Medical research archives最新文献

{"title":"Effect of Emotional Regulation on Impulsivity and Anxiety Through the Mediating Role of Mindfulness","authors":"Neeraj Panwar, N. Agarwal, Shivani Tanwar","doi":"10.18103/mra.v11i5.3807","DOIUrl":"https://doi.org/10.18103/mra.v11i5.3807","url":null,"abstract":"Background: Adolescence is a phase blended with various challenges and changes. How someone takes these challenges and accepts the changes (physically, emotionally, or psychologically) are the major concerns of social scientists. Objective: Keeping that objective in mind, current research has been done to assess if emotional regulation leads to impulsivity and anxiety through the moderating effect of mindfulness. Method: For the purpose, correlational research design has been followed and randomly 150 young adolescent females were selected from various public as well as private schools following similar kinds of academic board (CBSE). Standardized tools pertaining to emotion regulation, impulsivity, anxiety, and mindfulness were administered. To accomplish the objectives of the study, apart from descriptive statistics correlation of coefficients was run followed by structural equation modeling (SEM) to highlight the mediating role of mindfulness between emotion regulation, impulsivity, and anxiety. Conclusion: Major findings of the study revealed the direct effect of emotional suppression on anxiety and impulsivity through the moderating role of mindfulness whereas no such results were obtained for cognitive reappraisal. Hence, the proposed model has been partially found to be significant with the goodness of fitness index value of 0.935.","PeriodicalId":94137,"journal":{"name":"Medical research archives","volume":"84 19","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91403502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Are Health Technology Assessments Keeping Pace with Health Equity Priorities: A Review of Existing Approaches and Discussion of Emerging Practices","authors":"S. Garfield, Shannon Armstrong, Julie Nguyen, Christine Hildreth, Bianca Wu, Isabella James, Sylvie Babat, Malu Foley","doi":"10.18103/mra.v11i6.3903","DOIUrl":"https://doi.org/10.18103/mra.v11i6.3903","url":null,"abstract":"Health technology assessments are evaluation tools used by decision makers and governing bodies to evaluate the relative effectiveness, safety, and cost of new health technologies. Despite the significant access and reimbursement implications of the decisions informed by health technology assessments, health equity is not consistently included in these assessments. This review explores current health technology assessment approaches using global examples, examines how health technology assessments include health equity considerations, reviews how health equity is not optimally included in health technology assessments using a case study example, and discusses emerging practices to include more health equity related metrics using examples from sponsors and health technology assessment agencies. Results show that health technology assessments do not have a consistent, clearly defined measures of health equity impact or methods to include health equity-oriented measures in assessments. Additionally, most do not provide differentiated value assessments for health equity-oriented data or impact. However, innovators and health technology assessment organizations are presenting new approaches to evaluation. Some outside groups are advocating for change and investing in developing health equity checklists and frameworks for incorporation in health technology assessments. Moving forward, more research is needed to understand how to best incorporate heath equity-oriented measures into health technology assessments and how innovators can get more involved to inform both product development and evaluation efforts. If done well, health technology assessments can be developed to reward technologies and research programs that have a significant and measurable impact on delivering more equitable health outcomes.","PeriodicalId":94137,"journal":{"name":"Medical research archives","volume":"25 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83308269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Emerging Role of Photobiomodulation in COVID-19 Therapy Part II","authors":"Richard Williams","doi":"10.18103/mra.v11i8.4028","DOIUrl":"https://doi.org/10.18103/mra.v11i8.4028","url":null,"abstract":"Purpose: To empirically confirm the utility of photobiomodulation (PBM) in the treatment of acute and long COVID-19 guided by a mechanistic analysis of the photochemical effects of pulsed light on SARS-CoV-2 infections and disease progression. Background: COVID-19 comprises a coronavirus severe inflammatory disease infecting tissue populated by ACE-2 receptors of the upper and lower respiratory tract and AEC causing an overexpression of pro-inflammatory cytokines. Once in the lungs, viremic spread and cytokine profusion progresses into multi-organ hyperinflammation of visceral epithelium, vascular endothelium, and neurons of the CNS, PNS, ANS, and brain with long-term sequelae. In response to an oxidative state, red and NIR PBM down-regulates proinflammatory cytokines, activating M2 macrophages and Th2 helper cells to increase anti-inflammatory immune response in accordance with a biphasic dose response. Published reports confirm efficacious therapy of COVID-19 using conformal LED pads or scanned lasers. Results: A series of two acute COVID case studies comprising 69 ambulatory (stage 1-to-5) and five stage-6 hospitalized patients confirm the efficacious impact of whole-organ deep-tissue PBM using algorithmically-pulsed conformal LED pad optical delivery methods. Together, acute symptomatic recovery from two 64-84 min PBM sessions occurred within three days for 62/62 patients. Full recovery occurred within four sessions for all PBM patients (all but two cases resolved within one week). Prophylactic benefits were recorded in 17/17 asymptomatic-to-mild (stage 0-1) patients exposed to viral shedding of infected family members. PBM of long COVID outcomes include total resolution of dyspnea, ability to maintain SpO2 above 97% without oxygen supplementation, relief from digestive distress, elimination of brain fog, improved memory recall, restored executive function, and symptomatically managing emotional deficits. Total whole-organ PBM treatments to date comprise approximately three-hundred fifty cases comprising 60% acute COVID-19, 20% metabolic and respiratory long COVID, and 20% neurological long COVID. Unresolved cases totaling 0.25% include two cases of severe long COVID anxiety and nosophobia where PBM was found to deliver only short-term palliative relief. Conclusion: Ongoing results increasingly support the application of whole-organ deep tissue PBM in the treatment of acute and long COVID-19. Both conformal LED pads and scanning lasers demonstrate favorable outcomes. LED pads deliver higher fluences than scanned lasers in the same session times. Further studies of the prophylactic benefits of PBM are indicated.","PeriodicalId":94137,"journal":{"name":"Medical research archives","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80819208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neoadjuvant and Adjuvant Therapy; Calculating Costs","authors":"H. Guirgis","doi":"10.18103/mra.v11i8.4313","DOIUrl":"https://doi.org/10.18103/mra.v11i8.4313","url":null,"abstract":"Background: Neoadjuvant Nivolumab plus chemotherapy improved event-free survival in early resectable lung cancer. The target therapy Osimertinib is used as neoadjuvant, adjuvant and in advanced advanced/metastatic non-small lung cancer (a/m- NSCLC). The current clinical practice in a/m- NSCLC is to continue Osimertinib, if effective and safe. The estimated 3-year cost was $745,116, necessitating placement of $500,000 cap. The median immune check point inhibitors (ICI) 3-year cost of $404,388 was below the cap (Guirgis, ESMED, 2023). We aimed to quantify and compare ICI-and Osimertinib costs in earlier vs advanced stages in multiple solid tumors. Methods: Annual 2019-2020 costs of Osimertinib were calculated ad monthly optimal dose x 12. The ICI were calculated as dose x mg/m2 or per 80 kg x price x number of cycles. Results: The, 2-year Osimertinib cost in 1 st and 2 nd -line metastatic disease was $496,744, adjuvant 1-year $248,372 and neoadjuvant $31,046.","PeriodicalId":94137,"journal":{"name":"Medical research archives","volume":"44 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84639731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Global Emergency: Identifying Priorities for Reforming International Emergency Medical Systems","authors":"S. Thygerson, Gregory Memmott, Robbie Chaney","doi":"10.18103/mra.v11i5.3922","DOIUrl":"https://doi.org/10.18103/mra.v11i5.3922","url":null,"abstract":"Emergency Medical Systems differ around the world and perform at varying levels of effectiveness. This study analyzed how well countries met the emergency response requirements for emergency medical teams set by the World Health Organization and professional literature recommendations in the three levels of country classifications set by the United Nations. This was conducted through a stratified random sample of ten countries in the categories: developed, economies in transition, and developing, for a total of thirty countries. Each country was qualitatively analyzed for emergency response times, types of public-to-provider communication, insurance/financial coverage, certification level of emergency care provider, and level of emergency hospital care. These areas were compared to the WHO recommendations and the higher standards of care recommended by the professional literature. It was found that 90% of developing countries did not meet the WHO recommendation compared to 50% of transitioning economies, and 10% of developed countries. There was a strong positive correlation between Gross Domestic Product and overall effectiveness of an EMS system. Moving forward, it is recommended that the underlying problems be identified, risk factors evaluated, possible interventions created, and implementing interventions in developing countries to improve communication from public to provider in pre-hospital care, and hospital emergency care","PeriodicalId":94137,"journal":{"name":"Medical research archives","volume":"R-30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84754353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physical Factors of Food Influencing the Postprandial Blood or Plasma Glucose Level: A Narrative Review","authors":"R. Bipat, I. Magali, R. Soekhoe, J. Toelsie","doi":"10.18103/mra.v11i4.3739","DOIUrl":"https://doi.org/10.18103/mra.v11i4.3739","url":null,"abstract":"Emerging evidence suggests that a high postprandial glucose level in plasma or blood is an important factor for the etiology of non-communicable disorders like the metabolic syndrome, diabetes, obesity and cardiovascular disease. A high sugar content of the food naturally increases the postprandial glucose level. However, quite a few studies provided proof in the past that the physical properties like viscosity, temperature, and water content of the food we consume also may influence the level of this parameter. The aim of this study is to give a narrative review of present findings that showed the physical properties of consumed food influenced the postprandial glucose level. The online databases Medline, Pubmed, Google Scholar and Hinari have been searched for publications on “plasma glucose” and “temperature” or “viscosity” or “solubility” or “water content”. All articles dealing with the influence on the postprandial glucose level in the blood have been included. Articles written in a language we could not understand or without a proper translation into English have been excluded. In general, most available studies showed that the physical properties temperature, viscosity, and water content of consumed food influenced the postprandial glucose. An increased temperature, increased viscosity and decreased water content of the food is generally associated with a higher postprandial glucose level in blood or plasma after consumption. Further detailed studies in both preclinical as well as clinical trials should be considered to obtain more detailed results regarding this.","PeriodicalId":94137,"journal":{"name":"Medical research archives","volume":"76 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88576573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Congenital Heart Diseases in the Cleft Lip Palate Patients and its Perioperative Implications: An Observational Study In Rural Central Maharashtra, India","authors":"Monal Karkar, Abhinav Lambe","doi":"10.18103/mra.v11i7.2.4167","DOIUrl":"https://doi.org/10.18103/mra.v11i7.2.4167","url":null,"abstract":"Introduction: Congenital heart disease (CHD) is a common birth defect that occurs in approximately 1% of live births worldwide. Cleft lip and palate (CLP), another common birth defect, affecting approximately 1 in 600- 800 live births in India. Several studies have reported an association between CHD and CLP, however, there is limited data on the prevalence and types of CHD in patients with CLP in rural areas of developing countries, including India. This study aimed to investigate the prevalence and types of CHD in patients with CLP at a rural hospital in central Maharashtra, India. Methods: This retrospective study included medical records of patients with isolated Cleft lip, isolated cleft palate and patients with cleft lip and palate, between January 2018 and December 2020. The study was conducted at a rural hospital in central Maharashtra, India. The patients’ records were examined for any heart disease. Patients who had a diagnosis of CHD were identified through medical records and echocardiography reports. The prevalence and types of CHD were compared between the two groups using descriptive statistics and chi-square tests. Results: A total of 291 patients were included in our study. 169 were males and 122 were females. Congenital heart diseases were found in 12.37% (n=36) patients.5 Cleft lip (13%), 12 Cleft lip and palate (48%), 19 Isolated cleft palate (39%) were diagnosed with Congenital heart diseases. The types of Congenital Heart Diseases reported in our study were atrial septal defect, Ventricular septal defect, Patent ductus arteriosus, Pulmonic Stenosis and Tetralogy of Fallot. Conclusion: The most common types of CHD in both groups were ASD and VSD, but the prevalence of these defects was significantly higher in the CLP group. These findings have important implications for the multidisciplinary Perioperative management of patients with CLP, as they may require close monitoring for CHD and appropriate intervention if necessary, especially in resource-limited settings.","PeriodicalId":94137,"journal":{"name":"Medical research archives","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88801093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in Malpractice Payments and Adverse Actions against Pharmacists in the United States between 1990-2022","authors":"Mhay S., S. S., Kapadia U., Nair N., Nalliah RP.","doi":"10.18103/mra.v11i7.1.4043","DOIUrl":"https://doi.org/10.18103/mra.v11i7.1.4043","url":null,"abstract":"Background: We evaluated malpractice payments and adverse actions against pharmacists in the United States. Malpractice is defined as professional negligence by act or omission. Adverse actions are actions administered by the board of registration in a health profession against a provider. The purpose of the study is to analyze the trends in malpractice payments and adverse actions for pharmacists during the period 1990-2022. Methods: This is a retrospective study that utilizes the National Practitioner Data Bank (NPDB) data analysis tool for the period 1990-2022. This information was exported to a data visualization tool and trends were studied. Results: During the period of the study there were 2480 malpractice payments and 44,204 adverse action reports made against pharmacists. In the current study we found that there has been a 19.56% decline in the number of malpractice payments against pharmacists in the last 5 years from 46 in 2018 to 37 in 2022. Similarly, adverse action reports also show a downward trend from 2016 to 2022. Conclusion: Pharmacy profession implements multiple processes to protect patients from medication errors. As the volume of prescriptions increases in the US, there is an increased risk of error and subsequent litigation against pharmacists. Even though malpractice payments and adverse actions against pharmacists have continued to decline, the probability of an adverse action remains high for practicing pharmacists. As the role of pharmacist continues to evolve there is a need to keep up with the changes in the healthcare market.","PeriodicalId":94137,"journal":{"name":"Medical research archives","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89355256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding Attitudes and Practices of Low-Income Caregivers Toward Sugar-Sweetened Beverage Consumption in Preschool-Aged Children","authors":"C. Cooper, Angela Northrup, Michelle Iannacchino","doi":"10.18103/mra.v11i3.3459","DOIUrl":"https://doi.org/10.18103/mra.v11i3.3459","url":null,"abstract":"Sugar-sweetened beverage (SSB) consumption during early childhood has been linked to adverse health outcomes across the lifespan. Caregivers of young children are often unaware of the potential health harms of SSB and may lack knowledge, skills and environmental supports to limit SSB. The objectives of this study were to determine study caregivers’ attitudes and practices with regard to SSB and to identify themes that may inform future policies and interventions to limit these beverages. Guided by the Social Ecological Model (SEM), the research team interviewed low-income caregivers of children ages two to five at a health clinic in urban New York State. Interviews were recorded, transcribed, and coded for themes and further analyzed for determinants of behavior with regard to providing SSB. Five major themes emerged: Greater SSB knowledge led to healthier choices; confusion about the healthfulness of some SSB; SSB affordability, accessibility and cultural acceptability; children’s “pester power” to obtain SSBs; and, lack of SSB information from healthcare providers. Determinants such as perceived barriers to action, self-efficacy, cues to action, and perceived threat emerged from the themes. SSB are widely available, affordable and palatable. Healthcare providers seldom discuss children’s SSB intake specifically at well visits. SSB are frequently marketed and labeled as “healthy.” SSB are a significant source of empty calories and added sugars. Helping parents limit SSBs may reduce child overweight and obesity and minimize lifelong chronic disease risks. Heathcare providers, health campaigns and nutrition assistance programs may collaborate to help parents limit SSB intake in young children.","PeriodicalId":94137,"journal":{"name":"Medical research archives","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87260941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A COMPACT NEUTRON GENERATOR FOR THE NIORT® TREATMENT OF SEVERE SOLID CANCERS","authors":"M. Martellini","doi":"10.18103/mra.v11i3.3799","DOIUrl":"https://doi.org/10.18103/mra.v11i3.3799","url":null,"abstract":"In the last four years, TheranostiCentre S.r.l., Berkion Technology LLC and ENEA have patented and fabricated a first prototype of a Compact Neutron Generator (CNG) currently under testing in the ENEA laboratories. Besides the usual applications in the field of materials irradiation, this CNG - producing neutrons of 2.45 MeV energy by using the DD fusion reaction - was conceived for the neutron irradiation of the solid cancer’s tumour bed by means of the Intra-Operative Radiotherapy (IORT) technique, the so-called neutron-IORT (nIORT®). The CNG is self-shielded and light-weight (~120 kg) making possible its remote handling by a robotic arm. Accurate Monte Carlo simulations, modelling the CNG and the “open wound” biological tissues near its irradiation window, demonstrated that the apparatus - operated at 100 kV-10 mA - supplies a neutron flux ~108 cm-2 s-1 and can deliver equivalent dose rates ~2 Gy (RBE)/min. Hence, it can administer very high dose levels in limited treatment times. This article briefly summarizes the main findings of this collaborative research study, the clinical rationales underpinning the nIORT® idea and the potential performances of the CNG for the treatment of solid cancer pathologies. Indeed, the CNG can be installed in an operating room dedicated to nIORT® treatments, without posing any environmental and safety issues. Monte Carlo simulations have been carried out by envisioning the CNG equipped with an IORT applicator, that is an applicator pipe with a tuneable diameter to be inserted in the surgical cavity. By foreseeing the clinical endpoints of the standard IORT protocols, the irradiation performances for potential nIORT® treatments - obtained with an applicator pipe of 6 cm diameter - are here reported for different regimes: from 10 up to 75 Gy (RBE), that can be administered in a single session of about 4 to 30 minutes. Besides the dose peak in the centre of the tumour bed, the almost isotropic neutrons emission allows to irradiate the surroundings side-walls of the tumour bed – usually filled by potential quiescent cancer cells (QCCs) – and therefore reducing the chances of local recurrences by improving the local control of the tumour. The rapid decrease in tissues depth of the dose profile (in few centimetres) will spare the neighbouring organs at risk from harmful radiations. Thus, the CNG apparatus developed for nIORT® applications can potentially improve the resectability rate of a given neoadjuvant cancer treatment and, generally, could satisfy all five R’s criteria of radiotherapy. Furthermore, in comparing with the current IORT techniques with electrons or low-keV X-rays, the nIORT® exploiting a high-flux neutrons beam of 2.45 MeV energy could lead to some significant clinical advantages due to its larger Linear Energy Transfer (LET, ~ 40 keV/m as average) and significantly higher Relative Biological Effectiveness (RBE 16) than all other forms of ionizing radiation.","PeriodicalId":94137,"journal":{"name":"Medical research archives","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87401898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}