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1.
Zookeys ; 1210: 143-172, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39220722

RESUMEN

Herein a protocol is proposed to summarize the taxonomic situation for species, using the Neotropical Nasutitermes Dudley (Nasutitermitinae) as a test. The objective of this protocol is to allow comparisons between the available taxonomic information for species, and to provide objective criteria for assessing the information gaps for each taxon in order to prioritize topics for future investigation. Key aspects of taxonomic practice (condition of type specimens, helpfulness of descriptions and figures, compilation of distribution data, molecular data) were noted, the data were tabulated, and the taxa ranked. In addition, specific notes for each species have been included that may help to improve the solutions to the problems raised here.

2.
Front Psychol ; 15: 1334788, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39238777

RESUMEN

Purpose: Age-related changes in connected speech production remain a subject of debate, yielding inconsistent findings across various tasks and measures. This study aimed to investigate the effects of aging on picture description tasks using two types of pictures: a standardized picture (the Beach picture) and a culturally and linguistically modified picture tailored for Korean speakers (the Han River picture). Method: Twenty-four young adults and 22 older adults participated in two picture description tasks while their eye movements were recorded. Word-level linguistic variables were used to assess informativeness (Correct Information Units per minute) and productivity (noun and verb counts per utterance) of connected speech production. Eye-movement measures were employed to evaluate real-time cognitive processing associated with planning connected speech (pre-speech fixation counts and durations; eye fixations before the speech onset of each utterance). Results and conclusions: The findings revealed age-related declines in linguistic measures, with older adults exhibiting decreased CIUs per minute and smaller counts of nouns and verbs per utterance. Age-related changes in eye movement measures were evident in that older adults displayed longer pre-speech fixation durations. Unlike younger adults, older adults exhibited higher pre-speech fixation counts on the Han River picture compared to the Beach picture, suggesting cognitive challenges in performing the task that requires producing more words and detailed descriptions. These results suggest that aging is associated with reduced informativeness and productivity of connected speech, as well as a decline in cognitive processing efficiency.

3.
J Neuropsychol ; 2024 Sep 08.
Artículo en Inglés | MEDLINE | ID: mdl-39245899

RESUMEN

Since the early 1900s, the terms body schema and body image denoted the internal representations of the body. Bonnier's (1905, Revue Neurologique, 13, 605) schema is a conscious spatial representation of the size, shape, and position of the body, and of body parts, whose dysfunction brings about aschématia, and hypo-, hyper-, and paraschématia. The two schemata of Head and Holmes (1911, Brain, 34, 102) are an unconscious plastic postural schema, for the maintenance of posture and balance and for the coding of the position of body parts, and a conscious superficial schema, for the localisation of somatosensory stimuli. Pick's (1922, Psychologische Forschung, 1, 303) body schema refers to a structural description of the body, including the position of body parts and their spatial relationships, defective in autotopagnosia. Schilder's (1935, The image and appearance of the human body) body image is a comprehensive construct, covering physiological, evolutional, neurological and neuropsychological, psychiatric and sociological aspects. Lhermitte's (1939, L'image de notre corps) image, based on the views of the abovementioned authors, is defective in bodily neuropsychological disorders. The two terms have been used interchangeably, to denote (hemi-)asomatognosia, anosognosia, autotopagnosia, depersonalisation, personal neglect, phantom and supernumerary limbs, somatoparaphrenia. Their properties have been summarized with general dichotomies: schema for action in space ("where" system), image for perception ("what" system), after primary sensory processing. While schema and image fractionated into multiple representations of aspects of the body, the two terms are still used to refer to some of these representations, and to their disorders.

4.
J Prof Nurs ; 54: 180-188, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39266088

RESUMEN

BACKGROUND: Based on the involvement of qualified educators in its design, the Learning-by-Concordance tool aims to promote the learning of reasoning in contexts of uncertainty. However, data are still scarce on the experience of educators in terms of sharing and exposing their reasoning processes using this tool. PURPOSE: This study sought to explore the beliefs and experiences of educators when involved in the design of a Learning-by-Concordance tool. METHOD: This research used a descriptive qualitative design. Four dialogue groups were conducted with educators with different roles and responsibilities while designing a Learning-by-Concordance tool. A descriptive interpretative analysis of educators' verbatim quotes was done. FINDINGS: A total of 14 participants took part in the study. The results show the discomfort of educators despite their recognized expertise. Three themes emerged: 1- the need to be reassured by the opinions of colleagues; 2-feeling like impostors; and 3- concerns for the quality of instructional supports. CONCLUSIONS: The role taken by educators for teaching reasoning in contexts of uncertainty is to draw on practical experience where different types of knowledge intersect and are mobilized, to overcome feelings of insecurity, and to engage in close and authentic conversation with learners.


Asunto(s)
Docentes de Enfermería , Aprendizaje , Investigación Cualitativa , Humanos , Docentes de Enfermería/psicología , Femenino , Masculino , Incertidumbre , Adulto , Persona de Mediana Edad
5.
Med Hist ; : 1-17, 2024 Sep 13.
Artículo en Inglés | MEDLINE | ID: mdl-39268599

RESUMEN

In this textual comparison of seventeenth-century herbals, I show in detail that most of the descriptions and medicinal uses of English herbs included in Culpeper's small folio The English Physitian (1652) and its enlargement of the following year were lifted straight out of the works of John Parkinson, apothecary. This was a deliberate act by Culpeper, to make available to the people of England the best information on native plant medicines for use in treating their illnesses. He attacked the College of Physicians of London, whom the great majority of the population could not afford to engage, for trying to keep this knowledge secret. Among later historians of the herbal tradition, Culpeper's work was not accorded the same status as the great English herbals of William Turner, John Gerard, and John Parkinson, not because this borrowing was recognised but because its astrological content worked to divert attention from the quality and source of much of its guidance on treatment. Even contemporaries of Culpeper did not recognise the extent of the borrowing. Comparisons also reveal the limitations of Culpeper's powers of plant description and his lack of interest in the developing science of botany. The editorial decisions Culpeper made to reduce a great folio herbal to a much smaller book to be sold for 3d touch on domestic and other non-medical uses, while points of discussion common to both authors such as the doctrine of signatures and superstitious beliefs about plants are explored.

6.
Sensors (Basel) ; 24(17)2024 Aug 29.
Artículo en Inglés | MEDLINE | ID: mdl-39275507

RESUMEN

A data-driven approach to defect identification requires many labeled samples for model training. Yet new defects tend to appear during data acquisition cycles, which can lead to a lack of labeled samples of these new defects. Aiming at solving this problem, we proposed a zero-shot pipeline blockage detection and identification method based on stacking ensemble learning. The experimental signals were first decomposed using variational modal decomposition (VMD), and then, the information entropy was calculated for each intrinsic modal function (IMF) component to construct the feature sets. Second, the attribute matrix was established according to the attribute descriptions of the defect categories, and the stacking ensemble attribute learner was used for the attribute learning of defect features. Finally, defect identification was accomplished by comparing the similarity within the attribute matrices. The experimental results show that target defects can be identified even without targeted training samples. The model showed better classification performance on the six sets of experimental data, and the average recognition accuracy of the model for unknown defect categories reached 72.5%.

7.
Front Sports Act Living ; 6: 1230999, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39239476

RESUMEN

Introduction: We aimed to better understand longitudinal physical activity experiences among initially active adolescents and to identify and describe distinct physical activity profiles. Methods: A sample of 23 physically active participants [52% female; mean age = 12.2 (0.6) years at study inception] were selected from the MATCH study to take part in this nested qualitative descriptive study. Participants were interviewed once a year for six years. Following individual-level analyses, profiles were identified based on similarity of longitudinal experiences. Results: Four profiles captured participants' experiences: Independents (those who progressively seek activities that cater to their pursuit of autonomy); Multitaskers (those who participate in many different sports as an integral part of their lifestyle); Specialists (those who are dedicated to becoming the best they can be at one sport); Undecided (those who take part in physical activity to occupy time). Discussion: The exploration of longitudinal physical activity experiences led to the identification of distinct profiles that could be targets for tailored interventions, theory development, and participation models.

8.
Zookeys ; 1211: 1-15, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39262606

RESUMEN

Four new species of Yunguirius B. Li, Zhao & S.Q. Li, 2023 are described from China, namely: Yunguiriusparvus Wei & Liu, sp. nov. (♀), Yunguiriustrigonus Wei & Liu, sp. nov. (♀), Yunguiriuswangqiqiae Wei & Liu, sp. nov. (♀), and Yunguiriusxiannushanensis Wei & Liu, sp. nov. (♀).

9.
Zookeys ; 1210: 133-142, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39220721

RESUMEN

Altimella Wang & Zhang, gen. nov., a new genus belonging to Cicurinidae, is established, and two new species are described, Altimellanedong Wang & Zhang, sp. nov. (♂♀, type species) and A.ngamring Wang & Zhang, sp. nov. (♂♀), from Xizang, China. Detailed descriptions of somatic features and genital characteristics, photos of the habitus, photos and drawings of the copulatory organs, and a distribution map are provided.

10.
BMC Musculoskelet Disord ; 25(1): 698, 2024 Sep 02.
Artículo en Inglés | MEDLINE | ID: mdl-39223563

RESUMEN

INTRODUCTION: Conservative treatments such as physical therapies are usually the most indicated for the management of musculoskeletal pain; therefore, a detailed description of interventions enables the reproducibility of interventions in clinical practice and future research. The objective of this study is to evaluate the description of physical interventions for musculoskeletal pain in children and adolescents. METHODS: We considered randomized controlled trials that included children and adolescents between 4 and 19 years old with acute or chronic/persistent musculoskeletal pain. We included physical therapies related to all types of physical modalities aimed at reducing the intensity of pain or disability in children and adolescents with musculoskeletal pain. The description of interventions was assessed using the Template for Intervention Description and Replication (TIDieR) checklist. We performed electronic searches in the following databases: CENTRAL, MEDLINE, EMBASE, CINAHL, PsyINFO and PEDro up to April 2024. The description of physical interventions was presented using frequencies, percentages and 95% confidence intervals (CIs) of the TIDieR checklist items described in each study. We also calculated the total TIDieR score for each study and presented these data as mean and standard deviation. RESULTS: We included 17 randomized controlled trials. The description measured through the TIDieR checklist scored an average of 11 (5.2) points out of 24. The item of the TIDieR that was most described was item 1 (brief name) and most absent was item 10 (modifications). CONCLUSION: The descriptions of physical interventions for the treatment of musculoskeletal pain in children and adolescents are partially described, indicating the need for strategies to improve the quality of description to enable true clinical reproducibility.


Asunto(s)
Dolor Musculoesquelético , Ensayos Clínicos Controlados Aleatorios como Asunto , Humanos , Adolescente , Niño , Dolor Musculoesquelético/terapia , Dolor Musculoesquelético/diagnóstico , Ensayos Clínicos Controlados Aleatorios como Asunto/métodos , Reproducibilidad de los Resultados , Modalidades de Fisioterapia , Dimensión del Dolor/métodos , Preescolar , Adulto Joven , Resultado del Tratamiento , Manejo del Dolor/métodos , Lista de Verificación
11.
New Phytol ; 2024 Aug 16.
Artículo en Inglés | MEDLINE | ID: mdl-39152543

RESUMEN

More than 15% of all vascular plant species may remain scientifically undescribed, and many of the > 350 000 described species have no or few geographic records documenting their distribution. Identifying and understanding taxonomic and geographic knowledge shortfalls is key to prioritising future collection and conservation efforts. Using extensive data for 343 523 vascular plant species and time-to-event analyses, we conducted multiple tests related to plant taxonomic and geographic data shortfalls, and identified 33 global diversity darkspots (those 'botanical countries' predicted to contain most undescribed and not yet recorded species). We defined priority regions for future collection according to several socio-economic and environmental scenarios. Most plant diversity darkspots are found within global biodiversity hotspots, with the exception of New Guinea. We identify Colombia, Myanmar, New Guinea, Peru, Philippines and Turkey as global collection priorities under all environmental and socio-economic conditions considered. Our study provides a flexible framework to help accelerate the documentation of global plant diversity for the implementation of conservation actions. As digitisation of the world's herbaria progresses, collection and conservation priorities may soon be identifiable at finer scales.

12.
Food Chem X ; 23: 101627, 2024 Oct 30.
Artículo en Inglés | MEDLINE | ID: mdl-39100244

RESUMEN

The effects of adding cochineal carmine and annatto dyes in five mortadella formulations made with curcumin microcrystals were compared, and the preference was evaluated and described sensorially. Based on the optimized formulation obtained with color parameters, two formulations were elaborated: curcumin microcrystals and cochineal carmine were added. During 60 days, pH, objective color, water retention capacity, lipid oxidation, and texture profile analyses were performed. The results demonstrate the possibility of excluding sodium erythorbate from formulations containing curcumin microcrystals. There was no significant difference in lipid oxidation between the samples, presenting at the end of 60 days a value of 0.11 mg and 0.10 mg of MDA kg-1 for the two samples, respectively. There were also no significant differences between the two samples or the evaluated storage times, and the average values obtained for pH, WRC, objective color, and TPA were expected for this type of cooked meat sausage. In the presence of curcumin microcrystals, the synthetic antioxidant, sodium erythorbate, can be eliminated from the formulations, as it does not affect the physical-chemical parameters studied, such as pH, water retention capacity, color objective, and texture profile.

13.
Glob Qual Nurs Res ; 11: 23333936241271126, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39183735

RESUMEN

Young people with impaired functioning and/or disability do not receive as much education or as high an education as fully functioning young people, thus limiting their job opportunities. Therefore, the aim of this study was to investigate perspectives of young people with neuromuscular diseases regarding their choice of educational programs and possibilities to complete program requirements to gain knowledge for use in future counselling and the development of a national questionnaire survey. The design for this study was qualitative using the interpretive description methodology and Anthony Giddens' theory on modernity and self-identity. Data were generated through two focus group interviews with seven people between 18 and 30 years of age. Beginning and completing an education was influenced by the creation of identity: the importance of experiencing demands and expectations, the meaning of social relations when learning, and the consequences of accessibility for educational opportunities. The participants' sense of self-identity was built by testing boundaries and developing images through social relations with peers, parents, and teachers. How they acted and behaved in the social arena of school and education influenced their choices and chances of completing educational programs.

14.
Zookeys ; 1210: 99-115, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39185328

RESUMEN

Four new species of Liphistius belonging to the birmanicus species group are described from Myanmar based on both sexes: L.kalaw Zhan & Xu, sp. nov. (♂♀), L.kanpetlet Zhan & Xu, sp. nov. (♂♀), L.nawngau Zhan & Xu, sp. nov. (♂♀) and L.rostratus Zhan & Xu, sp. nov. (♂♀). Currently, Myanmar stands as the westernmost country where Liphistius is distributed, with the new species L.kanpetlet sp. nov. being found in the westernmost region of Myanmar.

15.
Insects ; 15(8)2024 Aug 22.
Artículo en Inglés | MEDLINE | ID: mdl-39194834

RESUMEN

Thirty-five genera and one hundred and two species of the tortricid tribe Olethreutini documented from Taiwan are listed, two genera and six species of which are newly recorded for China and two genera and eighteen species of which are newly recorded for Taiwan. Nine species are recorded in the mainland of China for the first time, which were endemic to Taiwan before this study. The local monographs of China and references are summarized with the examined specimens. The synonymies and geographic distribution in China are provided for each species, and a list of examined specimens is provided when applicable.

16.
MycoKeys ; 107: 273-325, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39169987

RESUMEN

Arbuscular mycorrhizal (AM) fungi - Glomeromycota and Endogonomycetes - comprise multiple species and higher-level taxa that have remained undescribed. We propose a mixed morphology- and DNA-based classification framework to promote taxonomic communication and shed light into the phylogenetic structure of these ecologically essential fungi. Based on eDNA samples and long reads as type materials, we describe 15 new species and corresponding genera (Pseudoentrophosporakesseensis, Hoforsarebekkae, Kahvenarebeccae, Kelottijaerviashannonae, Kungsaengenashadiae, Langduoadianae, Lehetuaindrekii, Lokrumastenii, Moosteastephanieae, Nikkaluoktamahdiehiae, Parniguacraigii, Riederbergasylviae, Ruuacoralieae, Tammsaareavivikae and Unemaeeanathalieae), the genus Parvocarpum as well as 19 families (Pseudoentrophosporaceae, Hoforsaceae, Kahvenaceae, Kelottijaerviaceae, Kungsaengenaceae, Langduoaceae, Lehetuaceae, Lokrumaceae, Moosteaceae, Nikkaluoktaceae, Parniguaceae, Riederbergaceae, Ruuaceae, Tammsaareaceae, Unemaeeaceae, Bifigurataceae, Planticonsortiaceae, Jimgerdemanniaceae and Vinositunicaceae) and 17 orders (Hoforsales, Kahvenales, Kelottijaerviales, Kungsaengenales, Langduoales, Lehetuales, Lokrumales, Moosteales, Nikkaluoktales, Parniguales, Riederbergales, Ruuales, Tammsaareales, Unemaeeales, Bifiguratales and Densosporales), and propose six combinations (Diversisporabareae, Diversisporanevadensis, Fuscutatacerradensis, Fuscutatareticulata, Viscosporadeserticola and Parvocarpumbadium) based on phylogenetic evidence. We highlight further knowledge gaps in the phylogenetic structure of AM fungi and propose an alphanumeric coding system for preliminary communication and reference-based eDNA quality-filtering of the remaining undescribed genus- and family-level groups. Using AM fungi as examples, we hope to offer a sound, mixed framework for classification to boost research in the alpha taxonomy of fungi, especially the "dark matter fungi".

17.
Can J Nurs Res ; : 8445621241273956, 2024 Aug 11.
Artículo en Inglés | MEDLINE | ID: mdl-39129341

RESUMEN

BACKGROUND: Population aging is a global phenomenon. Many older adults living with chronic conditions rely on family and friend caregivers. The growing demand for family and friend caregivers underscores the necessity for adequate and effective support services. PURPOSE: The Saskatchewan Caregiver Experience Study sought to gather the perspectives of caregivers of older adults and set priorities for caregiver support. METHODS: An online survey with open-ended questions was employed in this qualitative descriptive study. In this manuscript, we present our findings from the survey question: "What do you think is most important for support in your caregiving role? In other words, what are your top priorities for support?" FINDINGS: This survey question received n = 352 responses, evenly distributed across Saskatchewan in urban-large (33%), urban-small/medium (32%), and rural (35%) settings. Support priorities of Saskatchewan caregivers were found to be access to help when they need it; an ear to listen and a shoulder to lean on; assistance in optimizing the care recipient's health; having healthcare professionals that care; and improved policies, legislations, and regulations. CONCLUSION: Services and interventions that assist caregivers are more likely to be accessed and utilized when caregivers are given the opportunity to identify their own support priorities. This study has the potential to inform health and governmental systems to support caregivers of older adults provincially within Saskatchewan, nationally in Canada, and in a global context.

18.
J Med Internet Res ; 26: e56500, 2024 Aug 21.
Artículo en Inglés | MEDLINE | ID: mdl-39167785

RESUMEN

BACKGROUND: Large language models including GPT-4 (OpenAI) have opened new avenues in health care and qualitative research. Traditional qualitative methods are time-consuming and require expertise to capture nuance. Although large language models have demonstrated enhanced contextual understanding and inferencing compared with traditional natural language processing, their performance in qualitative analysis versus that of humans remains unexplored. OBJECTIVE: We evaluated the effectiveness of GPT-4 versus human researchers in qualitative analysis of interviews with patients with adult-acquired buried penis (AABP). METHODS: Qualitative data were obtained from semistructured interviews with 20 patients with AABP. Human analysis involved a structured 3-stage process-initial observations, line-by-line coding, and consensus discussions to refine themes. In contrast, artificial intelligence (AI) analysis with GPT-4 underwent two phases: (1) a naïve phase, where GPT-4 outputs were independently evaluated by a blinded reviewer to identify themes and subthemes and (2) a comparison phase, where AI-generated themes were compared with human-identified themes to assess agreement. We used a general qualitative description approach. RESULTS: The study population (N=20) comprised predominantly White (17/20, 85%), married (12/20, 60%), heterosexual (19/20, 95%) men, with a mean age of 58.8 years and BMI of 41.1 kg/m2. Human qualitative analysis identified "urinary issues" in 95% (19/20) and GPT-4 in 75% (15/20) of interviews, with the subtheme "spray or stream" noted in 60% (12/20) and 35% (7/20), respectively. "Sexual issues" were prominent (19/20, 95% humans vs 16/20, 80% GPT-4), although humans identified a wider range of subthemes, including "pain with sex or masturbation" (7/20, 35%) and "difficulty with sex or masturbation" (4/20, 20%). Both analyses similarly highlighted "mental health issues" (11/20, 55%, both), although humans coded "depression" more frequently (10/20, 50% humans vs 4/20, 20% GPT-4). Humans frequently cited "issues using public restrooms" (12/20, 60%) as impacting social life, whereas GPT-4 emphasized "struggles with romantic relationships" (9/20, 45%). "Hygiene issues" were consistently recognized (14/20, 70% humans vs 13/20, 65% GPT-4). Humans uniquely identified "contributing factors" as a theme in all interviews. There was moderate agreement between human and GPT-4 coding (κ=0.401). Reliability assessments of GPT-4's analyses showed consistent coding for themes including "body image struggles," "chronic pain" (10/10, 100%), and "depression" (9/10, 90%). Other themes like "motivation for surgery" and "weight challenges" were reliably coded (8/10, 80%), while less frequent themes were variably identified across multiple iterations. CONCLUSIONS: Large language models including GPT-4 can effectively identify key themes in analyzing qualitative health care data, showing moderate agreement with human analysis. While human analysis provided a richer diversity of subthemes, the consistency of AI suggests its use as a complementary tool in qualitative research. With AI rapidly advancing, future studies should iterate analyses and circumvent token limitations by segmenting data, furthering the breadth and depth of large language model-driven qualitative analyses.


Asunto(s)
Investigación Cualitativa , Humanos , Masculino , Adulto , Persona de Mediana Edad , Análisis de Datos , Investigadores/psicología , Investigadores/estadística & datos numéricos , Anciano
19.
Health Expect ; 27(1): e13942, 2024 02.
Artículo en Inglés | MEDLINE | ID: mdl-39102702

RESUMEN

BACKGROUND: Patient and public involvement (PPI) is a critical priority in research, policy, academia and advocacy organizations. PPI in dementia research is gaining momentum. However, these efforts are missing in international projects aimed at those living with advanced dementia in long-term care (LTC) homes. Additional complexities can arise in enacting PPI within the context of integration of a palliative approach to care and experiences around end-of-life in (EOL) dementia. The mySupport study involved implementing the Family Carer Decision Support (FCDS) intervention for care partners of those living with advanced dementia in LTC in six countries. RESEARCH DESIGN AND OBJECTIVE: An interpretive description study was conducted to explore the perspectives of international researchers from six countries on engaging people with lived experiences of dementia and EOL care in research processes. The findings from this study informed the development of a PPI strategy and a subsequent toolkit for the FCDS intervention. FINDINGS: Thirty-eight interviews were completed with project researchers: 12 from the United Kingdom, 8 from Canada, 7 from Ireland, 4 each from Italy and The Netherlands and 3 from the Czech Republic. Four broad themes describe international researchers' perspectives on advancing methods of engagement for people with lived experiences of dementia and EOL in international PPI activities: (1) Groundwork to engage in research; (2) planning for research activities is key; (3) focus on meaningful engagement and (4) having foresight for practical issues shaping PPI. DISCUSSION AND IMPLICATIONS: International projects that involve PPI can present many sources of challenges. The findings in this study highlight important considerations for foundational work for incorporating PPI in international projects. Learning from world leaders and those with lived experiences in various regions can be insightful and help share tools and resources. PATIENT OR PUBLIC CONTRIBUTION: PPI was envisioned as a critical part of conducting the mySupport study. The findings from this study informed the development of a PPI strategy and an international Strategic Guiding Council that included family carers of those living with advanced dementia in LTC homes in six countries. This manuscript focused on the perspectives of researchers on their engagement with people with lived experiences of dementia and EOL. The perspectives of persons with lived experiences on engaging in the mySupport research study will be reported in a forthcoming manuscript.


Asunto(s)
Demencia , Participación del Paciente , Cuidado Terminal , Humanos , Demencia/terapia , Demencia/psicología , Cuidado Terminal/psicología , Cuidadores/psicología , Investigadores/psicología , Entrevistas como Asunto , Reino Unido , Canadá , Cuidados a Largo Plazo , Cuidados Paliativos/psicología , Conducta Cooperativa , Países Bajos , Participación de la Comunidad , Femenino
20.
Rev Cardiovasc Med ; 25(7): 246, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-39139431

RESUMEN

Background: With the recent advances in the treatment of heart failure (HF), it is intriguing that a very small number of patients with dilated cardiomyopathy (DCM) have been observed as being fully recovered. However, knowledge of the progression and prognosis of patients with recovered DCM remains sparse. Herein, we conducted this study to investigate the clinical characteristics and prognosis of patients with recovered DCM. Methods: Consecutive patients with recovered DCM referred to our hospital between March 2009 and May 2021 were included. The recovered DCM patients were categorized into relapse and non-relapse groups. The primary endpoint was all-cause death, and the secondary endpoint was HF re-hospitalization during follow-up. Multivariate analyses were performed to identify predictors of relapse among recovered DCM patients. Kaplan-Meier analyses were used to assess the prognostic significance of relapse. Results: A comparatively large cohort of 122 recovered DCM patients from 10,029 DCM patients was analyzed. During a median follow-up duration of 53.5 months, the relapse rate among recovered DCM patients was 15.6% (19/122). Age (odds ratio, OR 1.079, 95% confidence interval, CI: 1.014-1.148; p = 0.017), systolic blood pressure (SBP) at diagnosis (OR 0.948, 95% CI: 0.908-0.990; p = 0.015) and changes in left ventricular ejection fraction from diagnosis to recovery ( Δ LVEF) (OR 0.898, 95% CI: 0.825-0.978; p = 0.013) were identified as predictors of relapse. Furthermore, among 122 patients, 5 (4.1%) experienced death, and 12 (9.8%) underwent HF re-hospitalization. Four deaths occurred in the relapse group, with one in the non-relapse group. All deaths were attributed to cardiovascular events. The long-term prognosis of the relapse group was significantly worse compared to the non-relapse group by Kaplan-Meier analysis (p < 0.001 based on the log-rank test). Multivariate analyses significantly associated relapse with all-cause mortality in recovered DCM patients (hazard ratio, HR 7.738, 95% CI: 1.892-31.636; p = 0.004). Conclusions: Recovered DCM patients are at risk of relapse. Older age, lower SBP, and smaller Δ LVEF were independently associated with relapse in recovered DCM patients. Relapse after recovery was related to an unfavorable long-term prognosis.

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