Medical research archives最新文献

{"title":"Dilated Cardiomyopathy - Exploring the Underlying Causes.","authors":"David F Wieczorek","doi":"10.18103/mra.v12i12.6111","DOIUrl":"10.18103/mra.v12i12.6111","url":null,"abstract":"<p><p>Cardiovascular disease is one of the world's leading causes of natural mortality, taking approximately 18 million lives each year. Dilated cardiomyopathy, a subgroup of cardiac diseases, has an annual incidence of 5 - 8 cases per 100,000 for European and North American populations. Common features of dilated cardiomyopathy include cardiac chamber enlargement, impaired systolic function, reduced ejection fraction, and arrhythmias, with an endpoint of ventricular dilation and heart failure. The focus of this paper is to review the non-genetic and genetic etiologies that lead to dilated cardiomyopathy. The non-genetic causes of dilated cardiomyopathy that are discussed include viruses, cardiotoxicity, recreational drugs, and chemotherapeutic medications. For the genes that lead to dilated cardiomyopathy, the focus of this paper is on cytoskeletal and sarcomeric protein genes. Our scope in defining this area will be to explore numerous mouse models that incorporate mutations found in humans that lead to dilated cardiomyopathy. The purpose of the paper is to define the morphological and physiological consequences of these mutations and how this information has furthered our understanding of the disease. Having gained invaluable knowledge from these animal models, it is hoped that new and improved therapeutic approaches can be developed for the treatment and prevention of dilated cardiomyopathy.</p>","PeriodicalId":94137,"journal":{"name":"Medical research archives","volume":"12 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12393173/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Qualitative Assessment of a Novel Intervention to Reduce Hospital Readmission Risk Among People with Diabetes.","authors":"Samuel Tanner, Emily Brzana, Andrew Deak, Dominic Recco, Madeline Tivon, Felicia Dillard, Samantha Watts, Neil Kondamuri, Sarah B Bass, Daniel J Rubin","doi":"10.18103/mra.v12i12.5882","DOIUrl":"10.18103/mra.v12i12.5882","url":null,"abstract":"<p><strong>Purpose: </strong>To qualitatively assess a novel intervention, the Diabetes Transition of Hospital Care (DiaTOHC) Program, designed to reduce hospital readmissions within 30 days of discharge among people with diabetes.</p><p><strong>Methods: </strong>In a separately reported randomized controlled trial of the DiaTOHC intervention, hospitalized people with diabetes were identified as high risk for 30-day hospital readmission using the Diabetes Early Readmission Risk Indicator (DERRI^®). Of these, 58 participants were randomized to the intervention. After the 30-day intervention, participants and study staff completed semi-structured interviews until saturation was achieved, yielding 21 participant and 4 staff interviews. Each one underwent thematic analysis.</p><p><strong>Results: </strong>Four themes were identified: (1) Participants were motivated to make lifestyle changes, (2) Weekly Navigator phone calls were an effective method to support participants, (3) The intervention improved some diabetes knowledge domains but not others, and (4) Perceived lack of control was associated with readmission. Participants with baseline hemoglobin A1C (A1C) ≥8% made more changes to their diabetes management due to the intervention but were less likely to review the educational materials and had more extreme blood glucose levels. Participants who completed fewer post-discharge phone calls were more likely to find the educational booklet helpful than those who completed more calls.</p><p><strong>Conclusions: </strong>Education, care coordination, and follow up are key components of the DiaTOHC Program that may improve diabetes self-management after a hospitalization and reduce readmission risk.</p>","PeriodicalId":94137,"journal":{"name":"Medical research archives","volume":"12 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12162107/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144287682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cultural Effects on the Performance of Older Haitian Immigrants on Timed Cognitive Tests.","authors":"Marie Adonis-Rizzo, Ruth M Tappen, Monica Rosselli, David Newman, Joshua Conniff, Jinwoo Jang, KwangSoo Yang, Borko Furht","doi":"10.18103/mra.v12i11.5868","DOIUrl":"10.18103/mra.v12i11.5868","url":null,"abstract":"<p><strong>Background: </strong>Ignoring the cultural factors that can affect performance on cognitive tests may result in use of tests that have not been validated for that group. One example is testing of Haitian Creole speaking adults who are increasingly affected by Alzheimer's disease and related dementias, for whom few tests have been validated.</p><p><strong>Aims: </strong>Our purpose is to describe differences in timed test performance between Haitian Creole and English-speaking participants and explore factors that may account for any differences in results found.</p><p><strong>Methods: </strong>Data was obtained from an ongoing longitudinal driving and cognition study \"In Vehicle Sensors to Detect Cognitive Change in Older Drivers.\" Two groups consisting of 12 Creole speaking and 12 English speaking older adults were matched by age and gender. Test scores were selected from the battery of tests administered in the parent study. The measures were translated by two bilingual Creole-English researchers. Group performance on five timed cognitive tests commonly used in research was compared.</p><p><strong>Results: </strong>The English-speaking group's mean scores were significantly higher than the Creole speaking group on the MoCA and the timed Animal category fluency, letter P fluency, Stroop Color Test, and Trail Making Test A and B. The most significant effects were noted in Letter P fluency, Trail Making Test A and B and Animal category fluency where the differences had large effect sizes. However, the Creole speaking group had higher mean scores than the English-Speaking group on the Stroop Color Word Test, although the difference was not statistically significant. It was not feasible to match education levels due to the differences in years of education across the groups. These results highlight the significant role of culture and linguistic context in cognitive task performance.</p><p><strong>Conclusions: </strong>The results suggest performance in cognitive testing among non-English speaking groups may be impacted by cultural factors related to time perception and the testing approach employed, leading to misinterpretation and misdiagnosis. Future studies should explore the fairness of various cognitive testing approaches with Haitian older adults and other societies with cultures and educational approaches different from those of Western cultures.</p>","PeriodicalId":94137,"journal":{"name":"Medical research archives","volume":"12 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11736698/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143019086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Achieving Chronic Care Equity by Leveraging the Telehealth Ecosystem (ACCTIVATE): A Multilevel Randomized Controlled Trial Protocol.","authors":"Adenike Omomukuyo, Andy Ramirez, Aliyah Davis, Alexandra Velasquez, Adriana L Najmabadi, Marianna Kong, Rachel Willard-Grace, William Brown, Andrew Broderick, Karla Suomala, Charles E McCulloch, Nora Franco, Urmimala Sarkar, Courtney Lyles, Amber S Tran, Anjana E Sharma, Delphine S Tuot","doi":"10.18103/mra.v12i11.6087","DOIUrl":"10.18103/mra.v12i11.6087","url":null,"abstract":"<p><strong>Background: </strong>Racial/ethnic and socioeconomic disparities in diabetes and hypertension outcomes persist in the United States (U.S.), and worsened during the COVID-19 pandemic. This was in part due to suboptimal implementation of telehealth in U.S. safety-net settings alongside the pre-existing \"digital divide\" - structural determinants that limit access to digital tools by marginalized communities. To improve health equity, it is critical that health systems in the U.S. integrate principles of digital and health literacy for more equitable chronic disease care.</p><p><strong>Methods: </strong>We are conducting a 2x2 factorial randomized controlled trial, in partnership with a Community Advisory Board, assessing a multi-level intervention addressing barriers that affect the equitable use of telehealth amongst low-income patients in San Francisco County. Patient-level support is provided through the evidence-based strategies of health coaching and digital navigation (\"digital coaching\"); clinic-level support includes equity dashboards, patient advisory councils, and practice facilitation. We are randomizing 600 low-income, racially/ethnically diverse English and Spanish-speaking patients with uncontrolled diabetes to receive digital coaching (n=200) vs. usual care (n=400) for 3 months; and 11 public health primary care clinics to clinic support vs. usual care for 24 months. We aim to evaluate the impact of patient and clinic level interventions to determine individual effectiveness and potential synergistic impact on clinical and process measures related to diabetes and telehealth outcomes.</p><p><strong>Results: </strong>The study's primary clinical outcome is change in patient-level Hemoglobin A1C (A1c); the primary process outcome is patient portal usage. Secondary clinical outcomes include changes in patient-level systolic blood pressure (SBP) and microalbuminuria (UACR), and changes in clinic-level A1c, SBP, and UACR. Secondary process outcomes assess patient-level changes in digital literacy, medication adherence, patient activation, and visit show rates, and clinic-level measures of telehealth adoption.</p><p><strong>Discussion: </strong>The ACCTiVATE trial tests a multi-level intervention developed through a stakeholder-engaged research approach and user-centered design to be feasible and acceptable for impacted communities. If efficacious, ACCTiVATE may provide a scalable model to improve chronic health outcomes and telehealth equity among marginalized racial/ethnic populations experiencing structural and interpersonal access barriers.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier NCT06598436. Registered 15 September 2024.</p>","PeriodicalId":94137,"journal":{"name":"Medical research archives","volume":"12 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11646453/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142831590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Augmenting the Hospital Score with social risk factors to improve prediction for 30-day readmission following acute myocardial infarction.","authors":"Iben Ricket, Michael E Matheny, Ruth M Reeves, Rashmee U Shah, Christine A Goodrich, Glenn Gobbel, Meagan E Stabler, Amy M Perkins, Freneka Minter, Chad Dorn, Bruce E Bray, Lee Christensen, Ramkiran Gouripeddi, John Higgins, Wendy W Chapman, Todd MacKenzie, Jeremiah R Brown","doi":"10.18103/mra.v12i11.6089","DOIUrl":"10.18103/mra.v12i11.6089","url":null,"abstract":"<p><strong>Background: </strong>Hospital Score is a well-known and validated tool for predicting readmission risk among diverse patient populations. Integrating social risk factors using natural language processing with the Hospital Score may improve its ability to predict 30-day readmissions following an acute myocardial infarction.</p><p><strong>Methods: </strong>A retrospective cohort included patients hospitalized at Vanderbilt University Medical Center between January 1, 2007, and December 31, 2016, with a primary index diagnosis of acute myocardial infarction, who were discharged alive. To supplement ascertainment of 30-day readmissions, data were linked to Center for Medicare & Medicaid Services (CMS) administrative data. Clinical notes from the cohort were extracted, and a natural language processing model was deployed, counting mentions of eight social risk factors. A logistic regression prediction model was run using the Hospital Score composite, its component variables, and the natural language processing-derived social risk factors. ROC comparison analysis was performed.</p><p><strong>Results: </strong>The cohort included 6,165 unique patients, where 4,137 (67.1%) were male, 1,020 (16.5%) were Black or other people of color, the average age was 67 years (SD: 13), and the 30-day hospital readmission rate was 15.1% (N=934). The final test-set AUROCs were between 0.635 and 0.669. The model containing the Hospital Score component variables and the natural language processing-derived social risk factors obtained the highest AUROC.</p><p><strong>Discussion: </strong>Social risk factors extracted using natural language processing improved model performance when added to the Hospital Score composite. Clinicians and health systems should consider incorporating social risk factors when using the Hospital Score composite to evaluate risk for readmission among patients hospitalized for acute myocardial infarction.</p>","PeriodicalId":94137,"journal":{"name":"Medical research archives","volume":"12 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11788934/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Osteosarcoma: A comprehensive review of model systems and experimental therapies.","authors":"Gabrielle M Robbins, Young Y Vue, Eric P Rahrmann, Branden S Moriarity","doi":"10.18103/mra.v12i11.6000","DOIUrl":"10.18103/mra.v12i11.6000","url":null,"abstract":"<p><p>Osteosarcoma (OSA) is a highly malignant bone tumor for which more than 50% of patients have or will develop metastatic disease, resulting in an abysmal 5-year survival rate of <29%. Despite the advances in science and medicine, the etiology of OSA remains unclear. Similarly, the standard of care (surgery and chemotherapy) has changed little in the past 5 decades. This stagnation in treatment options is in part due to inadequate preclinical models for OSA; many of these models are oversimplified and do not account for the complexities of patient disease. Further, current treatments are harsh and invasive (e.g. high dose chemotherapy and potential limb removal) leading to a reduction in a patient's quality of life (e.g. hearing loss, infertility, neuropathy), highlighting a need for developing more effective treatment strategies. Many experimental therapies have been tested in the preclinical and preclinical setting, with varying degrees of success. In this review, we will focus on pediatric and adolescent OSA, highlighting current animal models and experimental therapies.</p>","PeriodicalId":94137,"journal":{"name":"Medical research archives","volume":"12 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11801376/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143367167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Could Provider Bias Play a Role in Gynecological Health, Sexual Health and Gynecological Cancer Disparities Observed Among a Cohort of Non-English-Speaking Women with HIV living in Southern Florida?","authors":"Lunthita M Duthely, Rachel Mpanumpanu, Isabel Maldonado, Beverly Goldsmith, Isabelle I M Akinyemiju, Yulie Lugo, Elena Cyrus","doi":"10.18103/mra.v12i11.6056","DOIUrl":"10.18103/mra.v12i11.6056","url":null,"abstract":"<p><p>As part of an ongoing, prospective study developing an HIV adherence and engagement intervention for women in Southern Florida, we abstracted baseline demographic, psychosocial and medical history data charted in the participants' electronic medical records. Several differences were observed, in terms of documentation of gynecological and sexual and health data by patients' linguistic preference. The purpose of this quantitative, retrospective study was to test the differences of data documentation by linguistic group and comment on the findings.</p>","PeriodicalId":94137,"journal":{"name":"Medical research archives","volume":"12 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11999243/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mini-Dose Glucagon for Mild and Moderate Hypoglycemia in Type 1 Diabetes.","authors":"Hal Steven Farkas, Ellen Werber Leschek","doi":"10.18103/mra.v12i10.5866","DOIUrl":"10.18103/mra.v12i10.5866","url":null,"abstract":"<p><p>Tight glycemic control reduces the development and progression of microvascular and macrovascular complications in individuals with type 1 diabetes. However, it is also associated with an increased risk of hypoglycemia, which can deter some individuals from striving to achieve tight glycemic control. For this and other reasons, it is important to optimize the treatment of hypoglycemia in type 1 diabetes. The conventional approach to the management of mild to moderate hypoglycemia is oral carbohydrate ingestion, which can result in significant rebound hyperglycemia and the consumption of excess calories with resulting unwanted weight gain. Studies of the use of subcutaneous mini-dose glucagon for the prevention and treatment of mild to moderate hypoglycemia in a variety of settings have demonstrated that this approach is safe and effective and is less likely to result in significant hyperglycemia and the ingestion of unwanted oral carbohydrate calories.</p>","PeriodicalId":94137,"journal":{"name":"Medical research archives","volume":"12 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11816725/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143412139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics associated with social anxiety in adults with developmental stuttering: A review.","authors":"K R Bauerly","doi":"10.18103/mra.v12i10.5876","DOIUrl":"10.18103/mra.v12i10.5876","url":null,"abstract":"<p><p>People who stutter are at a greater risk for developing symptoms of social anxiety, with up to 22-60% of adults who stutter meeting the criteria for a clinical diagnosis. Negative attitudes and feelings about speaking and stuttering are reported to emerge as early as the preschool years and are suspected to be due to exposure to negative listener reactions, stereotyping and social isolation. Repeated negative experiences lead to feelings of fear, embarrassment and loss of control during speaking which over time, leads to the development of more severe difficulties with speaking and an overall apprehension to speak as they perceive themselves as an incompetent communicator. The present review aims to summarize risk factors, particularly temperament and environmental factors, that are reported to play a role in the emergence and maintenance of social anxiety in people who stutter. Another aim of this review is to summarize the features of social anxiety reported in adults who stutter, some of which, are similar to high socially anxious fluent speakers (e.g., avoidant strategies) while others are specific to stuttering (e.g., muscle tension). The clinical implications of these findings and recommendations for future research are also discussed.</p>","PeriodicalId":94137,"journal":{"name":"Medical research archives","volume":"12 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11626403/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142803891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Air Pollution as an Environmental Risk Factor for Alzheimer's Disease and Related Dementias.","authors":"Heui Hye Park, Matthew J Armstrong, Fredric A Gorin, Pamela J Lein","doi":"10.18103/mra.v12i10.5825","DOIUrl":"10.18103/mra.v12i10.5825","url":null,"abstract":"<p><p>Alzheimer's disease and related dementias are a leading cause of morbidity in our aging populations. Although influenced by genetic factors, fewer than 5% of Alzheimer's disease and related dementia cases are due solely to genetic causes. There is growing scientific consensus that these dementias arise from complex gene by environment interactions. The 2020 Lancet Commission on dementia prevention, intervention, and care identified 12 modifiable risk factors of dementia, including lifestyle, educational background, comorbidities, and environmental exposures to environmental contaminants. In this review, we summarize the current understanding and data gaps regarding the role(s) of environmental pollutants in the etiology of Alzheimer's disease and related dementias with a focus on air pollution. In addition to summarizing findings from epidemiological and experimental animal studies that link airborne exposures to environmental contaminants to increased risk and/or severity of Alzheimer's disease and related dementias, we discuss currently hypothesized mechanism(s) underlying these associations, including peripheral inflammation, neuroinflammation and epigenetic changes. Key data gaps in this rapidly expanding investigative field and approaches for addressing these gaps are also addressed.</p>","PeriodicalId":94137,"journal":{"name":"Medical research archives","volume":"12 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11736697/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143019078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}