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Introduction
Nutrition education is the cornerstone to maintain optimal pregnancy outcomes including gestational weight gain (GWG). Nevertheless, default for appointments is common and often lead to suboptimal achievement of GWG, accompanied with unfavourable maternal and child health outcomes. While mobile health (mHealth) usage is increasing and helps minimising barriers to clinic appointments among pregnant mothers, its effectiveness on health outcomes has been inconclusive. Therefore, this study aimed to address the gap between current knowledge and clinical care, by exploring the effectiveness of mHealth on GWG as the primary outcome, hoping to serve as a fundamental work to achieve optimal health outcomes with the improvement of secondary outcomes such as physical activity, psychosocial well-being, dietary intake, quality of life and sleep quality among pregnant mothers.

Methods and analysis
A total of 294 eligible participants will be recruited and allocated into 3 groups comprising of mHealth intervention alone, mHealth intervention integrated with personal medical nutrition therapy and a control group. Pretested structured questionnaires are used to obtain the respondents’ personal information, anthropometry data, prenatal knowledge, physical activity, psychosocial well-being, dietary intake, quality of life, sleep quality and GWG. There will be at least three time points of data collection, with all participants recruited during their first or second trimester will be followed up prospectively (after 3 months or/and after 6 months) until delivery. Generalised linear mixed models will be used to compare the mean changes of outcome measures over the entire study period between the three groups.

Ethics and dissemination
Ethical approvals were obtained from the ethics committee of human subjects research of Universiti Putra Malaysia (JKEUPM-2022-072) and medical research & ethics committee, Ministry of Health Malaysia: NMRR ID-22-00622-EPU(IIR). The results will be disseminated through journals and conferences targeting stakeholders involved in nutrition research.

Trial registration number
Clinicaltrial.gov ID: NCT05377151.

In sedia a rotelle dopo incidente, al Maggiore e Montecatone

Circulation, Volume 148, Issue Suppl_1, Page A13662-A13662, November 6, 2023. Background:Left atrial appendage (LAA) of Asians is generally larger and more complicated than that of non-Asians. Whereas the four classifications from previous reports are widely used in the world, different physicians have different point of views in the real-world practice.Purpose:To identify the relationship between morphological features of LAA and cardioembolic stroke in Japanese patients.Methods:All left atrial appendage closure (LAAC) cases in our institution performed between February 2020 and April 2023 were retrospectively analyzed. The three-dimensional printing of LAA was generated from cardiovascular computed tomography imaging data. The shapes of the LAA were classified into 3 morphological types: (1) The LAA with bi lobe was defined as “Scissors” type; (2) The one with complicated peripheral branches was “Paper” type; (3) The simple one was “Rock” type. We examined the relationship between the risk of cardioembolic stroke and the morphological features of the LAA.Results:The cohort consisted of 93 consecutive patients (age, 75±1 years; male gender, 72%; the size of WATCHMAN device, 29±0 mm). There were 41 (44%) patients who had a history of cardioembolic stroke (27% vs. 41% vs. 58%; Rock vs. Scissors vs. Paper types, p-value = 0.0466). In the multivariate analysis, the Paper type is the potential risk factor of cardioembolic stroke (p-value < 0.01) (Table1.2).Conclusions:The morphological features of LAA by three-dimensional printing was significantly related to cardioembolic stroke in this population. Physicians should pay attention to anticoagulant therapy management and proactively consider LAAC in LAA with complicated peripheral branches.

Annals of Internal Medicine, Ahead of Print.

Annals of Internal Medicine, Ahead of Print.

Esperti, cambio paradigma assistenza per vincere sfida Onu 2030

I primi risultati dello sportello di ascolto Sex and The Cancer