequence of angioplasty (HR 0.9, 95% CI 0.5-1.8), nor long-duration parenteral antibiotic therapy (HR 1.0, 95% CI 0.9-1.1) prevented failures. Our results might indicate the feasibility of a more practical approach to ischemic DFIs in terms of timing of vascularization and more oral antibiotic use
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