Search Results for: Studio REDUCE-IT e appropriatezza prescrittiva degli acidi grassi omega-3

In recent years, many of the sciences have found it increasingly easy to demonstrate how indispensable they are to modern life. This has been conspicuously true since the World War, during which science in the broadest sense made itself felt as a constructive factor in the solution of innumerable problems. This period of stress presented many serious difficulties that needed to be overcome promptly. The physicists and chemists, in particular, bent their energies to the task, with results that brought widespread acclaim. In the works of either construction or destruction, chemistry and physics contributed in many new and unanticipated ways. Necessity became the mother of invention in the scientific laboratories. The latter deserve much, and they have been justly lauded. One hears on many sides that “science has come into its own” in the last decade.

Objective
This study aimed to assess the pooled prevalence and factors of low birth weight among newborns in the top 20 countries with the highest infant mortality rates.

Design
We conducted a community-based cross-sectional analysis using data from Demography and Health Surveys across these countries. The final analysis included a weighted sample of 82 430 live births. We employed binary logistic regression to identify predictors of low birth weight, allowing for the interpretation of results as probabilities. This approach enhances the understanding of event likelihood, which is particularly valuable for policymakers. Statistical significance was determined at a 95% CI with p values

Introduction
Cardiogenic shock (CS) is a severe condition characterised by low cardiac output and often hypotension, which results in organ hypoperfusion due to cardiac failure. As a form of acute heart failure, this condition seems to share similar underlying pathological mechanisms. It is well established that iron deficiency is correlated with chronic and acute heart failure, causing worsening of the symptoms, reduction of quality of life and survival and simultaneously increasing the rehospitalisation rates for all causes in these patients. It remains unclear whether there is an association between iron deficiency and CS. The objective of this scoping review will be to determine the actual state of the art regarding the significance of iron deficiency in patients affected by CS.

Methods and analysis
We will conduct a systematic review of the literature using MEDLINE and EMBASE via ‘Ovid’ (Elsevier) and Web of Science (2024 Clarivate). The goal is to analyse the incidence and clinical significance of iron deficiency in patients affected by cardiogenic shock. To gain a deeper insight into the underlying pathophysiological mechanisms, the review will include basic research conducted on both human subjects and on animal models as well as observational, randomised controlled studies and systematic reviews and meta-analysis. To maximise the identification of relevant reports and reduce loss of information, a systematic search of the literature will be performed from inception until January 2025 using the terms “iron deficiency” as well as “iron”, “ferritin”, “transferrin”, “transferrin saturation”, “hepcidin” and “soluble transferrin receptor” matching these terms with the keywords “cardiogenic shock”, “acute heart failure”, “advanced heart failure”, “decompensated heart failure”, “lvad”, “left ventricular assist device”, “mechanical circulatory support”, “VA-ECMO” and “Extracorporeal Life Support”. We will also use the corresponding MeSH and Emtree terms. In order to find grey literature, we will use the OADT.org internet-based database.

Ethics and dissemination
No additional ethics approval is required, as this review is based on existing research without new data collection. Only studies with ethics approval will be included. We plan to publish our findings in a peer-reviewed journal and present them at international conferences on cardiology, intensive and acute cardiovascular care, cardiac surgery and cardioanaesthesiology.

Objectives
The scaling-up nutrition (SUN) initiative, which was launched in 2010 to eradicate malnutrition in all its forms by 2030, collaborates with a diverse range of stakeholders, such as governments, non-governmental organisations (NGOs), donors, businesses and academia. Given the widespread adoption of this multisectoral approach, it is crucial to explore methods for evaluating the perspectives of multiple stakeholders in child undernutrition topics.

Design
This scoping review was carried out following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist.

Data sources
Six peer-reviewed databases, including PubMed, Web of Science, Cochrane, Embase, CINAHL and PROQUEST ASSIA, were systematically searched.

Eligibility criteria
Original English studies published between 1 January 2010 and 1 June 2023, focusing on undernutrition in SUN countries.

Data extraction and synthesis
Two reviewers independently screened titles, abstracts and full texts for inclusion and extracted data using Rayyan.

Results
Out of the 4533 articles, 19 met the inclusion criteria for the review, and 5 more were added through manual searches. These studies were conducted in 14 SUN countries, with 62% using mixed methods and the remaining using qualitative methods. Six methods were used to gather stakeholder perspectives, including in-depth interviews, focus group discussions, Net-Map, organisational network analysis and Q methodology. Most studies focused on government, development partners and NGOs, while only two studies involved the business network.

Conclusions
Our study indicates that study on stakeholder perspectives in SUN countries focuses mainly on those showing progress in malnutrition/undernutrition reduction. Future research should explore countries with less progress to improve partnership frameworks. The SUN movement should establish a standard method for evaluating stakeholder perspectives, considering both outcomes and processes.

Trial registration number
The final protocol was registered prospectively with the Open Science Framework in July 2023 (https://osf.io/te7cb).

Studio, possibilità di prevenzione intervenendo sull’ipoacusia

Stroke, Ahead of Print. BACKGROUND:Stroke often results in significant impairments across various domains, including movement, language, cognition, and mood. Neurostimulants have been proposed as potential therapeutic interventions to enhance recovery in these areas.METHODS:This narrative literature review examines clinical trials investigating the efficacy of neurostimulants in poststroke recovery. It evaluates outcomes related to aphasia, motor deficits, cognition, fatigue, and depression.RESULTS:The qualitative analysis included 34 trials testing the following neurostimulants: methylphenidate (n=6), amphetamines (n=8), memantine (n=2), modafinil (n=2), levodopa (n=14), amantadine (n=1), bromocriptine (n=3), and ropinirole (n=1). Of the 34 studies, 31 were randomized, placebo-controlled (double-blind, n=27; single-blind, n=2; unblinded n=2), 2 were randomized and not placebo-controlled, and 1 was not randomized. Study design was either multiarm (n=23), crossover (n=10), or used subjects as their own control (n=1). Mean sample size was 49.4 (5–593).CONCLUSIONS:Current evidence suggests that memantine may be effective for aphasia, although few phase III trials exist, whereas bromocriptine and amphetamines lack sufficient evidence for long-term recovery of aphasia. Levodopa may improve motor aphasias but has not shown long-term benefits for motor recovery. Similarly, ropinirole has not been shown to improve poststroke motor outcomes. Methylphenidate has limited efficacy for cognitive improvement but may enhance poststroke functionality and mood. Modafinil may help with poststroke fatigue. In conclusion, there are promising results of positive effects of neurostimulants with few side effects, though studies are limited by heterogeneous designs and small sample sizes. Neurostimulant efficacy must be assessed in conjunction with specific rehabilitation modalities as part of larger, well-designed studies to best understand their effects on impairment.

Objectives
Organ procurement coordinators (OPCs) play a pivotal role in navigating end-of-life and second-birth narratives by securing familial consent for solid organ donation. Given the low rates of cadaveric organ donation in Türkiye and worldwide, OPCs are essential in advocating for and facilitating these donations. This study explores the reasons for refusal that OPCs have encountered during the familial consent process.

Design
We gathered the data through semistructured interviews with 30 OPCs. Thematic analysis was used to identify and analyse key themes, with a specific focus on cultural, religious, spiritual and folkloric barriers contributing to the low rates of cadaveric organ donation in Türkiye.

Setting
Hospitals and organ transplant centres operating under the jurisdiction of the Ankara Regional Coordination Centre in Türkiye.

Participants
Participants were recruited using a purposeful random sampling strategy to enhance credibility and reduce bias. Eligible informants included OPCs with at least 2 years of experience in the role. Among the 30 participants, 18 were based in central organ transplant centres associated with Training and Research Hospitals in Ankara, and 12 were from peripheral city hospitals.

Results
Coordinators identified five main barriers that hinder their ability to secure familial consent for cadaveric organ donation: (1) religion, (2) concerns about the wishes of the deceased, (3) desire to choose recipients, (4) familial dynamics and (5) folklore. Each category was further contextualised through subcategories derived from the frequency and nuances of recurring themes.

Conclusion
OPCs face significant challenges in promoting cadaveric organ donations due to cultural barriers. Their experiences underscore the need for culturally competent approaches in organ donation campaigns and the importance of supporting coordinators in their roles. Enhanced cultural understanding and targeted interventions could improve cadaveric organ donation rates.

Objective
Developmental language disorder (DLD) is a common communication disorder that impacts children’s ability to learn, comprehend and use language effectively, yet it remains under-researched, particularly in the Arab countries. This scoping review aims to provide a comprehensive narrative summary on the epidemiology of DLD among children aged ≤10 years in the Arab countries.

Design
A scoping review.

Data sources
PubMed, Scopus and Web of Science.

Eligibility criteria
We included studies that reported on the prevalence or risk factors of DLD in children aged ≤10 years from any Arab country. Only peer-reviewed publications were considered, and the study populations were required to consist of children without underlying medical conditions known to contribute to language or speech delay.

Data extraction and synthesis
Two reviewers independently performed abstract and full-text screening and extracted relevant data. The risk factors identified as linked to DLD were grouped into maternal and perinatal factors, factors related to children and family and environmental factors.

Results
From 4832 citations, 17 were deemed eligible and included in this review. The reviewed studies were conducted in only seven Arab countries, with the majority from Egypt (eight studies, 47.1%) and Saudi Arabia (four studies, 23.5%). The reported prevalence of DLD ranged from 3.2% in Egyptian children aged 3–6 years to 25.6% in Saudi Arabian children aged 1–5 years. Among the identified risk factors for DLD were sex, low birth weight, a history of speech and language delay in the family, parental socioeconomic status, perinatal complications, larger family size and early screen exposure.

Conclusion
The reported prevalence of DLD varied across the seven Arab countries. Strategies to address the preventable underlying DLD-associated risk factors are required. There is a clear gap in evidence related to the burden of DLD among children in most of the 22 Arab countries, which warrants further research.

Introduction
In the UK, the number of ethnically diverse older adults (OA) is growing. These individuals suffer complex health issues that are made worse by socioeconomic status, acculturation experiences and language barriers. Additionally, this varied group is the least active and a highly sedentary subgroup in the general population, which poses serious health concerns. Various interventions have been implemented with OAs to reduce their sedentary behaviour (SB) and enhance their physical activity (PA). However, there is still limited research that implements stakeholders’ perceptions in translating the interventions into real-life settings, particularly for ethnically diverse OAs. Therefore, the current study aims to explore stakeholders’ perceptions of the transferability of a 12-week home space intervention for ethnically diverse sedentary OAs, that is, aimed at reducing their SB and increasing their PA.

Methods
Exploratory qualitative research using in-depth interviews (IDIs) and a purposive sampling technique will be employed to recruit stakeholders. Before conducting the IDIs, the primary researcher (NAAM) will discuss the findings of the 12-week home space intervention study for ethnically diverse OAs to explain the intervention, and then the interview will revolve around the transferability of the intervention to transfer the intervention into real-world practice into the stakeholder contexts. A diverse group of stakeholders from Swansea, Wales, UK, representing a range of roles including health promotion professionals, programme leads, service providers, policymakers and researchers will be included. The qualitative data obtained will be analysed using reflexive thematic analysis.

Ethics and dissemination
Stakeholders will be required to provide written informed consent prior to initiation of the study. Ethical approval for this study has been obtained from the College of Engineering Research Ethics Committee (320249732903), Swansea University. The study’s results will be shared with the scientific community through a peer-reviewed journal publication and with study participants through seminars and workshops.

Introduction
The use of teleneuropsychology or neuropsychological remote assessment increased during and after the COVID-19 pandemic in 2020. Teleneuropsychology facilitates remote assessment for populations that do not have access to neuropsychological services as well as individuals who are vulnerable or have physical restrictions that would otherwise make it difficult for individuals to receive appropriate care. However, there are many instruments that are not validated or lack normative data for the overall population. Therefore, this study aims to develop normative data for a neuropsychological battery administered on telehealth with commonly used tools to identify cognitive performance in older adults.

Methods and analysis
The following study will use a previously informatics-generated list of participants who have a lower risk of developing Alzheimer’s disease and other related dementias. Participants will complete screening surveys related to cognitive and health status. They will also complete questionnaires related to sociodemographic information, depression, functionality and social determinants of health. Participants will undergo a teleneuropsychological battery examination via remote assessment. We estimate recruiting 500 participants to establish normative data.

Ethics and dissemination
The current protocol is approved by the University of Florida’s Institutional Review Board. Results will be analysed and disseminated in a research paper once sample number goals are completed.

Objectives
To explore patient, carer and clinician experiences of the QbTest and its impact on patient outcomes for attention deficit hyperactivity disorder (ADHD) diagnosis and medication management.

Design
Mixed-methods systematic review.

Data sources
MEDLINE, EMBASE, PsycINFO, CINAHL, ClinicalTrials.gov and WHO ICTRP (from inception to September 2024).

Study selection
Primary studies, of any design, that evaluated any version of the QbTest (QbMini

Introduction
The ARFID InitiativE Sweden (ARIES) investigates the genetic and environmental factors contributing to avoidant/restrictive food intake disorder (ARFID) in children and adolescents aged 6–14 years. ARIES will establish a national biobank and research registry. It aims to provide data for immediate research and track ARFID outcomes and clarify genetic links between ARFID and other conditions and analyse the gut microbiome to guide nutrition interventions.

Methods and analysis
The study will involve 1500 Swedish children and adolescents with ARFID and a control group of 500 Swedish children and adolescents without ARFID. Parents/guardians and their children will complete online questionnaires assessing ARFID and other eating disorder (ED) pathology, co-occurring conditions, quality of life and parental stress and ED pathology. All participants will provide a saliva sample for comprehensive genetic analyses. Additionally, a subset of participants will provide a stool sample to investigate the gut microbiome in ARFID.

Ethics and dissemination
ARIES was approved by the Swedish Ethical Review Authority (Dnr 2023-04638). All participants will give assent and their parents will complete informed consent. Data will be made available by the authors on reasonable request. Findings will be published in scientific journals and shared with the public and stakeholders in accessible ways, for example, via social media.

Introduction
Around 70% of people with psychosis experience auditory verbal hallucinations (AVHs), which can cause distress and impair the social functioning of the individual. AVATAR therapy works by facilitating a ‘face-to-face’ dialogue between the person and a digital representation (avatar) of their persecutory voice. Although there is cumulative evidence of this way of working with voices, enhancing the therapeutic focus on improved confidence and sense of control of the voices in social situations represents a promising way to boost generalisation of therapy gains into social contexts. We aim to enhance AVATAR therapy by incorporating immersive Virtual Reality (VR) social environments aiming to help the person to deal better with their voices in daily situations.

Methods and analysis
A randomised controlled feasibility trial will be conducted. 40 patients aged 18 or above who are at early stages of psychosis (first episode of psychosis in the last five years) and report distressing and interfering voices will be recruited. Participants will be randomised to receive either a novel, enhanced version of AVATAR therapy (AVATAR_VRSocial) in addition to usual care or usual care alone. Assessor-blinded assessments will be conducted at baseline, 3 months (post-intervention) and 6 months (follow­-up). Key therapeutic targets of AVATAR_VRSocial will be those established by the previous evidence of this approach (ie, power and control, self-esteem and future focus), while introducing exposure and management of distressing voices during social interactions. Analyses will focus on feasibility outcomes (recruitment, retention and completion rates) and preliminary estimates of intervention effects. Qualitative interviews will be carried out with participants allocated to AVATAR_VRSocial to gain a comprehensive understanding of participants’ views on the acceptability of the intervention and research procedures. Thematic analysis of the qualitative interviews will assess the acceptability of the intervention, trial procedures and the new VR technology and software involved.

Ethics and dissemination
The study has received ethical approval from the Ethics Commission at the Faculty of Psychology (Ruhr-Universität Bochum), and there is an independent Trial Steering Committee and Lived Experience Advisory Panel also supporting it. Findings will be disseminated through peer­-reviewed publications, conference presentations and science dissemination events.

Trial registration number
ISRCTN35980117.

Introduction
Neonatal sepsis is a key contributor to neonatal mortality worldwide, and low- and middle-income countries (LMIC) are disproportionately affected. With antimicrobial resistance challenging effective treatment of neonatal sepsis, it is increasingly urgent to improve infection prevention and control (IPC) in LMIC neonatal units (NNU) and reduce transmission of infections. One pathway to improvement which merits further exploration is the collaboration with families to build an IPC intervention.
Families are constantly present on neonatal units, and much of the hands-on care for their newborns is given by them. For IPC to be effective, families must adhere to IPC standards within the NNU, but furthermore, any IPC intervention implemented must be feasible and acceptable for families as well as the hospital staff as this will increase uptake and effectiveness of the intervention. This scoping review aims to provide an overview of parental involvement in infection prevention and control in low- and middle-income setting neonatal units.

Methods and analysis
This protocol was developed in line with the Joanna Briggs Institute recommendations. Searches will be carried out on six databases (Medline, CINAHL, Global Health, EMBASE, Web of Science and Global Index Medicus), and reference searching will be carried out on included studies. The search will be carried out from 2000 to present (end date 28/02/2024), and included languages will be English, French, Spanish and Portuguese. Screening and data extraction will be performed independently by two reviewers, with a third reviewer to resolve conflicts. Results will be reported by narrative synthesis of each sub-question in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines.

Ethics and dissemination
This study will be carried out using already published data exclusively and therefore does not require further ethical approval. Results will be disseminated through peer-reviewed publications and conference presentations and through engagement with peers and relevant stakeholders.

Trial registration number
Registered with Open Science Framework – https://osf.io/snc7a/?view_only=8ffc39d837594b4388c7394a838c3a9e

Stroke, Ahead of Print. BACKGROUND:Branch atherosclerosis disease (BAD) is prone to early neurological deterioration (END). The purpose of this study was to assess the efficacy and safety of argatroban plus dual antiplatelet therapy (DAPT) for preventing END in high-risk branch atherosclerosis disease patients.METHODS:This multicenter, open-label, blinded end point, randomized controlled trial including branch atherosclerosis disease patients with mild stroke (National Institutes of Health Stroke Scale score ≤5) was conducted at 4 centers in China from May 18, 2021 to February 8, 2023. Within 48 hours after symptom onset, patients were randomly assigned to receive argatroban plus DAPT or DAPT alone in a 1:1 ratio. The primary end points were the incidence of END (National Institutes of Health Stroke Scale score increase ≥2) within 7 days and excellent functional outcome (modified Rankin Scale score of 0 to 1) at 90 days.RESULTS:A total of 111 patients were randomized, with 11 excluded for specific reasons, resulting in 100 patients included in the modified intention-to-treat population. Among the 100 patients, 49 received argatroban plus DAPT and 51 received DAPT alone, 63 (63.0%) were men, and the median age was 64 (range, 55–74) years. END occurred in 20.4% (10/49) of the argatroban plus DAPT group and 47.1% (24/51) of the DAPT group (risk difference, 26.7% [95% CI, 14.1–39.2]; risk ratio, 2.31 [95% CI, 1.49–3.58];P=0.006). At the 90-day follow-up, 87.8% (43/49) in the argatroban plus DAPT group and 68.6% (35/51) in the DAPT group achieved an excellent functional outcome (risk difference, −19.1% [95% CI, −30.3 to −8.0]; risk ratio, 0.78 [95% CI, 0.67–0.91];P=0.025). There was 1 minor hemorrhage in each group.CONCLUSIONS:Argatroban plus DAPT is a safe and effective strategy to reduce END occurrence and improve 90-day functional outcome in high-risk branch atherosclerosis disease patients.REGISTRATION:URL:https://www.chictr.org.cn; Unique Identifier: ChiCTR21000 46487.

Stroke, Ahead of Print. BACKGROUND:Neuronal pyroptosis is involved in neuronal cell death and neurological damage after cerebral ischemia-reperfusion. 14,15-Epoxyeicosatrienoic acid (14,15-EET) can reduce neuronal loss induced by cerebral ischemia-reperfusion by regulating mitochondrial biological processes. However, it remains unclear how 14,15-EET regulates mitochondrial homeostasis, inhibits neuronal pyroptosis, and promotes neurological functional recovery after cerebral ischemia-reperfusion.METHODS:Mice with middle cerebral artery occlusion and reperfusion were used as an animal model to study the cerebral ischemia-reperfusion disease. The neurological function of mice was performed at 1, 3, and 5 days to test the therapeutic effects of 14,15-EET. Transmission electron microscope imaging and Nissl staining were used to analyze neuronal morphological structure, mitophagy, and neuronal pyroptosis. Western blot and transcriptome were used to detect the levels of mitophagy and neuronal pyroptosis signaling pathway–related molecules. HT22 cells were used in in vitro studies to detect the mechanism by which 14,15-EET reduces neuronal pyroptosis after oxygen-glucose deprivation/reoxygenation treatment.RESULTS:14,15-EET treatment reduced cerebral infarct volumes and improved neurological functional recovery in mice after cerebral ischemia-reperfusion. 14,15-EET treatment maintained the morphological structure of neurons in the ischemic penumbra area as well as the dendritic spine density in mice after cerebral ischemia-reperfusion. The upregulation of NLRP1 (NOD-like receptor thermal protein domain associated protein 1), IL (interleukin)-1β, caspase-1, and GSDMD (gasdermin D) induced by cerebral ischemia-reperfusion was inhibited, and the expression of mitophagy proteins Parkin and LC3B was increased by 14,15-EET treatment. Transcriptome profiling found that 14,15-EET exerts a neuroprotection role in promoting neural function recovery by activating the WNT (wingless-type MMTV integration site family) signaling pathway. We found that 14,15-EET upregulated the WNT pathway proteins such as WNT1, WNT3A, β-catenin, and p-GSK-3β (phosphorylation of glycogen synthase kinase 3β) in vivo and in vitro. The WNT signaling pathway inhibitor XAV-939 reduced the expression of mitophagy protein Parkin and upregulated the expression of caspase-1 and GSDMD in HT22 cells with oxygen-glucose deprivation/reoxygenation and 14,15-EET treatment.CONCLUSIONS:14,15-EET regulates mitochondrial homeostasis to inhibit neuronal pyroptosis, thereby promoting the recovery of neurological function in mice after cerebral ischemia-reperfusion. These results provide new ideas for maintaining mitochondrial homeostasis and inhibiting neuronal pyroptosis after cerebral ischemia-reperfusion.