Category: Nevin Manimala

Kardiologiia. 2024 Nov 30;64(11):76-83. doi: 10.18087/cardio.2024.11.n2733.

ABSTRACT

Aim To analyze the results of myocardial revascularization in the Russian Federation (RF) for ACS in 2023 compared to previous years.Material and methods The analysis included the number of cases of ST-segment elevation myocardial infarction (STEMI), non-ST-segment elevation acute coronary syndrome (NSTE-ACS), myocardial revascularization in the above-listed ACS forms, the number of fatal outcomes depending on the ACS form and the revascularization method used. The data for this analysis were obtained from the 2023 Ministry of Health of Russia monitoring in the section of revascularization in ACS and were compared with the data for the past 8 years.Results, conclusion In 2023, 438,315 patients were hospitalized for ACS in the Russian Federation: 309,158 with NSTE-ACS and 148,729 with STEMI. The total number of hospitalizations for ACS per 1 million of the Russian population was 2,982: 1,011 with STEMI and 2,103 with NSTE-ACS. The availability of primary PCI in 2023 reached its maximum of 55.3% compared to previous years; the total number of PCI for STEMI was 75.7%, and the mortality rate in the whole STEMI group was a minimum of 10.7% for the past 8 years. In 2023, the maximum number of PCIs for NSTE-ACS for the past 8 years was recorded, both in absolute values (120,990) and in relative values (39.1%). In the whole NSTE-ACS group, mortality was 2.5%, which was also the lowest for the past 8 years.

PMID:39637393 | DOI:10.18087/cardio.2024.11.n2733

J Med Internet Res. 2024 Dec 5;26:e49927. doi: 10.2196/49927.

ABSTRACT

BACKGROUND: Previous efforts to apply machine learning-based natural language processing to longitudinally collected social media data have shown promise in predicting suicide risk.

OBJECTIVE: Our primary objective was to externally validate our previous machine learning algorithm, the Suicide Artificial Intelligence Prediction Heuristic (SAIPH), against external survey data in 2 independent cohorts. A second objective was to evaluate the efficacy of SAIPH as an indicator of changing suicidal ideation (SI) over time. The tertiary objective was to use SAIPH to evaluate factors important for improving or worsening suicidal trajectory on social media following suicidal mention.

METHODS: Twitter (subsequently rebranded as X) timeline data from a student survey cohort and COVID-19 survey cohort were scored using SAIPH and compared to SI questions on the Beck Depression Inventory and the Self-Report version of the Quick Inventory of Depressive Symptomatology in 159 and 307 individuals, respectively. SAIPH was used to evaluate changing SI trajectory following suicidal mentions in 2 cohorts collected using the Twitter application programming interface.

RESULTS: An interaction of the mean SAIPH score derived from 12 days of Twitter data before survey completion and the average number of posts per day was associated with quantitative SI metrics in each cohort (student survey cohort interaction β=.038, SD 0.014; F_4,94=3.3, P=.01; and COVID-19 survey cohort interaction β=.0035, SD 0.0016; F_4,493=2.9, P=.03). The slope of average daily SAIPH scores was associated with the change in SI scores within longitudinally followed individuals when evaluating periods of 2 weeks or less (ρ=0.27, P=.04). Using SAIPH as an indicator of changing SI, we evaluated SI trajectory in 2 cohorts with suicidal mentions, which identified that those with responses within 72 hours exhibit a significant negative association of the SAIPH score with time in the 3 weeks following suicidal mention (ρ=-0.52, P=.02).

CONCLUSIONS: Taken together, our results not only validate the association of SAIPH with perceived stress, SI, and changing SI over time but also generate novel methods to evaluate the effects of social media interactions on changing suicidal trajectory.

PMID:39637380 | DOI:10.2196/49927

JMIR Form Res. 2024 Dec 5;8:e60193. doi: 10.2196/60193.

ABSTRACT

BACKGROUND: The landscape of substance use behavior among young adults has observed rapid changes over time. Intensive longitudinal designs are ideal for examining and intervening in substance use behavior in real time but rely on high participant compliance in the study protocol, representing a significant challenge for researchers.

OBJECTIVE: This study aimed to evaluate the effect of including a personalized data dashboard (DD) in a text-based survey prompt on study compliance outcomes among college students participating in a 21-day ecological momentary assessment (EMA) study.

METHODS: Participants (N=91; 61/91, 67% female and 84/91, 92% White) were college students who engaged in recent alcohol and cannabis use. Participants were randomized to either complete a 21-day EMA protocol with 4 prompts/d (EMA Group) or complete the same EMA protocol with 1 personalized message and a DD indicating multiple metrics of progress in the study, delivered at 1 randomly selected prompt/d (EMA+DD Group) via a microrandomized design. Study compliance, completion time, self-reported protocol experiences, and qualitative responses were assessed for both groups.

RESULTS: Levels of compliance were similar across groups. Participants in the EMA+DD Group had overall faster completion times, with significant week-level differences in weeks 2 and 3 of the study (P=.047 and P=.03, respectively). Although nonsignificant, small-to-medium effect sizes were observed when comparing the groups in terms of compensation level (P=.08; Cohen w=0.19) and perceived burden (P=.09; Cohen d=-0.36). Qualitative findings revealed that EMA+DD participants perceived that seeing their progress facilitated engagement. Within the EMA+DD Group, providing a DD at the moment level did not significantly impact participants’ likelihood of completing the EMA or completion time at that particular prompt (all P>.05), with the exception of the first prompt of the day (P=.01 and P<.001).

CONCLUSIONS: Providing a DD may be useful to increase engagement, particularly for researchers aiming to assess health behaviors shortly after a survey prompt is deployed to participants’ mobile devices.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/57664.

PMID:39637378 | DOI:10.2196/60193

JMIR Form Res. 2024 Dec 5;8:e63288. doi: 10.2196/63288.

ABSTRACT

BACKGROUND: Digitalization has profoundly transformed health care delivery, especially within primary health care, as a crucial avenue for providing accessible, cost-effective care. While eHealth services are frequently highlighted for improving health care availability and promoting equality, it is essential to recognize that digitalization can inadvertently exclude individuals who lack the prerequisites to use eHealth services, that is, those with low eHealth literacy. Previous research has identified lower eHealth literacy among older individuals, those with lower educational levels, and those who use the internet less frequently. However, in a Swedish context, only a few studies have investigated eHealth literacy.

OBJECTIVE: This study investigated eHealth literacy and its association with health-related internet use and sociodemographic characteristics among primary health care visitors.

METHODS: This cross-sectional study used a quantitative, descriptive approach. Swedish-speaking patients visiting a primary health care center participated by answering the multidimensional eHealth Literacy Questionnaire (eHLQ) and questions regarding sociodemographic characteristics and internet usage. The study compared mean scores using the Mann-Whitney U test and the Kruskal-Wallis test. A logistic regression analysis also explored the associations between eHealth literacy and significant independent variables identified in the univariate analyses.

RESULTS: As a group, the 172 participants rated highest in understanding and engagement with their health (median eHLQ score 3, IQR 2.8-3.4), as well as in feeling secure about the confidentiality of eHealth services (median eHLQ score 3, IQR 2-3), while they rated lower in motivation to use eHealth (median eHLQ score 2.6, IQR 2-3), the suitability of eHealth services to their personal needs (median eHLQ score 2.75, IQR 2-3), and their perceived ability to understand and use health-related internet information (median eHLQ score 2.6, IQR 2-3). The logistic regression analysis identified that lower eHealth literacy was associated with older age, particularly in domains related to finding, understanding, and using health-related internet information (odds ratio [OR] 1.02, 95% CI 1-1.05; P=.03); digital technology use (OR 1.05, 95% CI 1.02-1.08; P<.001); and accessing well-functioning eHealth services (OR 1.02, 95% CI 1-1.05; P=.03). Additionally, in the logistic regression analysis, perceiving health-related internet information as not useful was linked to lower literacy in all eHLQ domains except one.

CONCLUSIONS: Our findings regarding the primary challenges within our sample underscore the importance of developing and tailoring eHealth services to accommodate users’ individual needs better, enhancing motivation for eHealth use, and continuing efforts to improve overall health literacy. These measures, which both eHealth developers and health care professionals should consider, are crucial for addressing the digital divide and expanding access to eHealth services for as many people as possible.

PMID:39637377 | DOI:10.2196/63288

J Am Acad Orthop Surg Glob Res Rev. 2024 Dec 4;8(12). doi: 10.5435/JAAOSGlobal-D-24-00213. eCollection 2024 Dec 1.

ABSTRACT

INTRODUCTION: Forearm fractures contribute up to 40% of all pediatric fractures, with ≤39% of conservatively managed fractures resulting in malunion. Surgical management of malunion is challenging as precise calculation of multiplanar correction is required to obtain optimal outcomes. Advances in 3D computer modeling and printing have shown promising results in orthopaedics, reducing surgical time, blood loss, and fluoroscopy. This systematic review and meta-analysis are the first to explore the accuracy and functional outcome of 3D techniques in pediatric diaphyseal forearm malunion correction.

METHODS: A systematic review was carried out according to PRISMA guidelines.

RESULTS: Sixteen studies (44 patients) were included. Average 2D residual deformity was 1.84° (SD=1.68°). The average gain in range of movement (ROM) was 76.08° (SD=41.75°), with a statistically significant difference between osteotomies ≤12 months from injury and >12 months (96.36° vs. 64.91°, P = 0.027). Below a 2D residual deformity of 5.28°, no statistically significant difference on gain of ROM was found, indicating this as a nonconsequential residual deformity (P = 0.778). Multivariate regression analysis showed that 2D residual deformity and time to osteotomy only account for 6.3% gain in ROM, indicating that there are more factors to be researched.

CONCLUSION: This study found superior accuracy of 3D techniques, reporting lower residual deformities than published standard osteotomy data; however, the volume of literature was limited. Larger studies are required to explore additional factors that influence accuracy and ROM, such as 3D residual deformity and the effect of particular 3D printed adjuncts. This will aid clarity in determining superiority and improve cost-effectiveness.

PMID:39637302 | DOI:10.5435/JAAOSGlobal-D-24-00213

Pol Przegl Chir. 2024 Jul 11;96(6):70-84. doi: 10.5604/01.3001.0054.6636.

ABSTRACT

&lt;b&gt;Introduction:&lt;/b&gt; The bronchopleural fistula (BPF) remains one of the most severe complications after pneumonectomy. Several surgical methods may enhance bronchial stump healing and reduce the occurrence of BPF. Usually, surgeons use tissue buttressing, such as intercostal muscle flap (IMF), parietal pleura, pericardium fat pad, or mediastinal fat, to reinforce the bronchial stump. This paper reviews the literature describing the impact of different buttressing tissues on the occurrence of early post-pneumonectomy BPF.&lt;b&gt;Material and methods:&lt;/b&gt; We included all studies that described the use of bronchial stump buttressing in patients after pneumonectomy. Studies written in languages other than English were excluded. The search was performed using PubMed, Google Scholar, Embase, COCHRANE databases, and the clinical trial registry on December 1, 2023. We used the following search input: &quot;lung cancer&quot; AND &quot;pneumonectomy&quot; AND (&quot;bronchopleural fistula&quot; OR &quot;BPF&quot;) AND (&quot;tissue buttressing&quot; OR &quot;intercostal muscle flap&quot; OR &quot;mediastinal fat pad&quot;). We analysed the types of studies, the numbers of patients, and the most important conclusions. We performed descriptive statistics.&lt;b&gt;Results:&lt;/b&gt; Twenty-seven articles on the use of bronchial tissue buttressing were identified. Nine papers were rejected due to small sample size (&lt; 20 patients), surgical operation other than pneumonectomy or lobectomy, or papers older than 30 years. Ultimately, 16 articles were included in the analysis. Among them, three papers highlighted the statistically significant influence of bronchial stump buttressing in reducing the risk of BPF formation. Descriptive statistics were reported in nine studies, and two papers included the assessment of the blood perfusion in the buttressing tissue. Only one study was a randomized trial featuring a control group for comparison.&lt;b&gt;Discussion:&lt;/b&gt; Buttressing the bronchial stump remains a controversial issue in thoracic surgery. It could be beneficial for high-risk patients. Among different tissues, the ideal one has still not been identified. Future research should incorporate control groups and intraoperative assessments of the blood supply to the tissue employed for bronchial buttressing.

PMID:39635747 | DOI:10.5604/01.3001.0054.6636

J Pharm Policy Pract. 2024 Dec 3;17(1):2432446. doi: 10.1080/20523211.2024.2432446. eCollection 2024.

ABSTRACT

BACKGROUND: Fraud in pharmaceutical tenders is a severe form of corruption that poses a significant threat to public health, patients, and the community. Due to the substantial financial volume in the pharmaceutical sector, vulnerable points in decision-making for market entry and purchase are at risk. As a result, the objective of this study was to measure the level of transparency and risk of corruption in pharmaceuticals’ procurement practices in South Wollo, North-East Ethiopia.

METHODOLOGY: From October 1 to December 15, 2023, a multi-facility, cross-sectional study was conducted. The participants were pharmaceutical procurement committee (PPC) members. The World Health Organization’s (WHO’s) standardised interviewer-administered questionnaire was used to collect the data. The collected data was entered, cleaned, processed, and analyzed using Statistical Package for Social Sciences (SPSS) version 27. Both descriptive and inferential statistics (univariate and linear regression analyses) were computed. The relationship between the independent (health facility level) and dependent (level of transparency) variables was determined using beta with a p-value of less than 0.05 and a 95% CI.

RESULTS: One hundred eighty-seven respondents, from 47 health centres (low, medium, and high volume) and 14 hospitals (primary, secondary, and tertiary), participated. The aggregate result showed that pharmaceutical procurement practice was very vulnerable to corruption, with a transparency level of only 33.0% (3.3 out of 10). The univariate analysis demonstrated a significant disparity in the mean transparency scores between health centres and hospitals. The linear regression also showed that for every one standard deviation increase in the facility level, there was an associated 0.39 increase in the transparency level of pharmaceutical procurement (β = 0.39, 95% CI: 0.02-0.04).

CONCLUSION: The pharmaceutical procurement practice at the health facilities was generally found to be very vulnerable to corruption, which slightly increased with a decrease in facility levels and vice versa.

PMID:39635710 | PMC:PMC11616756 | DOI:10.1080/20523211.2024.2432446

Front Psychol. 2024 Nov 20;15:1431861. doi: 10.3389/fpsyg.2024.1431861. eCollection 2024.

ABSTRACT

PURPOSE: As future doctors, medical students’ prosocial behaviors may affect the relationship between doctors and patients. This study aims to explore the effects of trait mindfulness on prosocial behaviors, as well as the mediating role of psychological capital and the moderating role of moral identity among medical students.

METHODS: A cross-sectional survey was conducted between July and October 2023 across four medical colleges in China, using cluster random sampling. The questionnaire included general demographic information, the Prosocial Tendencies Measurement Scale, the Five-Facet Mindfulness Questionnaire, the Psychological Capital Questionnaire, and the Moral Identity Scale. The SPSS 25.0 and PROCESS v3.4 macro were used for descriptive statistics, correlation analysis, and mediation and moderation analyses.

RESULTS: A total of 2,285 samples were included. The analyses showed that prosocial behavior was positively correlated with trait mindfulness, psychological capital, and moral identity (r = 0.293, 0.444, and 0.528, p < 0.01); trait mindfulness predicts prosocial behavior (β = 0.292, 95% CI [0.253, 0.332]); and psychological capital played a partial mediation role between trait mindfulness and prosocial behaviors (β = 0.413, 95% CI [0.368, 0.459]). Furthermore, moral identity played the moderating roles between trait mindfulness and prosocial behavior (β = 0.049, 95% CI [0.011, 0.087]) and between PsyCap and prosocial behavior (β = 0.062, 95% CI [0.032, 0.092]).

CONCLUSION: Trait mindfulness, psychological capital, and moral identity are conducive to the development of medical students’ prosocial behavior. These findings provide evidence for the cultivation of prosocial behaviors and for the development of mental health courses, which should be tailored to medical students.

PMID:39635702 | PMC:PMC11614594 | DOI:10.3389/fpsyg.2024.1431861

Nanophotonics. 2021 Dec 22;11(11):2483-2505. doi: 10.1515/nanoph-2021-0660. eCollection 2022 Jun.

ABSTRACT

Nanophotonics inverse design is a rapidly expanding research field whose goal is to focus users on defining complex, high-level optical functionalities while leveraging machines to search for the required material and geometry configurations in sub-wavelength structures. The journey of inverse design begins with traditional optimization tools such as topology optimization and heuristics methods, including simulated annealing, swarm optimization, and genetic algorithms. Recently, the blossoming of deep learning in various areas of data-driven science and engineering has begun to permeate nanophotonics inverse design intensely. This review discusses state-of-the-art optimizations methods, deep learning, and more recent hybrid techniques, analyzing the advantages, challenges, and perspectives of inverse design both as a science and an engineering.

PMID:39635678 | PMC:PMC11502023 | DOI:10.1515/nanoph-2021-0660

Nanophotonics. 2023 Oct 13;12(21):4109-4116. doi: 10.1515/nanoph-2023-0549. eCollection 2023 Oct.

ABSTRACT

Chaotic semiconductor lasers have been widely investigated for high-speed random bit generation, which is applied for the generation of cryptographic keys for classical and quantum cryptography systems. Here, we propose and demonstrate a self-chaotic microlaser with enhanced chaotic bandwidth for high-speed random bit generation. By designing tri-mode interaction in a deformed square microcavity laser, we realize a self-chaotic laser caused by two-mode internal interaction, and achieve an enhanced chaotic standard bandwidth due to the photon-photon resonance effect by introducing the third mode. Moreover, 500 Gb/s random bit generation is realized and the randomness is verified by the NIST SP 800-22 statistics test. Our demonstration promises the applications of microlasers in secure communication, chaos radar, and optical reservoir computing, and also provides a platform for the investigations of multimode nonlinear laser dynamics.

PMID:39635643 | PMC:PMC11502037 | DOI:10.1515/nanoph-2023-0549